gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2021-31-1-54-63gastro-j-522Research ArticleНАЦИОНАЛЬНАЯ ШКОЛА ГАСТРОЭНТЕРОЛОГИИ, ГЕПАТОЛОГИИNATIONAL COLLEGE OF GASTROENTEROLOGY, HEPATOLOGYСвязь синдрома раздраженного кишечника и синдрома избыточного бактериального роста: бактериальная гипотеза в основе функционального заболеванияIrritable Bowel and Bacterial Overgrowth Syndromes: a Bacterial Link Hypothesis of Functional Diseasehttps://orcid.org/0000-0002-5699-541XИвашкинК. В.IvashkinK. V.

Ивашкин Константин Владимирович — кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии Института клинической медицины им. Н.В. Склифосовского.

119435, Москва, ул. Погодинская, д. 1, стр. 1.

Konstantin V. Ivashkin — Cand. Sci. (Med.), Ass. Prof., Chair of Internal Disease Propaedeutics, Gastroenterology and Hepatology, Sklifosovskiy Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1.

ivashkin_k_v_1@staff.sechenov.ruhttps://orcid.org/0000-0002-3851-626XГречишниковаВ. Р.GrechishnikovaV. R.

Гречишникова Василиса Романовна — ординатор кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии Института клинической медицины им. Н.В. Склифосовского.

119435, Москва, ул. Погодинская, д. 1, стр. 1.

Vasilisa R. Grechishnikova — Clinical Resident, Chair of Internal Disease Propaedeutics, Gastroenterology and Hepatology, Sklifosovsky Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1.

k.vasilis@mail.ruhttps://orcid.org/0000-0001-9276-6924РешетоваМ. С.ReshetovaM. S.

Решетова Мария Сергеевна — ординатор кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии Института клинической медицины им. Н.В. Склифосовского.

119435, Москва, ул. Погодинская, д. 1, стр. 1.

Maria S. Reshetova — Clinical Resident, Chair of Internal Diseases Propedeutics, Gastroenterology and Hepatology, Sklifosovsky Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University).119435, Moscow, Pogodinskaya str., 1, bld. 1.

maria.reshetova@icloud.comhttps://orcid.org/0000-0002-6815-6015ИвашкинВ. Т.IvashkinV. T.

Ивашкин Владимир Трофимович — доктор медицинских наук, академик РАН, заведующий кафедрой пропедевтики внутренних болезней, гастроэнтерологии и гепатологии Института клинической медицины им. Н.В. Склифосовского ПМГМУ им. И.М. Сеченова (Сеченовский университет) МЗ РФ; директор клиники пропедевтики внутренних болезней, гастроэнтерологии и гепатологии им. В.Х. Василенко УКБ № 2 ПМГМУ им. И.М. Сеченова (Сеченовский университет) МЗ РФ.

119435, Москва, ул. Погодинская, д. 1, стр. 1.

Vladimir T. Ivashkin — Member of the Russian Academy of Sciences, Prof., Dr. Sci. (Med.), Head of the Chair of Internal Diseases Propedeutics, Gastroenterology and Hepatology, Sklifosovsky Institute of Clinical Medicine; Director, Vasilenko Clinic of Internal Diseases Propedeutics, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1.

2135833@mail.ruПервый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет) Министерства здравоохранения Российской ФедерацииРоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation2021270120213115463Copyright © Ивашкин К.В., Гречишникова В.Р., Решетова М.С., Ивашкин В.Т., 20212021Ивашкин К.В., Гречишникова В.Р., Решетова М.С., Ивашкин В.Т.Ivashkin K.V., Grechishnikova V.R., Reshetova M.S., Ivashkin V.T.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/522Цель обзора

Цель обзора: оценить взаимосвязь между синдромом раздраженного кишечника (СРК) и синдромом избыточного бактериального роста (СИБР).

Основные положения

Основные положения. К «периферическим» механизмам развития СРК кроме неспецифического воспаления, повышенной проницаемости эпителия, активации местной иммунной системы может относиться и СИБР По данным разных методов, частота СИБР у пациентов с СРК составила 4-46%, в группе контроля — 0-13%. Ограничения методов диагностики СИБР затрудняют установление причинно-следственной связи СИБР и СРК. Нарушение моторики при СРК может предрасполагать к развитию СИБР. Провоспалительные цитокины и медиаторы при СИБР, в свою очередь, провоцируют развитие висцеральной гиперчувствительности и усиление моторики, которые являются ключевыми механизмами СРК. Оба состояния ассоциированы с качественным и количественным изменением микробиоты, что делает целесообразным применение пробиотиков, содержащих штаммы Lactobacillus и Bifidobacterium.

Вывод

Вывод: требуются дальнейшие исследования взаимосвязи СИБР и СРК, на основе которых возможна разработка оптимальных схем терапии, включающих пробиотики.

Aim

Aim. Assessment of the irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth syndrome (SIBO) interlinkage.

Key points

Key points. SIBO may represent a "peripheral" mechanism of IBS, aside to nonspecific inflammation, increased epithelial permeability and local immune system activation. In various assays, the SIBO rate in IBS patients was 4-46% vs. 0-13% in an intact cohort. A limited diagnosability of SIBO obscures the SIBO-IBS causal interplay. Impaired motility in IBS may predispose to the SIBO development. Proinflammatory cytokines and mediators in SIBO, in turn, provoke visceral hypersensitivity and intense motility, the key IBS factors. Both conditions relate to qualitative and quantitative changes in microbiota, which warrants the application of probiotic Lactobacillus and Bifidobacterium strains.

Conclusion

Conclusion. Further research into the SIBO-IBS interface is required for developing optimal probiotic-based therapies.

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The authors declare that there are no conflicts of interest present.