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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

1
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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