General Information on SIBO
Disease Details and Frequently Asked Questions
It is a syndrome defined by the pathological colonization of the small intestine by colonic bacteria, which ferment dietary nutrients into excessive amounts of gas and organic acids.
It is currently evidenced that approximately 60% to 80% of patients diagnosed with IBS are actually suffering from covert SIBO. While IBS is traditionally viewed as a functional neuro-muscular disorder of the colon, SIBO is a tangible bacterial invasion within the small intestine that is distinctly treatable with targeted antibiotics.
Gastric acid acts as the primary biochemical defense against ingested pathogens. Chronic utilization of Proton Pump Inhibitors (PPIs) drastically suppresses acid secretion, facilitating retrograde bacterial translocation. Additionally, post-infectious gastroparesis, diabetes mellitus, hypothyroidism, structural intestinal surgeries, and chronic stress are fundamental pathophysiological contributors.
The hallmark indicator is waking with a flat abdomen that balloons mimicking late-stage pregnancy within 30-60 minutes post-ingestion of triggers (especially wheat, sweets, alliums, and certain fruits), accompanied by trapped gas. Co-occurring symptoms include chronic diarrhea or recalcitrant constipation, eructation, nausea, Vitamin B12 malabsorption, brain fog, and systemic fatigue.
Since standard upper endoscopies cannot reach the distal small intestine, SIBO is definitively diagnosed utilizing a Breath Test. The patient ingests a specific carbohydrate substrate (Lactulose or Glucose) and subsequently exhales into collection bags every 15 minutes for a 3-hour duration. The bacterial fermentation of this substrate yields hydrogen and methane; an early and distinct elevation of these gases confirms the diagnosis.
Treatment encompasses three phases:
1. Eradication: Administration of specialized, gut-selective antibiotics (e.g., Rifaximin) for 14 days to eliminate the bacterial overgrowth without systemic absorption.
2. Dietary Restriction: Implementation of a Low FODMAP Diet or a SIBO-specific protocol for 1-2 months to deprive remaining bacteria of fermentable substrates (eliminating refined sugars, alliums, dairy, and legumes).
3. Motility Restoration (Prokinetics): Utilization of prokinetic agents to stimulate the Migrating Motor Complex (MMC), preventing bacterial relapse. (Caution: Arbitrary administration of commercial probiotics can exacerbate SIBO; physician supervision is mandatory).
Our health library contents are prepared for informational purposes only and with scientific data available at the time of recording. For all your questions, concerns, diagnosis, or treatment regarding your health, please consult your doctor or a healthcare institution.
