Small intestinal bacterial overgrowth (SIBO) occurs when there is an abnormal increase in the overall bacterial population in the small intestine — particularly types of bacteria not commonly found in that part of the digestive tract. SIBO commonly results when a circumstance slows the passage of food and waste products in the digestive tract, creating a breeding ground for bacteria. The excess bacteria often cause diarrhoea, bloating and may cause weight loss and malnutrition.
Symptoms
Signs and symptoms of SIBO often include:
- Loss of appetite
- Abdominal pain
- An uncomfortable feeling of fullness after eating
- Nausea
- Bloating
- Diarrhoea
- Unintentional weight loss
- Malnutrition
- IBS symptoms*
A double-blind randomized study* revealed that 84% of IBS patients exhibited bacterial overgrowth based on SIBO breath testing.
*Am J Gastroenterol. 2003 Feb; 98(2):412-9. Normalization of SIBO breath testing correlates with symptom improvement in irritable bowel syndrome. A double-blind, randomized, placebo-controlled study. Pimentel M, Chow EJ, Lin HC.
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Complications
Small intestinal bacterial overgrowth (SIBO) can cause persistent digestive problems, including:
- Poor absorption of fats, carbohydrates and proteins. Bile salts, which are normally needed to digest fats, are broken down by the excess bacteria in your small intestine, resulting in incomplete digestion of fats and diarrhea. Bacterial products may also harm the mucous lining (mucosa) of the small intestine, resulting in decreased absorption of carbohydrates and proteins. Bacteria can compete for available food. And compounds produced through the bacterial break-down of stagnant food can also trigger diarrhea. Together, these effects of bacterial overgrowth result in diarrhea, malnutrition and weight loss.
- Vitamin deficiency. As a result of incomplete absorption of fats, your body can’t fully absorb the fat-soluble vitamins A, D, E and K. Bacteria in the small intestine synthesize as well as use vitamin B-12, which is essential for the normal functioning of your nervous system and the production of blood cells and DNA. The overgrowth of bacteria can result in B-12 deficiency that can lead to weakness, fatigue, tingling, and numbness in your hands and feet and, in advanced cases, to mental confusion. Damage to your central nervous system resulting from B-12 deficiency may be irreversible.
- Weakened bones (osteoporosis). Over time, damage to your intestine from abnormal bacterial growth causes poor calcium absorption, and eventually may lead to bone diseases, such as osteoporosis.
- Kidney stones. Poor calcium absorption may also eventually result in kidney stones.
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With over 30 years of experience and more than half a million endoscopic procedures performed, Direct Endoscopy is one of Melbourne’s most established providers of gastroenterology and digestive health services. Our specialist gastroenterologists lead the way in colonoscopy, gastroscopy, and capsule endoscopy, delivering accurate diagnosis and advanced treatment in fully accredited hospital settings.
We provide comprehensive care across all areas of digestive health, from bowel cancer prevention and liver disease management to inflammatory bowel disease (IBD) and beyond.
Specialist-Led. Patient-Focused.
Expert-Led Patient Care
With over 30 years of experience and more than half a million endoscopic procedures performed, Direct Endoscopy is one of Melbourne’s most established providers of gastroenterology and digestive health services. Our specialist gastroenterologists lead the way in colonoscopy, gastroscopy, and capsule endoscopy, delivering accurate diagnosis and advanced treatment in fully accredited hospital settings.
We provide comprehensive care across all areas of digestive health, from bowel cancer prevention and liver disease management to inflammatory bowel disease (IBD) and beyond.
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What are symptoms of SIBO in adults?
Adults with SIBO may experience symptoms such as
- Bloating
- Excessive gas
- Abdominal pain or cramps
- Diarrhoea
- Nausea
- Vomiting
- Loss of Appetite
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What is the treatment for SIBO?
SIBO Treatment Options
Our specialists understand that there are different levels and types of SIBO. These distinctions matter when determining the most appropriate treatment. Depending on the extent of your condition, treatment may vary.
In managing the patient with SIBO attention is first directed towards the detection and elimination, where feasible, of any underlying cause and, secondly, to the correction of any resultant nutritional deficiencies. In many situations, unfortunately, an underlying cause cannot either be found or, if present, reversed; for many patients, therefore, therapy focuses on the suppression of SIBO with antibiotics. The primary treatment is the antibiotic Rifaximin. Other antibiotics include Ciprofloxacin and Metronidazole.
Recurrent SIBO: We closely monitor you for a recurrence of SIBO. If it happens, you will benefit from our experience treating the disease. As part of your treatment, we recommend following a FODMAP (low fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet and consulting with a nutritionist. The role of probiotics in SIBO remains unclear due to limited clinical studies.