你的肠易激问题可能是由一种鲜为人知的肠道疾病引起的

你的肠易激问题可能是由一种鲜为人知的肠道疾病引起的

Your gastrointestinal system contains about a hundred trillion bacteria. That may sound scary, but it's actually beneficial because these bacteria help with digestion, immunity and other important functions.

你的肠胃系统大约有一百万亿个细菌。这听起来很可怕，但实际上是有益的，因为这些细菌有助于消化、免疫和其他重要功能。

Even though they are basically helpful, the bacteria can go astray in disagreeable ways.

尽管它们基本上是有益的，但细菌也会以令人不快的方式误入歧途。

Small intestinal bacterial overgrowth (SIBO) is a condition where otherwise beneficial bacteria end up in the wrong part of the digestive system, then proliferate and cause unpleasant symptoms such as abdominal pain, gas, bloating, constipation and diarrhea.

小肠细菌过度生长(SIBO)是一种情况，在这种情况下，原本有益的细菌最终会进入消化系统的错误部分，然后增殖，并导致不愉快的症状，如腹痛、胀气、便秘和腹泻。

Bacteria can be healthy and helpful as long as they stay in the large intestine, explains Erica Ilton, a New York dietitian specializing in digestive disorders. "Anything that allows them to get into the small intestine is not great, and predisposes you to SIBO."

专门研究消化系统疾病的纽约营养学家艾丽卡·伊尔顿解释说:“只要细菌留在大肠内，它们就可能是健康有益的。”“任何能让它们进入小肠的东西都不好吃，而且容易让你上瘾。”

Haven't heard of SIBO yet? You're not alone.

还没听说过SIBO吗?你不是一个人。

It's more recognized now, but I still see patients who say their doctor didn't even know about it, says Hazel Veloso, a gastroenterologist at Johns Hopkins Medicine in Lutherville.

路德维尔约翰霍普金斯医学院的胃肠病学家Hazel Veloso说:“现在人们对它有了更多的认识，但我仍然看到病人说他们的医生甚至不知道它。”

This condition was once thought to occur in a small number of post-surgical patients, but recent studies suggest it's much more common than previously thought.

这种情况曾被认为只发生在少数术后患者身上，但最近的研究表明，这种情况比之前认为的要普遍得多。

A review in the journal Clinical and Translational Gastroenterology said that SIBO may be found in people who have irritable bowel syndrome, Crohn's disease, celiac disease, diverticulitis, pancreatitis, hypothyroidism, Parkinson's disease, scleroderma, diabetes and coronary artery disease — and this list is not exhaustive.

发表在《临床与转化胃肠病学》杂志上的一篇综述称，SIBO可能存在于肠易激综合症、克罗恩病、腹腔疾病、憩室炎、胰腺炎、甲状腺功能减退症、帕金森病、硬皮病、糖尿病和冠状动脉疾病患者身上，而这一列表并不详尽。

SIBO can also occur after certain abdominal surgeries, such as a gastric bypass. And it's also common in people who take proton pump inhibitors to reduce stomach acid (reduced acid allows bacteria to flourish).

SIBO也可能发生在某些腹部手术后，如胃旁路手术。这在那些服用质子泵抑制剂来减少胃酸的人身上也很常见(减少的胃酸使细菌大量繁殖)。

Veloso says that SIBO is also common among people who use narcotics such as oxycodone and morphine. The use of these medications slows down the passage of food through the gut, which is known as dysmotility. When food sits for longer in the small intestine, there's more time for bacteria to grow, which leads to SIBO.

维罗索说，SIBO在使用羟考酮和吗啡等麻醉剂的人群中也很常见。这些药物的使用减慢了食物通过肠道的速度，这被称为运动障碍。食物在小肠里停留的时间越长，细菌生长的时间就越长，这就导致了SIBO。

We're even now seeing SIBO come from gastrointestinal infections such as food poisoning, Veloso says. "Anything that causes the small bowel to be slow — even radiation for cancer or advancing age — can cause SIBO."

“我们现在甚至看到SIBO来自食物中毒等胃肠道感染，”Veloso说。“任何导致小肠变慢的东西——甚至是癌症放疗或衰老——都可能导致SIBO。”

If you have any of these conditions and suffer from bloating or diarrhea, ask your doctor about being tested for SIBO.

如果你有这些症状，并遭受腹胀或腹泻，问你的医生关于测试SIBO。

The gold-standard test for SIBO is a small bowel aspirate, but it's invasive and expensive, says Veloso. In this test, the doctor uses an endoscope to sample fluid from the small intestine, and tests it for the presence of bacteria that indicate SIBO.

“SIBO的金标准测试是小肠抽吸，但它是侵入性的，而且昂贵，”Veloso说。在这个测试中，医生使用内窥镜从小肠中提取液体，并检测细菌是否存在SIBO。

Whenever my patients say they have bloating, abdominal pain, fatigue, constipation or diarrhea, I order a lactulose breath test, Veloso says. "That's the easier way to test for SIBO, and it is noninvasive," she says.

“每当我的病人说他们有腹胀、腹痛、疲劳、便秘或腹泻时，我就会要求进行乳果糖呼吸测试，”维罗索说。“这是对SIBO进行检测的更简单的方法，而且是无创的，”她说。

For this test, the patient drinks a beverage containing lactulose (a type of sugar), then breathes into test tubes every 20 minutes over a span of three hours. The breath samples are tested to determine whether hydrogen and/or methane gas are being produced from intestinal bacteria.

在这项测试中，患者喝一种含有乳果糖(一种糖)的饮料，然后在三小时的时间里每隔20分钟向试管中呼气一次。对呼吸样本进行测试，以确定氢气和/或甲烷气体是否由肠道细菌产生。

Those gases are signs that bacteria are growing in the small intestine. Some doctors also use a glucose breath test, which is similar.

这些气体是细菌在小肠内生长的迹象。一些医生也使用类似的葡萄糖呼吸测试。

If you want one of these tests, you should see a doctor instead of ordering a do-it-yourself home test kit. It's too easy to misinterpret the results, and a misdiagnosis certainly won't help you figure out the right treatment.

如果你想做这些检查，你应该去看医生，而不是订购一个自己做的家庭测试包。人们很容易对结果产生误解，而误诊肯定不会帮助你找到正确的治疗方法。