Is Chronic Abdominal Pain in Pediatric Patients Due to Small Intestinal Bacterial Overgrowth?
| Status: | Completed |
|---|---|
| Conditions: | Pain |
| Therapuetic Areas: | Musculoskeletal |
| Healthy: | No |
| Age Range: | 8 - 18 |
| Updated: | 2/17/2017 |
| Start Date: | February 2007 |
| End Date: | September 2008 |
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.
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.
Inclusion Criteria:
- Subjects must be between the ages of 8 and 18
- Subjects must be able to swallow pills
- Healthy Controls must be siblings, other family members or friends of the CAP
subjects or children who are undergoing an overnight fast in order to obtain AM labs
for another purpose other than this study.
- Female CAP subjects who are sexually active or who may become sexually active during
the study will be required to practice an effective method of birth control (e.g.,
oral contraceptives, contraceptive patch or injection, IUD, double barrier method)
before entering into the study.
- All CAP subjects must meet the Rome II Criteria for Functional Bowel Disorders
Associated with Abdominal Pain or Discomfort in Children
Exclusion Criteria:
Subjects will be excluded if they:
- have a history of inflammatory bowel diseases, diabetes, cirrhosis or other liver
disease, juvenile rheumatoid arthritis, systemic lupus, a history of bowel resection
(including gastric, small bowel or colon; gallbladder surgery or appendectomy are NOT
exclusion criteria).
- have been treated with antibiotics or probiotics within the past 2 months.
- have a history of TB infection or positive Mantoux test performed at screening
- have a history of allergy to rifampin or rifaximin
We found this trial at
1
site
Childrens Hospital Los Angeles Children's Hospital Los Angeles is a 501(c)(3) nonprofit hospital for pediatric...
Click here to add this to my saved trials
