Septic Shock Associated With Cystostomy: A Fatal Case Due to Delayed Infection Recognition.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disease affecting up to 10% of the global population. However, its pathogenesis remains unclear. Previous studies have confirmed that the pathogenesis of IBS is related to abnormal gastrointestinal motility and visceral hypersensitivity. However, there are still no consistent markers or etiologic factors that can be used to explain the diverse symptoms of IBS. Accumulating evidence has confirmed that alterations in the gut microbiota, including its richness, diversity, composition, and metabolism, may be closely related to the symptoms of IBS. Small intestinal bacterial overgrowth (SIBO) might be involved in the development of IBS. SIBO is defined as excessive bacterial colonization of the small intestine, resembling that normally found in the colon. Culture duodenal aspirate (CFU/mL, ≥10 colony-forming units) is the most suggestive standard for the diagnosis of SIBO. However, this method is invasive, time-consuming, expensive, and greatly affected by the skills of the operating physician. The glucose hydrogen breath test can be used as a noninvasive method to diagnose SIBO and accurately reflects the growth of bacteria in the small intestine. Bloating, abdominal discomfort, and flatulence are common symptoms of SIBO that overlap with those of IBS. SIBO may be closely associated with the onset of IBS symptoms and may provide new insights into the pathogenesis of IBS.