Case Control Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Sep 9, 2025; 14(3): 99395
Published online Sep 9, 2025. doi: 10.5409/wjcp.v14.i3.99395
Exploring small intestinal bacterial overgrowth in functional upper gastrointestinal disorder: A comprehensive case-control study
Bhaswati C Acharyya, Meghdeep Mukhopadhyay
Bhaswati C Acharyya, Meghdeep Mukhopadhyay, Department of Pediatric Gastroenterology and Hepatology, Institute of Child Health, Kolkata 700017, West Bengal, India
Bhaswati C Acharyya, Department of Paediatric Gastroenterology, Manipal Hospital, Kolkata 700099, West Bengal, India
Author contributions: Acharyya BC planned, structured, and wrote the draft of the study; Mukhopadhyay M contributed to the conduction, result analysis, statistical calculation and writing of the final draft.
Institutional review board statement: The institutional Ethics Committee of AMRI Hospital approved the study (Approval No. AMRIMKP-EC/AP-10/2022-23).
Informed consent statement: Informed consent and assent have been obtained from the parents and subjects.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at bacharyya21@gmail.com. Participants gave informed consent for data sharing.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bhaswati C Acharyya, MD, Professor, Department of Pediatric Gastroenterology and Hepatology, Institute of Child Health, 11, Dr Biresh Guha Street, Kolkata 700017, West Bengal, India. bacharyya21@gmail.com
Received: July 21, 2024
Revised: December 15, 2024
Accepted: March 13, 2025
Published online: September 9, 2025
Processing time: 329 Days and 18.5 Hours
Core Tip

Core Tip: Small intestinal bacterial overgrowth (SIBO) is defined as an increased number of non-pathogenic bacteria over 105 organisms/mL of small intestinal content. The most common predisposing factors include, among others, gut motility disorders and chronic use of proton pump inhibitors. SIBO is suspected and excluded frequently in functional gastrointestinal (GI) disorders like functional abdominal pain, irritable bowel syndrome, functional dyspepsia, or functional defecation disorder. However, the extent of SIBO in functional GI disorders, which mainly manifest with upper gastrointestinal symptoms such as nausea, vomiting, epigastric pain, belching, dyspepsia, etc, has not been documented earlier. This study uniquely divides the proton pump inhibitor naive children into two groups: One with demonstrable endoscopic lesions (control) and the other without the endoscopic lesions (cases) and compares the prevalence of SIBO between these two groups instead of comparing the cases with healthy children without any symptoms. The result documented a significantly increased number of SIBO in the children with normal endoscopic evaluation. Henceforth, this study documents a need to evaluate the children with functional upper GI symptoms for SIBO.