Igama elithi SIBO limele “ukukhula kwebhaktheriya emathunjini amancane” futhi libhekisela ekukhuleni kwebhaktheriya emathunjini amancane, abonakala ngenani eleqile lamagciwane kule ngxenye yamathumbu kanye ne-malabsorption. Ukubonakaliswa komtholampilo okuvame kakhulu uhudo, igesi kanye nezimpawu ze-malabsorption. Izici ezibeka phambili ekukhuleni kwebhaktheriya zingama-anatomical (i-diverticulosis, i-blind loop, njll.) noma ukusebenza (ukuphazamiseka kokuhamba kwamathumbu, ukungabi khona kwe-gastric acid secretion). Ukwelashwa kuqukethe ukudla okunamafutha amaningi, okune-carbohydrate encane, ukuphathwa kokusilela, ukwelapha ngama-antibiotic abanzi, kanye nokuqedwa kwezinto ezinomthelela ukuze kuvinjelwe ukuphindeka.

Igama elithi SIBO limele “ukukhula kwebhaktheriya emathunjini amancane” noma ukwanda kwamagciwane emathunjini amancane. Ibonakala ngenani eleqile lamagciwane emathunjini amancane (> 105 / ml) angadala ukuphazamiseka kwe-malabsorption, okungukuthi ukumuncwa okwanele kwezinto zokudla.

Ngaphansi kwezimo ezijwayelekile, ingxenye eseduze yamathumbu amancane iqukethe amagciwane angaphansi kwe-105 / ml, ikakhulukazi amagciwane e-aerobic Gram-positive. Lokhu kuhlanganiswa kwebhaktheriya okuphansi kugcinwa yilokhu:

• umphumela we-contraction evamile yamathumbu (noma i-peristalsis);
• ukukhishwa okujwayelekile kwe-asidi yesisu;
• amafinyila;
• i-secretory immunoglobulins A;
• i-valve ye-ileocecal esebenzayo.

Uma kwenzeka ukukhula kwebhaktheriya, amagciwane amaningi,> 105 / ml, atholakala emathunjini aseduze. Lokhu kungaxhunyaniswa ne:

• izinto ezingavamile noma izinguquko ze-anatomical esiswini kanye / noma amathumbu amancane (i-diverticulosis yamathumbu amancane, izihibe zokuhlinzwa ezingaboni, izimo ze-post-gastrectomy, ukuqina noma ukuvinjelwa okuyingxenye) okukhuthaza ukwehla kokuqukethwe kwamathumbu, okuholela ekukhuleni kwamagciwane; 
• ukuphazamiseka kwezimoto komgudu wokugaya ukudla okuhambisana ne-neuropathy yesifo sikashukela, i-scleroderma, i-amyloidosis, i-hypothyroidism noma i-idiopathic intestinal pseudo-obstruction engase futhi yehlise ukuphuma kwamagciwane;
• ukungabi bikho kwe-gastric acid secretion (i-achlorhydria), okungenzeka ibe yisidakamizwa noma imvelaphi yokuhlinzwa.

Izinhlobo zebhaktheriya ezivame kakhulu zokukhula ngokweqile kwamagciwane emathunjini amancane zihlanganisa:

• I-Streptococcus sp ;
• Ama-bacterium sp ;
• I-Escherichia coli;
• i-Staphylococcus sp;
• I-Klebsiella sp ;
• kanye neLactobacillus.

Lawa mabhaktheriya eqile anciphisa amandla okumunca amangqamuzana amathumbu futhi adle imisoco, okuhlanganisa amacarbohydrates kanye novithamini B12, okungaholela ekulabsorption kwamacarbohydrate kanye nokuntuleka kwezakhi kanye namavithamini. Ngaphezu kwalokho, lawa mabhaktheriya nawo asebenza kusawoti we-bile ngokuwashintsha, avimbele ukwakheka kwama-micelles okuholela ekulabsorption kwe-lipids. Ukukhula okunamandla kwebhaktheriya ekugcineni kuholela ezilonda ze-mucosa yamathumbu. 

Iziguli eziningi azinazo izimpawu. Ukwengeza ekuncipheni kwesisindo sokuqala noma ukuntula imisoco namavithamini ancibilikayo ngamafutha (ikakhulukazi amavithamini A no-D), izimpawu ezivame kakhulu zihlanganisa:

• ukungakhululeki esiswini;
• isifo sohudo esibi kakhulu noma esingaphansi;
• i-steatorrhea, okungukuthi, inani eliphakeme ngokungavamile lama-lipids esitokisini, okubangelwa ukumuncwa kwe-lipids kanye nokulimala kolwelwesi lwamafinyila;
• ukuqunjelwa;
• igesi eningi, ebangelwa amagesi akhiqizwa ukuvutshelwa kwama-carbohydrate.

Ukwelashwa ngama-antibiotic kufanele kwenziwe, hhayi ukuqeda izitshalo zebhaktheriya kodwa ukuze kulungiswe ukuze kutholakale ngcono izimpawu. Ngenxa yemvelo ye-polymicrobial yezitshalo zamathumbu, ama-antibiotic e-spectrum ebanzi ayadingeka ukumboza wonke amagciwane e-aerobic kanye ne-anaerobic.

Ngakho-ke ukwelashwa kwe-SIBO kusekelwe ekuthatheni, izinsuku eziyi-10 kuye kweziyi-14, ngomlomo, eyodwa noma ezimbili zalawa ma-antibiotic alandelayo:

• i-amoxicillin / clavulanic acid 500 mg izikhathi ezi-3 / ngosuku;
• I-Cephalexin 250 mg izikhathi ezi-4 / ngosuku;
• I-Trimethoprim / sulfamethoxazole 160 mg / 800 mg kabili / ngosuku;
• Metronidazole 250 ukuze 500 mg izikhathi 3 noma 4 / ngosuku;
• I-Rifaximin 550 mg izikhathi ezi-3 ngosuku.

Lokhu kwelashwa okubanzi kwama-antibiotic kungase kube umjikelezo noma ukuguqulwa, uma izimpawu zivame ukuvela futhi.

Ngesikhathi esifanayo, izici ezivumela ukukhula ngokweqile kwamagciwane (ukungajwayelekile kwe-anatomical kanye nokusebenza) kufanele kuqedwe futhi kunconywe ukuguqulwa kokudla. Ngempela, amabhaktheriya adlulele ikakhulukazi agaya ama-carbohydrate kulumen yamathumbu esikhundleni se-lipids, ukudla okunamafutha amaningi kanye ne-fiber ephansi nama-carbohydrate - i-lactose free - kuyanconywa. Ukushoda kwamavithamini, ikakhulukazi uvithamini B12, nawo kufanele kulungiswe.