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Small intestinal bacterial overgrowth

MedGen UID:
1708316
•Concept ID:
C3160854
•
Disease or Syndrome
Synonyms: SIBO; small intestinal bacterial overgrowth
 
HPO: HP:0033163
Monarch Initiative: MONDO:0400000

Definition

An increased number and/or abnormal type of bacteria in the small bowel. Small intestinal bacterial overgrowth has been defined as the presence of greater than one hundred thousand bacteria (i.e. colony-forming units, CFU) per mL of proximal jejunal aspiration. The normal value is ten thousand or few CFU/ml. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVSmall intestinal bacterial overgrowth

Professional guidelines

PubMed

ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth.
Pimentel M, Saad RJ, Long MD, Rao SSC
Am J Gastroenterol 2020 Feb;115(2):165-178. doi: 10.14309/ajg.0000000000000501. PMID: 32023228
CLINICAL PRACTICE GUIDELINES FOR THE PERIOPERATIVE NUTRITION, METABOLIC, AND NONSURGICAL SUPPORT OF PATIENTS UNDERGOING BARIATRIC PROCEDURES - 2019 UPDATE: COSPONSORED BY AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY, THE OBESITY SOCIETY, AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY, OBESITY MEDICINE ASSOCIATION, AND AMERICAN SOCIETY OF ANESTHESIOLOGISTS - EXECUTIVE SUMMARY.
Mechanick JI, Apovian C, Brethauer S, Garvey WT, Joffe AM, Kim J, Kushner RF, Lindquist R, Pessah-Pollack R, Seger J, Urman RD, Adams S, Cleek JB, Correa R, Figaro MK, Flanders K, Grams J, Hurley DL, Kothari S, Seger MV, Still CD
Endocr Pract 2019 Dec;25(12):1346-1359. Epub 2019 Nov 4 doi: 10.4158/GL-2019-0406. PMID: 31682518
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article

Recent clinical studies

Etiology

Small intestinal bacterial overgrowth: current update.
Zafar H, Jimenez B, Schneider A
Curr Opin Gastroenterol 2023 Nov 1;39(6):522-528. Epub 2023 Sep 18 doi: 10.1097/MOG.0000000000000971. PMID: 37751393
Epidemiology of small intestinal bacterial overgrowth.
Efremova I, Maslennikov R, Poluektova E, Vasilieva E, Zharikov Y, Suslov A, Letyagina Y, Kozlov E, Levshina A, Ivashkin V
World J Gastroenterol 2023 Jun 14;29(22):3400-3421. doi: 10.3748/wjg.v29.i22.3400. PMID: 37389240Free PMC Article
Small Intestinal Bacterial Overgrowth.
Bushyhead D, Quigley EM
Gastroenterol Clin North Am 2021 Jun;50(2):463-474. Epub 2021 Apr 23 doi: 10.1016/j.gtc.2021.02.008. PMID: 34024452
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article
The Spectrum of Small Intestinal Bacterial Overgrowth (SIBO).
Quigley EMM
Curr Gastroenterol Rep 2019 Jan 15;21(1):3. doi: 10.1007/s11894-019-0671-z. PMID: 30645678

Diagnosis

Small intestinal bacterial overgrowth: current update.
Zafar H, Jimenez B, Schneider A
Curr Opin Gastroenterol 2023 Nov 1;39(6):522-528. Epub 2023 Sep 18 doi: 10.1097/MOG.0000000000000971. PMID: 37751393
Small Intestinal Bacterial Overgrowth.
Bushyhead D, Quigley EM
Gastroenterol Clin North Am 2021 Jun;50(2):463-474. Epub 2021 Apr 23 doi: 10.1016/j.gtc.2021.02.008. PMID: 34024452
ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth.
Pimentel M, Saad RJ, Long MD, Rao SSC
Am J Gastroenterol 2020 Feb;115(2):165-178. doi: 10.14309/ajg.0000000000000501. PMID: 32023228
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article
The Spectrum of Small Intestinal Bacterial Overgrowth (SIBO).
Quigley EMM
Curr Gastroenterol Rep 2019 Jan 15;21(1):3. doi: 10.1007/s11894-019-0671-z. PMID: 30645678

Therapy

Small intestinal bacterial overgrowth: current update.
Zafar H, Jimenez B, Schneider A
Curr Opin Gastroenterol 2023 Nov 1;39(6):522-528. Epub 2023 Sep 18 doi: 10.1097/MOG.0000000000000971. PMID: 37751393
Efficacy of an Irritable Bowel Syndrome Diet in the Treatment of Small Intestinal Bacterial Overgrowth: A Narrative Review.
Wielgosz-Grochowska JP, Domanski N, Drywień ME
Nutrients 2022 Aug 17;14(16) doi: 10.3390/nu14163382. PMID: 36014888Free PMC Article
Small Intestinal Bacterial Overgrowth.
Bushyhead D, Quigley EM
Gastroenterol Clin North Am 2021 Jun;50(2):463-474. Epub 2021 Apr 23 doi: 10.1016/j.gtc.2021.02.008. PMID: 34024452
ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth.
Pimentel M, Saad RJ, Long MD, Rao SSC
Am J Gastroenterol 2020 Feb;115(2):165-178. doi: 10.14309/ajg.0000000000000501. PMID: 32023228
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article

