Small bowel bacterial overgrowth (SBBO) occurs when there is a build-up of too much bacteria in the small bowel.
The Small Intestines
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SBBO is often caused by an abnormality in the small bowel. Food is not able to flow properly though the intestines. Conditions that may cause this include:
- Birth defect
- Conditions (eg, digestive disorder)
Examples of conditions that may increase the risk of SBBO include:
Other risk factors include:
Any condition that affects how food moves through the small bowel may increase the risk of SBBO.
Not all patients with SBBO will have symptoms. But symptoms may include:
SBBO can be difficult to diagnose. The symptoms may be similar to other conditions. Your doctor will:
- Ask about your symptoms and medical history
- Do a physical exam
Order tests, such as:
Blood tests to detects nutritional deficiencies (eg,
- Breath tests—involves fasting, eating some type of sugar, and then exhaling into a bag; the sample is analyzed to find out if there are levels of certain gases
- 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 (eg, carbohydrate-restricted diet)
Take supplements (eg,
In some cases,
is needed with a special formula.
For severe cases, surgery may be needed. This is done to correct an abnormality in the small bowel.
If you have any of the conditions that are linked to SBBO, get proper treatment. This may reduce your chance of having a build-up of bacteria in the small bowel.
Bures J, Cyrany J, Kohoutova D, et al. Small intestinal bacterial overgrowth syndrome.
World J Gastroenterol.
Dibaise J, Young R, Vanderhoof J. Enteric microbial flora, bacterial overgrowth, and short-bowel syndrome. University of South Alabama Gastroenterology Continuing Education website. Available at:
http://usagiedu.com/articles/sibo/sibo.pdf. Published 2006. Accessed May 12, 2011.
Lin H. Small intestinal bacterial overgrowth.
Vanderhoof J, Young R, Murray N, Kaufman SS. Treatment strategies for small bowel bacterial overgrowth in short bowel syndrome.
J Pediatr Gastroenterol Nutr.
Last reviewed September 2013 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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