Przerost bakteryjny jelita cienkiego (SIBO) a rak: wszechstronny przegląd najnowszych powiązań Artykuł przeglądowy

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Opublikowane: wrz 30, 2025
DOI: https://doi.org/10.24292/01.OR.152091225
Słowa kluczowe:
SIBO, cancer, oncology, review

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Szymon Czerski
Uniwersytet Medyczny we Wrocławiu, Wrocław, Poland
http://orcid.org/0009-0003-8168-1820
Łukasz Sabik
Uniwersytet Medyczny we Wrocławiu, Wrocław, Poland
http://orcid.org/0009-0007-6083-9923
Anna Pawlus
Uniwersytet Medyczny we Wrocławiu, Wrocław, Poland
http://orcid.org/0009-0002-2342-7552
Dawid Domasławski
Uniwersytet Medyczny we Wrocławiu, Wrocław, Poland
http://orcid.org/0009-0007-3327-6504
Mateusz Mierniczek
Wojewódzki Szpital Specjalistyczny im. św. Rafała w Czerwonej Górze, Czerwona Góra 10, 26-060 Chęciny, Polska
http://orcid.org/0009-0009-9571-7859
Karol Zagórski
4 Wojskowy Szpital Kliniczny z Polikliniką SP ZOZ, ul. Weigla 5, 50-981 Wrocław, Polska
http://orcid.org/0009-0000-3809-3642

Abstrakt

Przerost bakteryjny jelita cienkiego (SIBO) jest coraz częściej rozpoznawany w onkologii. Często komplikuje leczenie, obniża jakość życia oraz może przyczyniać się do karcynogenezy poprzez przewlekły stan zapalny. Testy oddechowe, szeroko stosowane w diagnostyce SIBO, wykazują obiecujący potencjał w wykrywaniu polipów i raka jelita grubego na wczesnym etapie. Obecnie stosowane terapie (antybiotyki, dieta, probiotyki) przynoszą jedynie częściową poprawę, a dane dotyczące ich skuteczności w onkologii są ograniczone. Rozpoznawanie i leczenie SIBO w opiece onkologicznej może poprawić wyniki terapii i wymaga dalszych badań.

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Jak cytować
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Czerski S, Sabik Łukasz, Pawlus A, Domasławski D, Mierniczek M, Zagórski K. Przerost bakteryjny jelita cienkiego (SIBO) a rak: wszechstronny przegląd najnowszych powiązań. OncoReview [Internet]. 30 wrzesień 2025 [cytowane 10 czerwiec 2026];15(2(58):46-4. Dostępne na: https://www.journalsmededu.pl/index.php/OncoReview/article/view/3347
Numer
Tom 15 Nr 2(58) (2025)
Dział
PERSONALIZED ONCOLOGY
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Copyright: ? Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)

