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SIBO

Small intestinal bacterial overgrowth (SIBO) refers to the clinical scenario in which the small intestine harbors an overgrowth of abnormal bacteria.

Small intestinal bacterial overgrowth (SIBO) refers to the clinical scenario in which the small intestine harbors an overgrowth of abnormal bacteria. It is proposed that this overgrowth comes from migration of large intestine microbes which are predominantly gram-negative aerobes and anaerobic organisms that ferment carbohydrates into gas. In long term, SIBO can cause malabsorption of nutrients and essential vitamins.

Symptoms include: gas, bloating, nausea, diarrhea, abdominal pain, early satiety

Causes of SIBO

  • Anatomical abnormalities of proximal gut
  • Impaired gastric acid production and pancreatic and biliary secretions
  • Advance age affecting gastric motility
  • Specific diseases associated with SIBO include diabetes, scleroderma, celiac disease, amyloidosis, hypothyroidism, gastroparesis, intestinal pseudo-obstruction, pancreatitis, cirrhosis
  • Low Fiber diet
  • Medications (antibiotic, narcotics, PPIs)
  • Dysbiosis, Constipation, IBS, dysmotility

Antibiotics remain the mainstay of SIBO treatment, various alternative or adjunctive therapies include:

  • Dietary interventions
  • Probiotics, and herbal combinations to eradicate bacterial overgrowth and support gastric motility. There is accumulating evidence demonstrating the antimicrobial properties of a growing number of herbs including garlic, black cumin, cloves, cinnamon, thyme, all-spices, bay leaves, mustard, and rosemary.