Small Bowel Bacterial Overgrowth
Factors that may increase your chance of SBBO include:
- Crohn disease
- Irritable bowel syndrome (IBS)
- Short bowel syndrome
- Intestinal stricture (narrowing in the small intestine)
- Digestive disorders, such as celiac disease or lactose intolerance
- Blind loop syndrome (when part of the intestine is bypassed)
- Intestinal infections, such as food poisoning or traveler’s diarrhea
- Chronic pancreatitis
- End-stage kidney or liver disease
Other risk factors include:
- Intestinal surgery
- An obstruction in the small intestine
- Weakened immune system
- Older age
Any condition that affects how food moves through the small bowel may increase the risk of SBBO.
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include
- Blood tests
- Breath tests—to analyze certain gases that may be present after fasting and eating specific sugars
- Culture of intestinal fluid (aspirate)—a catheter is used to get a sample of fluid from the small bowel
The goals are to:
- Reduce the levels of harmful bacteria in the small bowel
- Treat the underlying condition
Antibiotics are often prescribed to treat SBBO. Usually treatment is temporary, but in some cases you may need to take antibiotics for a longer period.
To make sure that you get the proper nutrients, you may need to:
- Work with a dietitian
- Follow a special diet, such as a carbohydrate-restricted diet
- Take vitamins and/or supplements
- Take probiotics
In some cases, tube feeding is needed with a special formula.
For severe cases, surgery may be needed. This is done to correct an abnormality in the small bowel.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
Copyright © EBSCO Information Services
All rights reserved.
a (SBBO; Bacterial Overgrowth, Small Bowel; Small Intestine Bacterial Overgrowth; SIBO; Bacterial Overgrowth, Small Intestine)
American Gastroenterological Association http://www.gastro.org
National Institute of Diabetes and Digestive and Kidney Diseases https://www.niddk.nih.gov
Canadian Association of Gastroenterology https://www.cag-acg.org
Canadian Digestive Health Foundation http://www.cdhf.ca
Bacterial overgrowth syndrome. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gastrointestinal-disorders/malabsorption-syndromes/bacterial-overgrowth-syndrome. Updated May 2016. Accessed October 3, 2017.
Bures J, Cyrany J, Kohoutova D, et al. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol. 2010;16(24):2978–2990.
Lactose and glucose hydrogen breath test. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/articles/lactose-and-glucose-hydrogen-breath-test. Accessed October 3, 2017.
Lin H. Small intestinal bacterial overgrowth. JAMA. 2004;292(7):852-858.
Short bowel syndrome. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115699/Short-bowel-syndrome . Updated May 6, 2014. Accessed October 3, 2017.
Vanderhoof J, Young R, Murray N, Kaufman SS. Treatment strategies for small bowel bacterial overgrowth in short bowel syndrome. J Pediatr Gastroenterol Nutr. 1998;27(2):155-160.