Bibliografia

1. Bures J, Cyrany J, Kohoutova D et al. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol. 2010; 16(24): 2978-90. http://doi.org/10.3748/wjg.v16.i24.2978.
2. Dukowicz AC, Lacy BE, Levine GM. Small intestinal bacterial overgrowth: a comprehensive review. Gastroenterol Hepatol (NY). 2007; 3(2): 112-22.
3. Madigan KE, Bundy R, Weinberg RB. Distinctive clinical correlates of small intestinal bacterial overgrowth with methanogens. Clin Gastroenterol Hepatol. Clin Gastroenterol Hepatol. 2022; 20(7): 1598-605.e2. http://doi.org/10.1016/j.cgh.2021.09.035.
4. Ghoshal UC, Shukla R, Ghoshal U. Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional and Organic Dichotomy. Gut Liver. 2017; 11(2): 196-208. http://doi.org/10.5009/gnl16126.
5. Feng X, Li X. The prevalence of small intestinal bacterial overgrowth in diabetes mellitus: a systematic review and meta-analysis. Aging (Albany NY). 2022; 14(2): 975-88. http://doi.org/10.18632/aging.203854.
6. El Kurdi B, Babar S, El Iskandarani M et al. Factors that affect prevalence of small intestinal bacterial overgrowth in chronic pancreatitis: a systematic review, meta-analysis, and meta-regression. Clin Transl Gastroenterol. 2019; 10(9): e00072. http://doi.org/10.14309/ctg.0000000000000072.
7. Losurdo G, Marra A, Shahini E et al. Small intestinal bacterial overgrowth and celiac disease: a systematic review with pooled-data analysis. Neurogastroenterol Motil. 2017; 29(6): e13028. http://doi.org/10.1111/nmo.13028.
8. Li X, Feng X, Jiang Z et al. Association of small intestinal bacterial overgrowth with Parkinson’s disease: a systematic review and meta-analysis. Gut Pathog. 2021; 13: 25. http://doi.org/10.1186/s13099-021-00420-w.
9. Kruszewski A, Szyszka M, Kucharska M et al. Proton Pump Inhibitors. Investigating Their Role in Small Intestinal Bacterial Overgrowth. Quality in Sport. 2024; 20: 56729. http://doi.org/10.12775/QS.2024.20.54123.
10. Pimentel M, Saad RJ, Long MD et al. ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth. Am J Gastroenterol. 2020; 115(2): 165-78. http://doi.org/10.14309/ajg.0000000000000501.
11. Soliman N, Kruithoff C, San Valentin EM et al. Small Intestinal Bacterial and Fungal Overgrowth: Health Implications and Management Perspectives. Nutrients. 2025; 17(8): 1365. http://doi.org/10.3390/nu17081365.
12. Ginnebaugh B, Chey WD, Saad R. Small Intestinal Bacterial Overgrowth: How to Diagnose and Treat (and Then Treat Again). Gastroenterol Clin North Am. 2020; 49(2): 321-37. http://doi.org/10.1016/j.gtc.2020.04.010.
13. Nickles MA, Hasan A, Shakhbazova A et al. Alternative treatment approaches to small intestinal bacterial overgrowth: a systematic review. J Altern Complement Med. 2021; 27(2): 147-60. http://doi.org/10.1089/acm.2020.0275.
14. Rezaie A, Pimentel M, Rao SS. How to Test and Treat Small Intestinal Bacterial Overgrowth: an Evidence-Based Approach. Curr Gastroenterol Rep. 2016; 18(2): 8. http://doi.org/10.1007/s11894-015-0482-9.
15. Deng L, Liu Y, Zhang D et al. Prevalence and treatment of small intestinal bacterial overgrowth in postoperative patients with colorectal cancer. Mol Clin Oncol. 2016; 4(5): 883-7. http://doi.org/10.3892/mco.2016.807.
16. Andreyev HJN, Muls AC, Lalji A et al. Guide to managing persistent upper gastrointestinal symptoms during and after treatment for cancer. Frontline Gastroenterol. 2017; 8(4): 295-323. http://doi.org/10.1136/flgastro-2016-100714.
17. Borre M, Muls AC, Andreyev HJN et al. Dietary intervention improves gastrointestinal symptoms after treatment of cancer in the pelvic organs. J Clin Med. 2023; 12(14): 4766. http://doi.org/10.3390/jcm12144766.
18. Liang S, Xu L, Zhang D et al. Effect of probiotics on small intestinal bacterial overgrowth in patients with gastric and colorectal cancer. Turk J Gastroenterol. 2016; 27(3): 227-32. http://doi.org/10.5152/tjg.2016.15375.
19. Wang W, Zhang D, Liu Y et al. Diagnostic value of methane-hydrogen breath test combined with intestinal flora testing in screening for colorectal polyps. Front Med (Lausanne). 2025; 12: 1530558. http://doi.org/10.3389/fmed.2025.1530558.
