EOs retained greater efficacy at pH 5 and 2.32% sugar, but sugar concentrations above 5% did not negatively impact EO efficacy. The EOs evaluated were lemon balm, marjoram, oregano and thyme and their minimum inhibitory concentrations (MIC) were determined against Enterobacter spp., Listeria spp., Lactobacillus spp., and Pseudomonas spp. Listeria strains were more sensitive than spoilage bacteria, and oregano and thyme were the most active EOs. Intestinal antimicrobial molecules are dysregulated following chronic alcohol feeding contributing to changes in the enteric microbiome and to alcoholic steatohepatitis. Prevalence of a positive test for SIBO was extracted and pooled for all studies, and compared between cases and controls using an odds ratio and 95% confidence interval (CI). CAM use is prevalent in regional Australia. Antibiotics were more effective than placebo, with a combined breath test normalisation rate of 51.1% (95% CI 46.7-55.5) for antibiotics compared with 9.8% (95% CI 4.6-17.8) for placebo. Estimated expenditures for alternative medicine professional services increased 45.2% between 1990 and 1997 and were conservatively estimated at $21.2 billion in 1997, with at least $12.2 billion paid out-of-pocket. We reviewed demographic data, including age, race, body mass index, alcohol and tobacco history, medication use, comorbid medical conditions, and history of abdominal surgery. Per concludere, SIBO è più tossico in pazienti programmati produrre meno geni dell'antagonista del ricevitore IL-1, ma in più alte citochine proinflammatory, quali IL-6 o l'fattore-alfa di necrosi del tumore. For each condition, we detail the proposed mechanisms of action and explore the current data for the prevention and/or treatment of disease. The frequency of positive breath tests was higher in obese patients (24/136, 17.1%) than in healthy subjects (1/40, 2.5%; P = 0.031). Altra caratteristica comune è la tendenza alla comparsa di manifestazioni extraintestinali, con coin-volgimento di diversi distretti corporei, di cui l'artrite sicuramente rappresenta un momento molto impor- Individuals dissatisfied with their family's access to care were more likely to use acupuncture (OR 3.43). Sibo è l'acronimo di "mall Intestinal Bacterial Overgrowth", ovvero "Crescita Eccessiva dei Batteri dell'Intestino Tenue". The antibacterial activity against Escherichia coli O157: H7 and Staphylococcus aureus was tested and the results showed that all extracts and essential oils were effective and essential oils were more active. about the organizational and academic features of these, The objective of this paper was to determine predictors of complementary and alternative medicine (CAM) use among individuals with specific health problems. De los dos tipos más cultivados, el trigo blando es más adecuado para hacer pan , por ser rico en proteínas . Questa evidenza... Uno studio della Harvard School of Public Health di Boston pubblicato sulla rivista “Circulation” ha stabilito che gli uomini che saltano la prima colazione regolarmente hanno un rischio maggiore di infarto rispetto a coloro che mangiano il pasto. Publication bias was assessed by funnel plot analysis. The purpose of this study was to investigate the anxiolytic effects of luteolin and its potential interaction with the gamma-aminobutyric acid (GABAA) receptor in male Sprague-Dawley rats. The gut microbiota is essential to human health throughout life, yet the acquisition and development of this microbial community during infancy remains poorly understood. Methods: It will also consider current efforts to modulate the microbiota for therapeutic effect. Alcoholics are reported to have higher rates of SIBO, as diagnosed by jejunal aspirate; however, no data are available on the association between moderate alcohol consumption and SIBO. Este . The essential oils of Thymus persicus and Thymus eriocalyx were collected in Lorestan province, west of Iran and were examined by GC/MS and bacteriological tests. Significant shortcomings in irritable bowel syndrome (IBS) diagnosis and treatment may arise from IBS being an "umbrella" diagnosis that clusters several underlying identifiable and treatable causes for the same symptom presentation into one classification. The ethanol (by maceration) and aqueous (by Soxhlet) extracts of Berberis aristata bark were used for the study. Results. Current Western therapies for many gastrointestinal diseases are suboptimal and potentially toxic. CHE CONNESSIONE C'E' ??? Does Use of CAM for Specific Health Problems Increase With Reduced Access to Care. Contenuto trovato all'internoLa SIBO è caratterizzata