SIBO is a group of clinical signs and symptoms affecting the gastrointestinal tract caused by an overabundance of bacteria in the small intestine and it is usually found in the large intestine (colon).
In the patient's interview, chronic or frequent antibiotic therapy, slow gastrointestinal motility (related to taking medications or intestinal anatomical abnormalities), long-term use of PPIs or old age (related to low gastric acid levels) IBS (irritable bowel syndrome) or exposure to excessive stress. Vitamin deficiencies and the associated poor nutrition of the body are often observed in patients with bacterial overgrowth syndrome, which can lead to chronic fatigue, lack of energy or depressed mood.
Symptoms:
The most common symptoms of SIBO include: flatulence, belching, feeling of fullness, non-specific abdominal pain
Diagnostics:
Disease diagnosis is based on a breath test that measures the levels of gases produced by the fermentation of carbohydrates by abnormal bacteria in the gut.
It is important to use tests that determine the concentration of both hydrogen and methane in the diagnosis of SIBO, due to the fact that pathogenic bacteria can produce both of these substances. Taking measurements of only hydrogen (which most commercially available tests do) may give false-negative results by failing to detect methane-producing methanogens that are a potential cause of the patient's symptoms (this is especially important in patients suffering from constipation)
2 or 3 hour breath test (longer test is recommended in patients with slow gastrointestinal motility and constipation) after consuming a solution of water and lactulose
We use Genova Diagnostics and Quintron Breath test
Treatment:
Depending on the test result and the patient's preferences, treatment includes the use of antibiotics, an appropriate diet (at our Institute we use a Specific Carbohydrate Diet, lowFODMAPs or a liquid elemental diet) as well as relapse prevention, which is extremely important in the treatment of SIBO, with the use of prokinetics or preparations stimulating the production of hydrochloric acid. in the stomach.
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