Is Chronic Abdominal Pain in Pediatric Patients Due to Small Intestinal Bacterial Overgrowth?
Status:
Completed
Trial end date:
2008-09-01
Target enrollment:
Participant gender:
Summary
Chronic abdominal pain (CAP) is an extremely pervasive childhood condition and, like IBS in
adults, it is one of the functional bowel disorders without a clear framework of
understanding or an effective treatment. However, new research suggests that small intestinal
bacterial overgrowth (SIBO) may be the unifying pathophysiology that explains the variety of
symptoms experienced by patients with IBS. As CAP in children is believed to be a precursor
to IBS in adults, we hypothesize that children with this disorder have a significantly
greater prevalence of small intestinal bacterial overgrowth (SIBO) than normal, healthy
children, and that eradication of bacterial overgrowth with antibiotics will reduce symptoms
of chronic abdominal pain in children with this condition. To prove this, we will first aim
to determine the prevalence of SIBO in both healthy children and those with CAP. We will do
this by performing a lactulose breath hydrogen test, the gold standard for the noninvasive
measurement of SIBO, on 40 healthy controls and 80 subjects with CAP. We will then assess
whether eradication of SIBO with antibiotics will reduce symptoms of chronic abdominal pain
in children with this condition. To do this we will randomize, in a double-blinded fashion,
the 80 CAP patients to receive a 10-day course of either the antibiotic Rifaximin or a
placebo. After completion of the treatment we will evaluate all these patients for
eradication of bacterial overgrowth by repeating a lactulose breath hydrogen test. We will
also assess for symptom improvement by re-administering questionnaires.