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SIBO (Small Intestinal Bacterial Overgrowth)

Abnormally increased numbers of bacteria in the small intestine causing malabsorption and symptoms.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is SIBO (Small Intestinal Bacterial Overgrowth)?

SIBO (small intestinal bacterial overgrowth) is characterized by an increase in the bacterial count in the small intestine above the normal threshold (10^3 colonies/mL). It is generally due to migration of colonic bacteria into the small bowel or motility disorders.

Reduced gastric acid, intestinal motility disorders (diabetes, scleroderma, postsurgical), anatomical abnormalities (diverticula, strictures, blind loop), immune deficiencies, and pancreatic insufficiency play roles in the pathogenesis. Bacterial overgrowth leads to gas production by fermentation, mucosal damage, and malabsorption.

Glucose or lactulose breath testing (hydrogen and methane measurement) is the diagnostic gold standard; jejunal aspirate culture is more invasive. Treatment involves correcting the underlying cause and antibiotics (primarily rifaximin).

Symptoms

Severe bloating and gas
Increased postprandial abdominal fullness
Chronic diarrhea or steatorrhea
Abdominal pain and cramps
Weight loss
Vitamin deficiencies (B12, fat-soluble vitamins)
Fatigue and weakness
Food intolerances

Risk Factors

Gastrointestinal motility disorders
Diabetes mellitus and autonomic neuropathy
Scleroderma and connective tissue diseases
Small bowel surgery and adhesions
Ileocecal valve resection
Chronic pancreatitis
Proton pump inhibitor use
Immunodeficiency states

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Chronic bloating and gas complaints
  • Unexplained diarrhea and weight loss
  • Cases resistant to IBS treatment
  • Patients with underlying motility disorders
  • B12 and fat-soluble vitamin deficiencies
  • Symptoms after prior bowel surgery

Treatment Methods

01
Treatment of the underlying cause
02
Rifaximin 550 mg three times daily for 10–14 days
03
Addition of neomycin in methane-predominant forms
04
Metronidazole or amoxicillin as alternatives
05
Selective use of probiotics
06
Low-FODMAP diet as a supportive measure
07
Vitamin and mineral replacement
08
Prokinetics in motility disorders

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.