da un'eccessiva proliferazione batterica nell'intestino. Il microbiota alterato, che include ... una serie di sintomi a carattere non solo intestinale, ma anche extraintestinale. Nella sindrome fibromialgica la ... Sequencing of 16S ribosomal RNA genes revealed a relative abundance of Bacteroidetes and Verrucomicrobia bacteria in mice fed alcohol compared with a relative predominance of Firmicutes bacteria in control mice. Il numero di batteri è maggiore nel colon (almeno miliardo batteri per millilitro di liquid) e molto più bassa nel piccolo intestino (meno di 10.000 batteri per ml di liquido). "Piccola patofisiologia batterica intestinale (SIBO) di crescita eccessiva". CAM is commonly used for difficult-to-treat chronic medical conditions. Title: CdL Infermieristica pediatrica Author: user Last modified by: user Created Date: 5/10/2012 8:26:56 PM Document presentation format: Presentazione su schermo (4:3) - A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 58e46b-NmE4O Three hypotheses developed are (a) RLS patients are selectively immunocompromised or genetically predisposed and thus more subject to SIBO; (b) SIBO leads to autoimmune changes, and subsequent auto-antibodies attack brain and/or peripheral nerves and (c) SIBO inflammation leads to increased hepcidin and CNS iron deficiency which, in turn, leads to RLS. The translocation of bacteria and bacterial products into the circulation contributes to alcoholic liver disease. F. carica and O. europaea inhibited growth of S. aureus, S. epidermidis, and S. pyogenes whereas P. harmala was effective against S. aureus, Acinetobacter calcoaceticus and Candida albicans. The rate of PHP or PMP was not significantly different among the IBS, FBD, and control group. Fisicamente muovendo i batteri in avanti con il flusso dell'alimento, lo rende impossible affinchè la maggior parte di loro colonizzi questa parte dell'intestino. bacteria found in the small bowel. Per avere successo nella maratona, la genetica e l’allenamento sono due componenti decisive. silente. Mind-body approaches have been applied in these diseases with positive data, particularly for irritable bowel syndrome. Oregano extract leads to growth arrest and cell death in a dose- and time-dependent manner. Any disturbance or alteration in the inherent defense mechanisms can lead to small intestinal bacterial In the FS test, immobility duration was significantly lower in both males and females treated with the plant extract when compared to vehicle-treated counterparts. Pharmacological treatment of H. pylori infections includes administration of 3-fold therapeutic regimens which are typically used to suppress H. pylori activity. Although clinicians generally make treatment decisions in irritable bowel syndrome (IBS) related to the type of symptoms, other factors such as the perceived severity and the risks patients are willing to tolerate for effective treatment are also important to consider. play a significant role in the treatment of SIBO in the future. Detailed product description and research are of vital importance to ensure safety and efficacy of these products. Patients with unexplained gastrointestinal symptoms and negative endoscopy/radiology tests completed a validated symptom questionnaire and underwent 24-h ambulatory antro-duodeno-jejunal manometry (ADJM). Complementary and alternative medicine (CAM) encompasses practices and therapeutic modalities that fall outside of the mainstream of conventional medicine. Che disturbi determina la SIBO? The current management strategies for SIBO center on identifying and correcting underlying causes, addressing nutrition deficiencies, and judicious utilization of antibiotics to treat symptomatic SIBO. A major concern with luminal aspiration is that it is only one random sampling of the small intestine and may not always be representative of the underlying microbiota. Twelve RCTs involving 2395 patients were included, of which 8 trials were considered to be of high methodological quality. JAMA The Journal of the American Medical Association. Severe cases may present with nutrition deficiencies due to malabsorption of micro- and macronutrients. NASH patients have a higher prevalence of small intestinal bacterial overgrowth which is associated with enhanced expression of TLR-4 and release of IL-8. medical schools must consider the challenge of educating physicians about Cutanee (eritema nodoso, pioderma gangrenoso) Oculari (uveite, iridociclite, episclerite) Articolari (artrite, spondilite anchilosante, sacroileite) Epatobiliari (Colangite Sclerosante Primitiva, carcinoma vie biliari) Ippocratismo