Prognosis

Epidemiology of small intestinal bacterial overgrowth.
Efremova I, Maslennikov R, Poluektova E, Vasilieva E, Zharikov Y, Suslov A, Letyagina Y, Kozlov E, Levshina A, Ivashkin V
World J Gastroenterol 2023 Jun 14;29(22):3400-3421. doi: 10.3748/wjg.v29.i22.3400. PMID: 37389240Free PMC Article
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article
Coeliac disease.
Glissen Brown JR, Singh P
Paediatr Int Child Health 2019 Feb;39(1):23-31. Epub 2018 Aug 13 doi: 10.1080/20469047.2018.1504431. PMID: 30099930
Lactose Intolerance in Adults: Biological Mechanism and Dietary Management.
Deng Y, Misselwitz B, Dai N, Fox M
Nutrients 2015 Sep 18;7(9):8020-35. doi: 10.3390/nu7095380. PMID: 26393648Free PMC Article
Small intestinal bacterial overgrowth syndrome.
Bures J, Cyrany J, Kohoutova D, Förstl M, Rejchrt S, Kvetina J, Vorisek V, Kopacova M
World J Gastroenterol 2010 Jun 28;16(24):2978-90. doi: 10.3748/wjg.v16.i24.2978. PMID: 20572300Free PMC Article

Clinical prediction guides

AGA Clinical Practice Update on Evaluation and Management of Belching, Abdominal Bloating, and Distention: Expert Review.
Moshiree B, Drossman D, Shaukat A
Gastroenterology 2023 Sep;165(3):791-800.e3. Epub 2023 Jul 13 doi: 10.1053/j.gastro.2023.04.039. PMID: 37452811
Alternative Treatment Approaches to Small Intestinal Bacterial Overgrowth: A Systematic Review.
Nickles MA, Hasan A, Shakhbazova A, Wright S, Chambers CJ, Sivamani RK
J Altern Complement Med 2021 Feb;27(2):108-119. Epub 2020 Oct 19 doi: 10.1089/acm.2020.0275. PMID: 33074705
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article
Coeliac disease.
Glissen Brown JR, Singh P
Paediatr Int Child Health 2019 Feb;39(1):23-31. Epub 2018 Aug 13 doi: 10.1080/20469047.2018.1504431. PMID: 30099930
Lactose Intolerance in Adults: Biological Mechanism and Dietary Management.
Deng Y, Misselwitz B, Dai N, Fox M
Nutrients 2015 Sep 18;7(9):8020-35. doi: 10.3390/nu7095380. PMID: 26393648Free PMC Article

Recent systematic reviews

Show Me What You Have Inside-The Complex Interplay between SIBO and Multiple Medical Conditions-A Systematic Review.
Sroka N, Rydzewska-Rosołowska A, Kakareko K, Rosołowski M, Głowińska I, Hryszko T
Nutrients 2022 Dec 24;15(1) doi: 10.3390/nu15010090. PMID: 36615748Free PMC Article
Efficacy of rifaximin in treating with small intestine bacterial overgrowth: a systematic review and meta-analysis.
Wang J, Zhang L, Hou X
Expert Rev Gastroenterol Hepatol 2021 Dec;15(12):1385-1399. Epub 2021 Nov 26 doi: 10.1080/17474124.2021.2005579. PMID: 34767484
Alternative Treatment Approaches to Small Intestinal Bacterial Overgrowth: A Systematic Review.
Nickles MA, Hasan A, Shakhbazova A, Wright S, Chambers CJ, Sivamani RK
J Altern Complement Med 2021 Feb;27(2):108-119. Epub 2020 Oct 19 doi: 10.1089/acm.2020.0275. PMID: 33074705
Probiotics for Preventing and Treating Small Intestinal Bacterial Overgrowth: A Meta-Analysis and Systematic Review of Current Evidence.
Zhong C, Qu C, Wang B, Liang S, Zeng B
J Clin Gastroenterol 2017 Apr;51(4):300-311. doi: 10.1097/MCG.0000000000000814. PMID: 28267052
Systematic review with meta-analysis: rifaximin is effective and safe for the treatment of small intestine bacterial overgrowth.
Gatta L, Scarpignato C
Aliment Pharmacol Ther 2017 Mar;45(5):604-616. Epub 2017 Jan 12 doi: 10.1111/apt.13928. PMID: 28078798Free PMC Article

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