Small intestinal bacterial overgrowth (SIBO) is a condition hallmarked by an increase in the concentration of colonic-type bacteria in the small bowel. Watery diarrhea, bloating, abdominal pain and distension are the most common clinical manifestations. Additionally, malnutrition and vitamin (B12, D, A, and E) as well as minerals (iron and calcium) deficiency may be present. SIBO may mask or worsen the history of some diseases (celiac disease, irritable bowel disease), may be more common in some extra-intestinal disorders (scleroderma, obesity), or could even represent a pathogenetic link with some diseases, in which a perturbation of intestinal microbiota may be involved. On these bases, we performed a review to explore the multiple links between SIBO and digestive and extra-intestinal diseases.

Background Abdominal ultrasound (US) is a reliable method for visualizing gastric wall layers and measuring their thickness. The objective of this study is to characterize the ultrasound features of H. pylori-induced gastritis and assess its predictive potential role for this condition. Methods A cohort of 119 patients underwent gastroscopy with biopsy and abdominal US to evaluate antral wall thickness (AWT), submucosal wall thickness (SLT), mucosal wall thickness (MLT), gastric motility, and the presence of ingested material. They were divided into three groups: group A (normal mucosa without H. pylori infection), group B (gastritis H. pylori negative) and group C (gastritis H. pylori positive). Results: SLT and reduced gastric motility were significantly increased in the H. pylori gastritis group (p < 0.001). Multivariate analysis identified SLT as the only significant independent predictor of H. pylori gastritis (p < 0.001). An SLT threshold of 1.55 mm was determined as optimal for differentiating H. pylori-positive patients from -negative, yielding a sensitivity of 77% and a specificity of 72%. Conclusions These findings suggest that H. pylori gastritis is characterized by submucosal layer thickening and impaired gastric motility.