Связь синдрома раздраженного кишечника и синдрома избыточного бактериального роста: бактериальная гипотеза в основе функционального заболевания

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

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

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