Small Intestine Bacterial Overgrowth

Evan R Locke, MD and Michael J Kim, FAAFP, MD Reviewed 05/2023

BASICS

DESCRIPTION

Small intestinal bacterial overgrowth (SIBO) is a syndrome characterized by chronic gastrointestinal (GI) symptoms in the presence of excessive bacterial colonization of the small in...

DIAGNOSIS

HISTORY

The most common symptoms reported in SIBO are abdominal pain, bloating, flatulence, diarrhea, distension
Less common symptoms include fatigue, poor concentration

DIFFERENTIAL DIAGNOSIS

F...

TREATMENT

GENERAL MEASURES

The primary goal of treatment is symptomatic improvement by eradicating microbial overgrowth
- Treatment of underlying conditions should always be pursued sim...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Monitor for signs/symptoms of nutritional deficiencies
Continue to offer psychological support to patients and offer behavioral health referral w...

REFERENCES

Avelar Rodriguez D, Ryan PM, Toro Monjaraz EM, et al. Small Intestinal Bacterial Overgrowth in Children: A State-Of-The-Art Review. Front Pediatr. 2019;7:363. doi: 10.3389/fped.2019.00363....

ADDITIONAL READING

Massey BT, Wald A. Small Intestinal Bacterial Overgrowth Syndrome: A Guide for the Appropriate Use of Breath Testing. Dig Dis Sci. 2021;66(2):338-347.
Nickles MA, Hasan A, Shakhbazov...

CLINICAL PEARLS

Typical symptoms of SIBO include abdominal pain, bloating, flatulence, diarrhea, distension
Breath testing is the test of choice for the diagnosis of SIBO
Treatment should focus on treat...

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