Microbiota, infecciones gastrointestinales, inflamación de bajo grado y antibioticoterapia en el síndrome de intestino irritable. Una revisión basada en evidencias

Schmulson, M.; Bielsa, M.V.; Carmona-Sánchez, R.; Hernández, A.; López-Colombo, A.; López Vidal, Y.; Peláez-Luna, M.; Remes-Troche, J.M.; Tamayo, J.L.; Valdovinos, M.A.

doi:10.1016/j.rgmx.2014.01.004

Cited by 29Gastrointestinal motility and disordersGut microbiota and healthMicroscopic Colitis

Microbiota, infecciones gastrointestinales, inflamación de bajo grado y antibioticoterapia en el síndrome de intestino irritable. Una revisión basada en evidencias

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Schmulson, M., Bielsa, M.V., Carmona-Sánchez, R., Hernández, A., López-Colombo, A., López Vidal, Y., Peláez-Luna, M., Remes-Troche, J.M. +2 more·2014·Revista de Gastroenterología de México

DOI 10.1016/j.rgmx.2014.01.004

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Abstract

Existen controversias sobre la prevalencia del síndrome de intestino irritable (SII)-postinfeccioso (PI), sobrepoblación bacteriana (SPB), alteraciones en la microbiota, inflamación de bajo grado y antibioticoterapia en SII. Realizar una revisión basada en evidencia de estos factores. Se realizó una revisión de la literatura hasta julio del 2012 y se incluyeron artículos adicionales hasta agosto del 2013, los cuales fueron analizados mediante el sistema del Centro para Medicina Basada en Evidencia de la Universidad de Oxford (OCEBM). 1. Existe mayor probabilidad de SPB mediante pruebas de aliento pero la prevalencia es muy variable (2-84%). 2. La microbiota intestinal es diferente en SII que en sujetos sanos, pero no se ha establecido una característica común presente en todos los pacientes. 3. La incidencia y prevalencia del SII-PI varía del 9-10% y 3-17%, respectivamente; esta última disminuye con el tiempo. La etiología bacteriana es la más frecuente, pero se han reportado casos posvirales y parasitarios. 4. Existe un subgrupo de pacientes con incremento de células enterocromafines, linfocitos intraepiteliales y mastocitos en la mucosa intestinal, pero no se han determinado diferencias entre SII-PI y SII-No PI. 5. La microbiota metanogénica se asocia con el SII con estreñimiento. 6. La rifaximina en dosis de 400 mg TID/10 días o 550 mg TID/14 días es efectiva en la mejoría de síntomas globales y distensión abdominal en SII. La efectividad del retratamiento parece ser similar a la del primer ciclo. Se requieren más estudios para determinar la microbiota intestinal propia del SII y las diferencias en inflamación de bajo grado entre SII-PI y SII-No PI. La rifaximina ha demostrado efectividad en el tratamiento del SII independientemente de los factores anteriores. Post-infectious irritable bowel syndrome (PI-IBS) prevalence, small intestinal bacterial overgrowth (SIBO), altered microbiota, low-grade inflammation, and antibiotic therapy in IBS are all controversial issues. To conduct an evidence-based review of these factors. A review of the literature was carried out up to July 2012, with the inclusion of additional articles as far as August 2013, all of which were analyzed through the Oxford Centre for Evidence-Based Medicine (OCEBM) system. 1. There is greater SIBO probability in IBS when breath tests are performed, but prevalence varies widely (2-84%). 2. The gut microbiota in individuals with IBS is different from that in healthy subjects, but a common characteristic present in all the patients has not been established. 3. The incidence and prevalence of PI-IBS varies from 9-10% and 3-17%, respectively, and the latter decreases over time. Bacterial etiology is the most frequent but post-viral and parasitic cases have been reported. 4. A sub-group of patients has increased enterochromaffin cells, intraepithelial lymphocytes, and mast cells in the intestinal mucosa, but no differences between PI-IBS and non-PI-IBS have been determined. 5. Methanogenic microbiota has been associated with IBS with constipation. 6. Rifaximin at doses of 400 mg TID/10 days or 550 mg TID/14 days is effective treatment for the majority of overall symptoms and abdominal bloating in IBS. Retreatment effectiveness appears to be similar to that of the first cycle. Further studies are required to determine the nature of the gut microbiota in IBS and the differences in low-grade inflammation between PI-IBS and non-PI-IBS. Rifaximin has shown itself to be effective treatment for IBS, regardless of prior factors.