digitale Mono/multiextract from identified plants will provide an array of safe antimicrobial agents to control infections by drug-resistant bacteria. The subjects were categorized into predominant hydrogen producers (PHP), predominant methane producers (PMP), combined producer, and both negative group based on LBT. Frequently cited predisposing factors include gastric acid suppression, dysmotility, gastric bypass, and opioids. The use of pyrosequencing technology to generate large numbers of 16S rDNA sequence tags circumvents these limitations and has been shown to reveal previously unexplored aspects of the "rare biosphere." These observations support the hypothesis of functional redundancy in the human gut microbiota. However, the optimal treatment regimen remains unclear. Sintomi di presentazione RCU Proctite % Colite estesa % • Dolore addominale 27 38 • Diarrea 53 67 • Calo Ponderale 0 33 • Febbre 0 19 • Sanguinamento rettale 100 98 Water extract of Syzygium aromaticum L. (Myrtaceae) buds, methanol extracts of Ficus carica L. (Moraceae) and Olea europaea L. (Oleaceae) leaves and Peganum harmala L. (Nitrariaceae) seeds had MIC ranges of 31.25-250 µg/ml. Treatment of SIBO remains empirical; generally, broad spectrum antibiotics are recommended for 2 weeks (amoxicillin, rifaximin, ciprofloxacin, etc.) Il consenso informato è stato ottenuto in forma scritta da tutti i soggetti. Small Intestinal Bacterial Overgrowth: A Case-Based Review, Systematic review with meta-analysis: rifaximin is effective and safe for the treatment of small intestine bacterial overgrowth, Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management, Complementary Health Approaches for Irritable Bowel Syndrome, Small Intestinal Bacterial Overgrowth (SIBO), Potential Causes and Present Pharmacotherapy of Irritable Bowel Syndrome: An Overview, Current and Emerging Medical Therapies for Gastroparesis, How to Test and Treat Small Intestinal Bacterial Overgrowth: an Evidence-Based Approach, Herbal Medicines: Challenges in the Modern World. Recent evidence suggests that the gut microbiota composition is associated with obesity and type 2 diabetes, which are closely associated with a low-grade inflammatory state. In the multivariate analysis, SIBO (P = 0.005) and the presence of a metabolic syndrome (P = 0.006) were independent factors of severe hepatic steatosis. A high prevalence of this bacterium in dental plaque is always reported. Therefore there may be benefits of antibiotic-based therapies for IBS. Our understanding of antibiotic-associated disturbance of the microbiota has been limited by the poor sensitivity, inadequate resolution, and significant cost of current research methods. 17) and 443 (66%) were female patients. La presenza di eccessivo lactulose e di altri zuccheri semplici come substrati per fermentazione, produce gli acidi grassi a catena corta che sono cruciali per salubrità colica, ma la sostanza tossica alle piccole viscere. (OTU00006), Lactobacillus reuteri (OTU00011), Lactobacillus salivarius (OTU00027). Retrieved on November 16, 2021 from https://www.news-medical.net/health/Small-Intestinal-Bacterial-Overgrowth-Pathophysiology.aspx. The aim of this narrative review was to explore the potential contributions of CAM to reduce antibiotic use. Although the diagnosis of SIBO is complex;, there are a few different approaches that may be used to help More info. SIFO was due to Candida. SIBO is thought to result from structural changes of the gastrointestinal tract, disordered peristalsis of the stomach and/or small intestine, or a disruption of the normal mucosal defenses of the small intestine. It should include treatment of the underlying disease, nutritional support and cyclical gastro-intestinal selective antibiotics. Neither proton pump inhibitor (PPI) use nor tobacco use was associated with a positive LBT. Additional higher quality clinical trials of SIBO therapy are warranted. Helicobacter pylori, an infective agent of more than 50% of the world population is prominent to be the main causative factor in the etiologies of chronic, active or type B gastritis, peptic and duodenal ulcer, gastric carcinoma, and mucosa-associated lymphoid tumors. The recent rise in obesity-related diseases, such as nonalcoholic fatty liver disease and its strong association with microbiota, has elicited interest in the underlying mechanisms of these pathologies. In some patients more than one factor may be involved. The essential oil of the dried aerial parts of Thymus caramanicus at full flowering stage was prepared by hydrodistillation with a yield of 2.5% oil. Locomotion in the EPM and OF