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Management of Small Intestinal Bacterial Overgrowth in Adult Patients

Jamie Rasmussen1, David M Duriancik

  • 1Jamie Rasmussen, MS, is Registered Dietitian, Department of HEV, Central Michigan University, Mt Pleasant. David M. Duriancik, PhD, is Associate Professor, Department of HEV, Central Michigan University, Mt Pleasant, and Department of Biology, University of Michigan-Flint, Flint.

Gastroenterology Nursing : the Official Journal of the Society of Gastroenterology Nurses and Associates
|May 31, 2019
PubMed

Insights

Small intestinal bacterial overgrowth (SIBO) occurs when gut bacteria move to the small intestine. Diagnosis involves breath tests or cultures, with antibiotics and nutritional support as primary treatments.

Area of Science:

  • Gastroenterology
  • Microbiology

Background:

  • The human gastrointestinal tract relies on a complex interplay of mechanical processes, enzymes, transport molecules, and colonic bacteria.
  • Gastrointestinal imbalances or anatomical issues can cause bacteria to migrate to atypical locations, such as the small intestine.
  • This migration can lead to small intestinal bacterial overgrowth (SIBO), a condition where bacteria proliferate in an area normally containing few or no microbes.

Purpose of the Study:

  • To summarize the current understanding of small intestinal bacterial overgrowth (SIBO).
  • To highlight diagnostic methods and treatment strategies for SIBO.
  • To identify research gaps and the need for targeted studies on SIBO.

Main Methods:

  • Diagnosis of SIBO typically involves hydrogen breath tests or jejunal aspirate cultures.
  • Current treatment recommendations focus on antibiotics to eradicate or modify bacterial overgrowth.
  • Nutritional support is crucial for correcting deficiencies and alleviating symptoms associated with SIBO.

Main Results:

  • SIBO symptoms can closely resemble those of functional gastrointestinal diseases, complicating diagnosis.
  • Antibiotics are the established first-line treatment for SIBO.
  • Nutritional interventions play a key role in managing SIBO and its associated deficiencies.

Conclusions:

  • SIBO is a significant condition often studied in conjunction with other diseases, limiting independent research.
  • More targeted research is essential to develop accurate and effective recommendations for managing SIBO.
  • Understanding SIBO requires further investigation beyond its co-occurrence with other gastrointestinal disorders.

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