If a patient has SIBO, the presence of extra gas is detected through a noticeable increase in hydrogen levels. After drinking a sugar solution, doctors measure hydrogen levels in the patient’s breath four times (during the lactose test, blood sugar levels are also measured). SIBO can be diagnosed via a hydrogen breath test with lactose or glucose. In a nutshell, chronic digestion problems can reduce one’s overall well-being. In extreme cases, pressure on the diaphragm can lead to heart pain, shortness of breath, changes in skin pigment, and even exhaustion. If gas enters the large intestine, it collects and can cause pain on both sides of the ribs. The normal bacterial flora in the small intestine proliferates to an extent which significantly deranges the normal physiological processes of digestion and absorption. Moreover, accelerated peristalsis means that certain fatty acids, vitamin B12 and iron are not well-absorbed and can subsequently lead to fatty stool, weight loss, and a deficiency state.Ĭhronic symptoms such as increased flatulence, colicky abdominal pain, and malabsorption can have a negative impact on a person’s quality of life.īlind loop syndrome is a form of SIBO which ensues after abdominal surgery. Such symptoms can hinder the smooth contraction of digestive tract muscles (peristalsis) and lead to constipation or even diarrhea. The pressure in the stomach resulting from gas can also cause nausea, heartburn, and spastic abdominal pain primarily located near the navel and right lower abdomen. On account of the build-up of gas, someone with SIBO usually feels bloated, experiences excessive flatulence, burps, and has bad breath. Symptoms of SIBO can present 30-90 minutes after eating and they are triggered by bacteria caused malabsorption. Additional mechanisms which prevent the spread of bacteria in the small intestine include immunoglobulins in the mucous membrane, pancreatic juice, and gall bladder bile. Both the ileocecal valve, which separates the small intestine from the large intestine, and peristaltic waves, which ensure that digestive tract muscles contract smoothly, prevent the infiltration of large intestine bacterial flora into the small intestine. These bacteria have numerous physiological functions, one of which is the further digestion of fermented food from the small intestine. The large intestine, on the contrary, houses a thick layer of bacteria consisting of approximately 10 10-10 12 bacteria per milliliter. Bacteria ingested through eating are predominantly killed by gastric acid, which means that only minimal amounts of bacteria are detectable in the small intestine. In its normal physiological state, the small intestine contains a small amount of bacteria, approximately 10 3-10 4 bacteria per milliliter. Further studies are needed to guide clinicians in the workup and treatment of SIBO.Small intestinal bacterial overgrowth (SIBO) is a disorder whereby bacteria excessively grows in the small intestine it is not a severe disorder and does not lead to organ damage. SIBO can be a challenging condition and requires an integrative, patient-centered approach. Integrative medicine approaches, including diet, supplements and manual therapies, are also reviewed. This narrative review highlights a clinical case and the most recent literature regarding SIBO, including history, clinical presentation, prevalence, pathophysiology, diagnostic workup, treatment and prevention. Symptoms improve with antimicrobial treatment, but recurrence is common. SIBO is associated with many challenging and chronic conditions such as fibromyalgia, chronic fatigue and chronic pain syndromes, and has been shown to be a causative factor in two out of three cases of irritable bowel syndrome. Clinical presentation is varied, including abdominal pain, bloating, malabsorption and systemic symptoms. The microbes feed on dietary carbohydrates and starches via fermentation, leading to gas production, inflammation and damage to the lining of the small intestine. Small intestinal bacterial overgrowth (SIBO) is a condition of increased microbial load in the small intestine.
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