20. Li L, Wang J, Zhang H et al. Ability of lactulose breath test results to accurately identify colorectal polyps through the measurement of small intestine bacterial overgrowth. World J Gastrointest Surg. 2023; 15(6): 1138-48. http://doi.org/10.4240/wjgs.v15.i6.1138.
21. Chen WR, Hu DX, Liang XF et al. Gas Production Characteristics of Small Intestinal Bacteria in Patients with Colorectal Cancers: A Study Using the Lactulose Breath Test (preprint). 2024. http://doi.org/10.21203/rs.3.rs-4791552/v1.
22. Zhang X, Liu X, Xie W et al. The value of hydrogen and methane breath test in predicting colorectal polyps (preprint). 2020. http://doi.org/10.21203/rs.3.rs-38671/v1.
23. Sakamaki A, Yokoyama K, Yamazaki H et al. Small Intestinal Bacterial Overgrowth Is a Predictor of Overt Hepatic Encephalopathy in Patients with Liver Cirrhosis. J Clin Med. 2025; 14(5): 1491. http://doi.org/10.3390/jcm14051491.
24. Dharmawardana N, Li Y, Huang L et al. Breath methane to hydrogen ratio as a surrogate marker of intestinal dysbiosis in head and neck cancer. Sci Rep. 2020; 10(1): 1095. http://doi.org/10.1038/s41598-020-72115-2.
25. Rezaie A, Buresi M, Lembo A et al. Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus. Am J Gastroenterol. 2017; 112(5): 775-84. http://doi.org/10.1038/ajg.2017.46.
26. Kuntza S, Krieghoff-Henning E, Kather JN et al. Gastrointestinal cancer classification and prognostication from histology using deep learning: systematic review. Eur J Cancer. 2021; 155: 254-68. http://doi.org/10.1016/j.ejca.2021.07.012.
27. Maher J, McConnell H. New pathways of care for cancer survivors: adding the numbers. Br J Cancer. 2011; 105(S1): S5-S10. http://doi.org/10.1038/bjc.2011.417.
28. Muls AC. Gastrointestinal consequences of cancer treatment and the wider context: a bad gut feeling. Acta Oncol. 2013; 52(4): 682-9. http://doi.org/10.3109/0284186X.2013.873140.
29. Andreyev HJN, Lalji A, Mohammed K et al. The FOCCUS study: a prospective evaluation of the frequency, severity and treatable causes of gastrointestinal symptoms during and after chemotherapy. Support Care Cancer. 2020; 28(10): 4485-94. http://doi.org/10.1007/s00520-020-05610-x.
30. Mechlińska A, Frąckiewicz K, Gładyś-Cieszyńska K et al. Small intestinal bacterial overgrowth and intestinal methanogen overgrowth in gastrointestinal malignancies. Wspołczesna Onkol. 2025; 29(1): 11-21. http://doi.org/10.5114/wo.2025.148643.
31. Perez Aisa A, Garcia Gavilan MC, Alcaide Garcia J et al. Small intestinal bacterial overgrowth is common after gastrectomy but with little impact on nutritional status. Gastroenterol Hepatol. 2018; 41(10): 618-24. http://doi.org/10.1016/j.gastrohep.2018.07.001.
32. Heneghan HM, Zaborowski A, Fanning M et al. Prospective study of malabsorption and malnutrition after esophageal and gastric cancer surgery. Ann Surg. 2020; 271(6): 1141-7. http://doi.org/10.1097/SLA.0000000000001445.
33. Bjorneklett A, Fausa O, Midtvedt T. Small-bowel bacterial overgrowth in the postgastrectomy syndrome. Scand J Gastroenterol. 1983; 18(2): 289-93. http://doi.org/10.3109/00365528309181595.
34. Savva KV, Hage L, Belluomo I et al. Assessment of the burden of small intestinal bacterial overgrowth (SIBO) in patients after oesophagogastric cancer resection. J Gastrointest Surg. 2021; 25(8): 1946-54. http://doi.org/10.1007/s11605-021-05177-w.
35. Larsen HM, Krogh K, Borre M et al. Chronic loose stools following right-sided hemicolectomy for colon cancer and the association with bile acid malabsorption and small intestinal bacterial overgrowth. Colorectal Dis. 2023; 25(2): 307-16. http://doi.org/10.1111/codi.16409.
36. Roszkowska P, Klimczak E, Ostrycharz E et al. Small Intestinal Bacterial Overgrowth (SIBO) and twelve groups of related diseases—current state of knowledge. Biomedicines. 2024; 12(5): 1030. http://doi.org/10.3390/biomedicines12051030.
37. Sroka N, Rydzewska-Rosołowska A, Kakareko K et al. “Show me what you have inside”— the complex interplay between SIBO and multiple medical conditions – a systematic review. Nutrients. 2023; 15(1): 90. http://doi.org/10.3390/nu15010090.
