Small intestinal bacterial overgrowth

bacterial overgrowthsmall bowel bacterial overgrowth syndromesmall intestine bacterial overgrowthbacterial overgrowth syndromeintestinal bacterial overgrowth
Small intestine bacterial overgrowth (SIBO), also termed bacterial overgrowths, or small bowel bacterial overgrowth syndrome (SBBOS), is a disorder of excessive bacterial growth in the small intestine.wikipedia
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Irritable bowel syndrome

IBSbowelirritable bowel
Some studies reported up to 80% of patients with irritable bowel syndrome (IBS) have SIBO (using the hydrogen breath test).
Theories include combinations of gut–brain axis problems, gut motility disorders, pain sensitivity, infections including small intestinal bacterial overgrowth, neurotransmitters, genetic factors, and food sensitivity.

Hydrogen breath test

breath testingglucose breath testhydrogen
Some studies reported up to 80% of patients with irritable bowel syndrome (IBS) have SIBO (using the hydrogen breath test). However, the usual methodology of these studies involves the use of breath testing as an indirect investigation for SIBO.
A hydrogen breath test (or HBT) is used as a diagnostic tool for small intestine bacterial overgrowth and carbohydrate malabsorption, such as lactose, fructose, and sorbitol malabsorption.

Malabsorption

malabsorption syndromeintestinal malabsorptionmalabsorption of nutrients
Patients with bacterial overgrowth typically develop symptoms including nausea, bloating, vomiting, diarrhea, malnutrition, weight loss and malabsorption, which is caused by a number of mechanisms.
Glucose hydrogen breath test for bacterial overgrowth

Rifaximin

Hydrogen-positive patients were then given a 10-day course of rifaximin, a non-absorbable antibiotic that does not leave the digestive tract and therefore does not enter the circulation or reach the skin. A variety of antibiotics, including tetracycline, amoxicillin-clavulanate, metronidazole, neomycin, cephalexin and trimethoprim-sulfamethoxazole have been used; however, the best evidence is for the use of rifaximin.
Rifaximin is particularly indicated where small intestine bacterial overgrowth is suspected of involvement in a person's IBS.

Steatorrhea

steatorrhoeafatty stoolfatty feces
Steatorrhea, a sticky type of diarrhea where fats are not properly absorbed and spill into the stool, may also occur.
Conditions producing intestinal malabsorption. These include celiac disease, bacterial overgrowth, tropical sprue, Giardiasis (a protozoan parasite infection), Zollinger-Ellison syndrome, short bowel syndrome, inflammatory bowel disease and abetalipoproteinemia.

Proton-pump inhibitor

proton pump inhibitorproton pump inhibitorsproton-pump inhibitors
Risk factors for the development of bacterial overgrowth include dysmotility; anatomical disturbances in the bowel, including fistulae, diverticula and blind loops created after surgery, and resection of the ileo-cecal valve; gastroenteritis-induced alterations to the small intestine; and the use of certain medications, including proton pump inhibitors.
PPIs may predispose an individual to developing small intestinal bacterial overgrowth or fungal overgrowth.

Crohn's disease

Crohn’s diseasechronCrohn
Patients with Crohn's disease or other diseases of the ileum may require surgery that removes the ileocecal valve connecting the small and large bowel; this leads to an increased reflux of bacteria into the small bowel.
People with Crohn's often also have issues with small bowel bacterial overgrowth syndrome, which has similar symptoms.

Lactulose

lactulose intolerance
Lactulose breath testing has shown that patients with fibromyalgia have a more pronounced degree of abnormal results compared to both IBS patients and the general population.
Lactulose is used as a test of small intestine bacterial overgrowth (SIBO).

Neomycin

neomycin sulfateneomycin Bframycetin
A variety of antibiotics, including tetracycline, amoxicillin-clavulanate, metronidazole, neomycin, cephalexin and trimethoprim-sulfamethoxazole have been used; however, the best evidence is for the use of rifaximin.
It has also been used to treat small intestinal bacterial overgrowth.

