Small Intestinal Bacterial Overgrowth: A Critical Review of an Underrecognized but Disrupting Entity

Small intestinal bacterial overgrowth (SIBO) is a common gastrointestinal (GI) problem, but its diagnosis is often missed in the clinical setting. Because its diagnosis mostly requires invasive testing, often its true prevalence is unknown. Commonly presenting complaints include abdominal distension, diarrhea, and malabsorption. Multiple predisposing factors have been recognized in peer-reviewed literature, including achlorhydria, motility disorders, anatomical abnormalities of the gastrointestinal tract, and immunodeficiency disorders, including cancer. Multiple culture-dependent and independent methods are used to confirm diagnosis. Symptomatic relief can be achieved through multiple antibiotics regimens, but correction of underlying etiology, if possible, is necessary for long-lasting cure. Increased awareness and clinical vigilance can transform the landscape of SIBO via better management of patients with GI and related disorders.