Small Intestinal Bacterial Overgrowth

What is it?

Small intestinal bacterial overgrowth, or SIBO, is a condition where there is an overpopulation of bacteria in the small bowel.

What are the symptoms?

First you must understand that there is a diverse microbiome in your GI tract with the vast majority of the bacteria being located in the large intestines or colon. When bacteria overpopulate the small intestine they compete with your body for nutrients you digest. When the bacteria break down the food instead of your body, excessive gasses are created which leads to bloating. Dependent on the type of bacteria in the small intestine this can lead to either diarrhea or constipation.

Why does it occur?

Incompetence or prior surgery to the ileocecal valve that separates the small intestine from the large intestine, motility issues, diabetes, diverticulosis of the small bowel, exocrine pancreatic insufficiency amongst others.

How can we test for it?

This can be easily tested for with a breath test that lets us know which, if any, bacteria is causing SIBO. The test includes the ingestion of glucose, or lactulose if diabetic, and you breath into multiple bags over the course of 90 to 120 minutes. The test records the elevation of certain gasses which let us know if the bacteria in your small intestine are breaking down the sugar at abnormal and elevated rates.

What is the treatment?

The treatment is typically a 2 week course of antibiotics which are well tolerated.

How long until I feel better?

The symptom relief is drastic with most patients feeling close to 100% better after treatment.

Can SIBO come back?

Depending on the underlying cause of SIBO symptoms may recur within 3 months to a year and another course of antibiotics may be warranted.