38. Kanda T, Goto T, Hirotsu Y et al. Molecular mechanisms: connections between nonalcoholic fatty liver disease, steatohepatitis and hepatocellular carcinoma. Int J Mol Sci. 2020; 21(4): 1525. http://doi.org/10.3390/ijms21041525.
39. Ma X, Wang H, Zhang P et al. Association between small intestinal bacterial overgrowth and toll-like receptor 4 in patients with pancreatic carcinoma and cholangiocarcinoma. Turk J Gastroenterol. 2019; 30(2): 177-83.
40. Kaźmierczak-Siedlecka K, Ruszkowski J, Skonieczna-Żydecka K et al. Gastrointestinal cancers: the role of microbiota in carcinogenesis and the role of probiotics and microbiota in anti-cancer therapy efficacy. Cent Eur J Immunol. 2020; 45(4): 476-87. http://doi.org/10.5114/ceji.2020.103353.
41. Del Castillo E, Meier R, Chung M et al. The microbiomes of pancreatic and duodenum tissue overlap and are highly subject specific but differ between pancreatic cancer and non-cancer subjects. Cancer Epidemiol Biomarkers Prev. 2019; 28(2): 370-83. http://doi.org/10.1158/1055-9965.EPI-18-0542.
42. Michaud DS. Role of bacterial infections in pancreatic cancer. Carcinogenesis. 2013; 34(10): 2193-7. http://doi.org/10.1093/carcin/bgt249.
43. Krishnan J, Selvarajoo K, Tsuchiya M et al. Toll-like receptor signal transduction. Exp Mol Med. 2007; 39(4): 421-38. http://doi.org/10.1038/emm.2007.47.
44. Minemura M, Shimizu Y. Gut microbiota and liver diseases. World J Gastroenterol. 2015; 21(6): 1691-702. http://doi.org/10.3748/wjg.v21.i6.1691.
45. Ghoshal UC, Goel A, Quigley EMM et al. Gut microbiota abnormalities, small intestinal bacterial overgrowth, and non-alcoholic fatty liver disease: an emerging paradigm. Indian J Gastroenterol. 2020; 39(1): 9-21. http://doi.org/10.1007/s12664-020-01027-w.
46. Skrzydło-Radomańska B, Cukrowska B. How to recognize and treat small intestinal bacterial overgrowth? J Clin Med. 2022; 11(20): 6017. http://doi.org/10.3390/jcm11206017.
47. Krajicek EJ, Hansel SL. Small intestinal bacterial overgrowth: a primary care review. Mayo Clin Proc. 2016; 91(12): 1828-33. http://doi.org/10.1016/j.mayocp.2016.07.025.
48. Silva BCD, Ramos GP, Barros LL et al. Diagnosis and treatment of small intestinal bacterial overgrowth: an official position paper from the Brazilian Federation of Gastroenterology. Arq Gastroenterol. 2025; 62: e24107. http://doi.org/10.1590/S0004-2803.24612024-107.
49. Rao SSC, Rehman A, Yu S et al. Brain fogginess, gas and bloating: a link between SIBO, probiotics and metabolic acidosis. Clin Transl Gastroenterol. 2018; 9(6): 162. http://doi.org/10.1038/s41424-018-0030-7.
50. Chojnacki C, Popławski T, Konrad P et al. Antimicrobial treatment improves tryptophan metabolism and mood in patients with small intestinal bacterial overgrowth. Nutr Metab (Lond). 2022; 19(1): 66. http://doi.org/10.1186/s12986-022-00700-5.
51. Cangemi DJ, Lacy BE, Wise J. Diagnosing small intestinal bacterial overgrowth: a comparison of lactulose breath tests to small bowel aspirates. Dig Dis Sci. 2021; 66(6): 2042-50. http://doi.org/10.1007/s10620-020-06484-z.
52. Achufusi TGO, Sharma A, Zamora EA et al. Small intestinal bacterial overgrowth: comprehensive review of diagnosis, prevention, and treatment methods. Cureus. 2020; 12(6): e8860. http://doi.org/10.7759/cureus.8860.
53. Hammer HF, Fox MR, Keller J et al.; European H₂–CH₄ breath test group. European guideline on indications, performance, and clinical impact of hydrogen and methane breath tests in adult and pediatric patients: European Association for Gastroenterology, Endoscopy and Nutrition, European Society of Neurogastroenterology and Motility, and European Society for Paediatric Gastroenterology, Hepatology and Nutrition consensus. United European Gastroenterol J. 2022; 10(1): 15-40. http://doi.org/10.1002/ueg2.12133.
54. Viswanathan L, Larion S, Shaffer N et al. Endoscopically assisted glucose breath test (EAGBT): a novel diagnostic approach for distal SIBO. Gastroenterology. 2017; 152(5 Suppl 1): S413. http://doi.org/10.1016/S0016-5085(17)31609-8.
55. Kalantar-Zadeh K, Berean KJ, Ha N et al. A human pilot trial of ingestible electronic capsules capable of sensing different gases in the gut. Nat Electron. 2018; 1: 79-87. http://doi.org/10.1038/s41928-017-0004-x.