Small intestinal bacterial overgrowth syndrome

Small Intestinal Bacterial Overgrowth Syndrome (SIBO), also known as small bowel bacterial overgrowth syndrome (SBBOS), is a disorder of excessive bacterial growth in the small intestine. Unlike the colon, which is rich with bacteria, the small intestine usually has fewer bacterial organisms. The excessive bacteria can lead to symptoms such as malnutrition, diarrhea, and vitamin deficiencies due to the malabsorption of nutrients.

Causes

SIBO is often associated with diseases that affect the normal motility of the small intestine, leading to an abnormal stasis of bowel contents. Conditions that can lead to SIBO include, but are not limited to, diabetes mellitus, scleroderma, Crohn's disease, and cirrhosis. Surgical procedures that create a blind loop in the intestine can also predispose individuals to SIBO.

Symptoms

Common symptoms of SIBO include:

• Abdominal pain
• Bloating and gas
• Diarrhea
• Weight loss and malnutrition
• Fatigue

Diagnosis

Diagnosis of SIBO is typically made through a combination of symptom assessment, laboratory tests, and sometimes imaging studies. The hydrogen breath test is a common non-invasive test used to diagnose SIBO. It measures the amount of hydrogen in the breath after the patient drinks a glucose or lactulose solution. Elevated levels of hydrogen suggest the presence of excessive bacteria in the small intestine.

Treatment

Treatment for SIBO often involves a combination of antibiotics to reduce bacterial overgrowth, prokinetics to improve gut motility, and dietary changes to reduce the intake of foods that ferment in the gut, producing gas. In some cases, surgery may be required to correct anatomical abnormalities contributing to the condition.

Prevention

Preventive measures for SIBO include managing underlying conditions that can predispose an individual to the syndrome, such as diabetes and Crohn's disease. Regular follow-up with a healthcare provider to monitor and treat these conditions can help reduce the risk of developing SIBO.

See also

• Gastrointestinal tract
• Irritable bowel syndrome
• Leaky gut syndrome