Coeliac disease

celiac diseasecoeliacceliac
Diseases like scleroderma and possibly celiac disease cause diffuse slowing of the bowel, leading to increased bacterial concentrations.
A careful interpretation of the symptomatic response is needed, as a lack of response in a person with coeliac disease may be due to continued ingestion of small amounts of gluten, either voluntary or inadvertent, or be due to other commonly associated conditions such as small intestinal bacterial overgrowth (SIBO), lactose intolerance, fructose, sucrose, and sorbitol malabsorption, exocrine pancreatic insufficiency, and microscopic colitis, among others.

Tropical sprue

spruesprue, tropical
There is an overlap in findings between tropical sprue, post-infectious irritable bowel syndrome and small intestinal bacterial overgrowth in the pathophysiology of the three conditions and also SIBO can similarly sometimes be triggered by an acute gastrointestinal infection.
Folic acid deficiency, effects of malabsorbed fat on intestinal motility, and persistent small intestinal bacterial overgrowth may combine to cause the disorder.

Prokinetic agent

prokineticgastroprokinetic agentprokinetics
Small bowel bacterial overgrowth syndrome is treated with an elemental diet or antibiotics, which may be given in a cyclic fashion to prevent tolerance to the antibiotics, sometimes followed by prokinetic drugs to prevent recurrence if dysmotility is a suspected cause.
Animal research has found that supplementation with the probiotics Lactobacillus rhamnosus and Bifidobacterium lactis enhances the speed and strength of phase III of the migrating motor complex in the small intestine resulting in reduced small intestinal bacterial overgrowth and bacterial translocation.

Rosacea

acne rosaceagranulomatous rosaceaphymatous rosacea
Intestinal bacteria may play a causal role in the dermatological condition rosacea.
Small intestinal bacterial overgrowth (SIBO) was demonstrated to have greater prevalence in rosacea patients and treating it with locally acting antibiotics led to rosacea lesion improvement in two studies.

Small intestine

small bowelsmall intestinessmall
Small intestine bacterial overgrowth (SIBO), also termed bacterial overgrowths, or small bowel bacterial overgrowth syndrome (SBBOS), is a disorder of excessive bacterial growth in the small intestine.
Small intestinal bacterial overgrowth

D-xylose absorption test

D-xylose testxylose is used to test
The D-xylose test involves having a patient drink a certain quantity of D-xylose, and measuring levels in the urine and blood; if there is no evidence of D-xylose in the urine and blood, it suggests that the small bowel is not absorbing properly (as opposed to problems with enzymes required for digestion).
A decreased urinary excretion of D-xylose is seen in conditions involving the GI mucosa, such as small intestinal bacterial overgrowth and Whipple's disease.

Achlorhydria

hypochlorhydriaachyliaachlorhydric
Irrespective of the cause, achlorhydria can result as known complications of bacterial overgrowth and intestinal metaplasia and symptoms are often consistent with those diseases:

Jejunoileal bypass

intestinal bypassjejunoileal
Many complications that followed jejunoileal bypass operations were caused by bacterial overgrowth in the excluded blind loop.

Bile acid malabsorption

bile acid diarrheaprimary bile acid diarrheabile salt malabsorption
Type 3: Secondary to various gastrointestinal diseases including cholecystectomy, vagotomy, small intestinal bacterial overgrowth, radiation enteropathy, celiac disease, chronic pancreatitis, etc.

Fatty liver disease

fatty liverhepatic steatosisfatty liver, alcoholic
Nutritional: obesity, malnutrition, total parenteral nutrition, severe weight loss, refeeding syndrome, jejunoileal bypass, gastric bypass, jejunal diverticulosis with bacterial overgrowth

Bo

Bacterial overgrowth, a medical disorder of malabsorption

Radiation enteropathy

radiation enteritispelvic radiation disease
Small intestinal bacterial overgrowth

Dysbiosis

abnormal composition of the gut flora
Dysbiosis is most commonly reported as a condition in the gastrointestinal tract, particularly during small intestinal bacterial overgrowth (SIBO) or small intestinal fungal overgrowth (SIFO).

Systemic scleroderma

systemic sclerosisprogressive systemic sclerosisDiffuse systemic sclerosis
The small intestine can also become involved, leading to bacterial overgrowth and malabsorption of bile salts, fats, carbohydrates, proteins, and vitamins.

Gastroparesis

delayed gastric emptyingdelayed stomach emptyingdiabetic gastric stasis
Small intestine bacterial overgrowth is commonly found in patients with gastroparesis.