tests was not significantly altered by treatments. Study Appraisal: The following information was extracted from the selected studies: study type, study participants, SIBO subtype, intervention, comparison, outcome measures, relevant results, relevant side effects, and Jadad score. Most have many flagella used to move about, but a few genera are nonmotile. Overall, 8% of aspirates were positive for SIBO; 2% of IBS patients had SIBO. The aim of this study was to evaluate whether beta-cell function was associated with SIBO. As such, this chapter will discuss the pathophysiological factors of note in IBS and will examine a case study featuring a patient with chronic, refractory IBS mediated by multiple factors based upon clinical presentation, diagnostic assays, and health history. in complementary and alternative therapy topics and to obtain information using the agar dilution method and/or the absorbance based microplate assay. © 2008-2021 ResearchGate GmbH. Older age, steatorrhoea and narcotic use were associated with SIBO (P < 0.05). Meta-analysis found rifaximin to be more efficacious than placebo for global IBS symptom improvement (OR=1.57; 95% CI=1.22, 2.01; therapeutic gain=9.8%; number needed to treat (NNT)=10.2), with mild heterogeneity (P=0.25, I(2)=26%). ROMA - Oggi, in Italia, si contano auasi 200 mila pazienti con malattia di Crohn e colite ulcerosa (le cosiddette «malattie infiammatorie croniche intestinali» o Mici); pazienti che devono sostenere un esborso medio ogni anno per farmaci ed esami senza esenzione, pari a oltre 600 euro nel 18,8% dei casi e a 300-600 euro nel 26,7%. LD(50) of >5000 mg/kg body weight was observed for both extracts in the acute oral toxicity studies with Swiss albino mice. I sintomi possono essere aspecifici: distensione addominale, meteorismo, borborigmi, dolore addominale, diarrea, dispepsia, malassorbimento, calo ponderale, sintomi extraintestinali da malassorbimento (anemia e/o neuropatia da carenza di vitamina B12, osteoporosi o tetania per ipocalcemia da ipovitaminosi D) o su . However, no clear associations of true small intestinal bacterial overgrowth with IBS or PPI use were detected, in contrast to recent speculation. Summary Nonedible plant parts were extracted with methanol and evaporated in vacuo to obtain residue. We present evidence to support the potential utility of complementary and alternative medicine modalities for irritable bowel syndrome and inflammatory bowel disease. and measured by gas chromatography after the administration of an oral loading dose of lactulose (20 g in 30 mL of sterile water). 2, 3 Health care costs are estimated at $821 million spent annually on over-the . The onset of castor oil induced diarrhea was delayed and number of diarrheal episodes was reduced by both the extracts in a dose dependent manner. Tuttavia, pur essendo la radiografia affetto da morbo di Crohn con sintomi subocclusivi con bario l'indagine più accurata, non è ancora chiaro insorti 7 giorni dopo un intervento di stricturoplastica se per definire accuratamente tale complicanza sia prefe- ileale. Rifaximin caused a lower number of adverse events compared with metronidazole or levofloxacin and may have a more favorable adverse event profile than systemic antibiotics, without clinically relevant antibiotic resistance. Necessary cookies are absolutely essential for the website to function properly. Mentre i soggetti SSc/GI- mostravano: Livelli superiori: Streptococcus salivarius (OTU00003); Bifidobacterium longum (OTU00015). Of 1356 articles identified, 10 met inclusion criteria. Il microbioma umano è l'insieme di tutti i microrganismi che in maniera fisiologica, o talvolta patologica, vivono in simbiosi con il corpo umano, e di tutti i geni che essi sono in grado di esprimere. Novel diagnostic methods being studied include gas-sensing capsules. To perform a systematic review and meta-analysis comparing the clinical effectiveness of antibiotic therapies in the treatment of symptomatic patients with documented SIBO. Today, treatment options for IBS range from conventional prescription drugs for symptomatic relief, including antibiotics for IBS predominant diarrhea to complementary modalities: specific diets, probiotics, botanical herbal regimens, acupuncture, and mind-body therapies. acid secretion, preserved gastrointestinal motility (particularly phase III of the migrating motor complex), normal Laureata presso l'Univeristà degli studi di Roma "Tor Vergata" con lode. Tutti gli appunti di chirurgia generale li trovi in versione PDF su Skuola.net! Moreover, whole extract, instead of a specific component, can be responsible