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These broad-spectrum antibiotics are absorbable, causing local and systemic side effects.
“however, these drugs are absorbable causing local and systemic side effects”
From Gut microbiota role in irritable bowel syndrome: New therapeutic strategies (2016) · cites this paper as [287]
Other broad-spectrum antibiotics reducing bacterial overgrowth have been challenged in the treatment of IBS, including tetracycline, amoxicillin clavulanate, metronidazole and fluoroquinolones such as norfloxacin.
“Other broad-spectrum antibiotics reducing bacterial overgrowth have been challenged in the treatment of IBS, including tetracycline, amoxicillin clavulanate, metronidazole and fluoroquinolones such as norfloxacin [287,288]”
From Gut microbiota role in irritable bowel syndrome: New therapeutic strategies (2016) · cites this paper as [287]

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Sorted by citations

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Retracted
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Microbiota y síndrome de intestino irritable
Alatorre-Cruz, J. M., Carreño-López, R., Alatorre-Cruz, G. C., Santiago-Saenz, Y. O., Domínguez-Castillo, C., & García-García, S. D. C. (2019) · Zenodo (CERN European Organization for Nuclear Research) · doi:10.5281/zenodo.5090743
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Microbiota, gastrointestinal infections, low-grade inflammation, and antibiotic therapy in irritable bowel syndrome (IBS): an evidence-based review
Schmulson, M. J., Bielsa, M. V., Carmona-Sánchez, R., Hernández, A., López‐Colombo, A., López‐Vidal, Y., Peláez‐Luna, M., Remes-Troche, J. M., Tamayo, J. L., & Valdovinos, M. A. (2014) · Revista de Gastroenterología de México (English Edition) · doi:10.1016/j.rgmxen.2014.01.001 · Cited by 38 · see citing works
Self-citation
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Síndrome del intestino irritable: papel del sistema inmune y de los probióticos
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Authors: Schmulson, M., Bielsa, M. V., Carmona-Sánchez, R., Hernández, A., López-Colombo, A., López Vidal, Y., Peláez-Luna, M., Remes-Troche, J. M., Tamayo, J. L., & Valdovinos, M. A.
Affiliations: Hospital General de México (MX)
Universidad Autónoma de Guadalajara (MX)
Instituto Nacional de Cancerología (MX)
Universidad Veracruzana (MX)
Universidad Autónoma de Sinaloa (MX)
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (MX)
Corresponding author: Schmulson, M.
ORCID: Schmulson, M.
Remes-Troche, J.M.
Valdovinos, M.A.
Venue: Revista de Gastroenterología de México
Publisher: Elsevier BV
Published: 2014-04
Volume: 79
Issue: 2
Pages: 96-134
ISSN: 0375-0906 (ISSN-L)
DOI: 10.1016/j.rgmx.2014.01.004
OpenAlex: W2139881652
Cited by: 29
References: 149
Citations by year: 2026: 1 · 2023: 2 · 2022: 5 · 2021: 3 · 2020: 3 · 2018: 1 · 2017: 3 · 2016: 2 · 2015: 5 · 2014: 4
FWCI: 0.76
Type: journal article
Language: es
Open access: gold
doi.org
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
creativecommons.org/licenses/by-nc-nd/4.0/ (vor, 335 d)
Locations: Revista de Gastroenterología de México (publishedVersion, cc-by-nc-nd)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Health Sciences › Medicine › Epidemiology › Microscopic Colitis
Keywords: post-infectious irritable bowel syndrome, gut microbiota, bacterial overgrowth, low-grade intestinal inflammation, antibiotic therapy, rifaximin, irritable bowel syndrome with constipation, intraepithelial lymphocytes, mast cells, prevalence, bacterial etiology, abdominal distension, symptom improvement

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Microbiota, infecciones gastrointestinales, inflamación de bajo grado y antibioticoterapia en el síndrome de intestino irritable. Una revisión basada en evidencias

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