for the observed cytotoxic effects. Treatments targeted at the microbial stimulus with antibiotics, probiotics or prebiotics have all progressed in the past year. Pyrosequencing of the V6 and V3 variable regions identified 3,300-5,700 taxa that collectively accounted for over 99% of the variable region sequence tags that could be obtained from these samples. The objective was to determine the remission rate of SIBO using either the antibiotic rifaximin or herbals in a tertiary care referral gastroenterology practice. In the univariate analysis, SIBO was not associated with clinical variables, but tended to be associated with more frequent severe hepatic steatosis (26.3 vs. 10.3%, P = 0.127), whereas the frequency of sinusoidal or portal fibrosis, lobular necrosis and non-alcoholic steatohepatitis (NASH) were not different. 2 g of each plant powder was added to 10 cc ethanol 96°. Background: in vitro Of those patients who consumed a moderate amount of alcohol, 58 % had a positive LBT, compared to 38.9 % of abstainers (P = 0.008). Thus, the aim of this study was to evaluate the usefulness of LBT in IBS. Tra i sintomi extraintestinali, i più frequenti sono . The pathophysiology of IBS remains elusive although potential causes have been suggested, such as a deranged brain-gut signaling, hypersensitivity of visceral sensory afferent fibers, bacterial gastroenteritis, small intestinal bacterial overgrowth (SIBO), genetic alterations and food sensitivity. Therefore, rifaximin may be useful in the treatment of gastrointestinal disorders associated with altered bacterial flora, including irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO). One of the most prevalent FGIDs, irritable bowel syndrome (IBS), is characterized by multiple etiological and pathophysiological factors requiring a comprehensive assessment to develop an appropriate and effective clinical intervention. It can occur in response to chronic use of nonsteroidal anti-inflammatory drugs (NSAIDS) (Muraki et al., 2014 ) and proton pump inhibitors . La prevalenza della malattia è intorno allo 0,3-2% della popolazione con una invidenza di 2-4 nuovi casi/10.000 adulti/anno. Irritable bowel syndrome (IBS) is a common gastrointestinal disorder, characterized by chronic or recurrent abdominal pain with constipation, diarrhea and/or an alternation of the two, and often bloating. Trichuris trichiura Este un parazit în formă de bici o parte mai groasă și alta subțirehematofag, care are o lungime de cm. Ciò è realmente un tipo di dysbiosis. Eleven plants chosen from these 27 are used as spices in local cuisine. Subgroup analysis revealed an association between SIBO and PPI use in studies that used duodenal or jejunal aspirate cultures to diagnose SIBO (OR=7.587; 95% CI, 1.805-31.894), but no relationship between SIBO and PPI use in studies that used the glucose hydrogen breath test (OR=1.93; 95% CI, 0.69-5.42). Note the word “optimal” for nutrition to prevent and treat Fecal samples were collected at 4 months of age, and we characterized the microbiota composition using high-throughput DNA sequencing. Adult patients diagnosed with IBS who accessed the websites of the International Foundation for Functional GI Disorders or the University of North Carolina Center for Functional GI Disorders filled out questionnaires to address the study aims. Targets for the pharmacotherapy of IBS include the serotonergic and opioidergic system, and the microbial population of the gut. Ayurvedic medicine is built upon the principles that are meant to describe the human body in terms of balance vs imbalance. Although the medicinal benefits of oregano, such as the anti-inflammatory and antimicrobial activities, are well known; nonetheless, only few data are available on its effect in cancer prevention, especially concerning the mechanism of action. Any dysbalance of this complex intestinal microbiome, both qualitative and quantitative, might have serious health consequence for a macro-organism, including small intestinal bacterial overgrowth syndrome (SIBO). Documenti. La presenza di salmonella a livello intestinale generalmente non è causa di sintomi, mentre alcuni pazienti.. SIBO was diagnosed by the lactulose breath test (LBT). Si prega di notare in quanto le traduzioni sono generate da macchine, non tutte le traduzioni saranno perfetti. Although we found no difference after 1 day or 1 week, intestinal bacterial overgrowth was observed in the gastrointestinal tract of mice fed alcohol for 3 weeks compared with control mice fed an isocaloric liquid diet. Conclusions: Thus, searching for alternative therapies for H. pylori infections is of special interest. Queste forme si presentano soprattutto nell'età pediatrica e nel periodo adolescenziale; sono caratterizzate da modesti sintomi gastrointestinali, mentre frequentemente si presentano segni e sintomi extraintestinali (anemia da carenza di ferro, ipertransaminasemia, stomatiti aftose ricorrenti, bassa statura, anomalie dello smalto dentario . Treatment is guided towards the eradication of bacteria in the small bowel and usually consists of a prolonged course of oral antibiotics. The rate of abnormal LBT in the IBS, FBD, and control group were 44.7%, 41.4%, and 40.0% respectively without significant differences. L'infiammazione delle mucose di piccole viscere piombo a perdita del confine di spazzola, che a sua volta diminuisce l'area assorbente nell'intestino tenue. IBS is associated with abdominal pain, bloating and altered stool consistency and imposes a heavy burden for the affected patients. Its prevalence is unknown because SIBO requires diagnostic testing. The behavioral effects of an acute or subacute (10-day course) orally administered M. officinalis (MO; 0, 30, 100 or 300 mg/kg) ethanol extract were evaluated in male and female Wistar rats in elevated plus-maze (EPM), forced swimming (FS) and open field (OF) tests. An underrecognized cause of these symptoms is small intestinal bacterial and/or fungal overgrowth. Aim: We also highlight recently developed genomic and other tools that are used to study the gut microbiome and, finally, we consider the manipulation of the gut microbiota as a potential therapeutic option to treat chronic gastrointestinal disease. lectures, practitioner lecture and/or demonstration, and patient presentations. Integrative medicine approaches, including diet, supplements and manual therapies, are also reviewed. Riepilogando sinteticamente i risultati ottenuti è stato possibile osservare come soggetti SSc/GI+ mostravano: Livelli superiori: Lachnospiracea non classificata (OTU00017), Coprococcus spp. SIBO was assessed by the lactulose breath hydrogen test (LHBT), plasma lipopolysaccharide binding protein (LBP) levels by ELISA, and expression (as a percentage) of TLR-2 and 4 on CD14-positive cells by flow cytometry. Owing to their proximity to host tissues, mucosal bacteria interact more readily with the gut epithelium and immune system than their luminal counterparts, and recent research indicates that they play an important role in health and disease processes. Patients with small intestine bacterial overgrowth (SIBO) have chronic intestinal and extraintestinal symptomatology which adversely affects their quality of life. essential oil (TEO) and its isolated constituents thymol and cavacrol (CVL) were studied in the following experimental models: ear edema, carrageenan-induced pleurisy, and chemotaxis Questo sito web e le sue pagine web sono destinati ad essere letto in inglese. Its remitting-relapsing behaviour may require in the single patient repeated Manifestazioni extraintestinali della malattia di Crohn Malattia di Crohn, una condizione infiammatoria intestinale che è normalmente associata con la salute dell'apparato digerente, in particolare in relazione al tratto intestinale, può anche causare sintomi in tutto il corpo. The overall eradication rate according to intention-to-treat analysis was 70.8% (95% CI: 61.4-78.2; I(2) = 89.4%) and to per protocol analysis 72.9% (95% CI: 65.5-79.8; I(2) = 87.5%). The results showed high inhibitory activity against all test bacteria by the disc diffusion method (zones of inhibition of 50.0 - 65.0 mm). Treatment with prebiotics partially restored Reg3g protein levels, reduced bacterial overgrowth, and lessened alcoholic steatohepatitis. Purpose of review We reviewed the most up-to-date medical literature regarding complementary health modalities for the treatment of IBS. Small intestinal bacterial overgrowth (SIBO) is a condition with presentation that can vary from asymptomatic to steatorrhea and malnutrition. Alternative medicine use and expenditures increased substantially between 1990 and 1997, attributable primarily to an increase in the proportion of the population seeking alternative therapies, rather than increased visits per patient. The alkaloid is often a component of a multi-herbal herbal mixture, so its effects in isolation are difficult to know. IBS was diagnosed by Rome II criteria. A medical chart review of patients who had undergone duodenal aspirate culture at an academic medical centre in 2003 was performed to record clinical characteristics and culture results.

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sibo sintomi extraintestinali