2025 - SIBO - Small Intestinal Bacterial Overgrowth

2024 Research Articles

Overview

Causes/ Risk Factors
Diseases
TBI

Traumatic Brain Injury and Gut Microbiome: The Role of the Gut-Brain Axis in Neurodegenerative Processes. PMID: 40087204
- Summary: “Damage to the CNS [central nervous system] associated with TBI [traumatic brain injury] leads to GI dysmotility, which promotes small intestinal bacterial overgrowth (SIBO).”

Endometriosis

High prevalence of small intestinal bacterial overgrowth and intestinal methanogen overgrowth in endometriosis patients: A case-control study. PMID: 39959963
- Summary: high prevalence of SIBO in Endometriosis, especially methane with increased prevalence of constipation, dizziness and acid reflux, although some have hydrogen and diarrhea.

Cystic Fibrosis

Pathophysiology

Comparative analysis of amino acid auxotrophies and peptidase profiles in non-dysbiotic and dysbiotic small intestinal microbiomes. PMID: 40103612
- Summary: “In SIBO, the small intestinal microbiome shifts towards a metabolic state resembling that of the large intestine, particularly in its increased abundance of extracellular peptidase genes.”
European Consensus on Malabsorption-UEG & SIGE, LGA, SPG, SRGH, CGS, ESPCG, EAGEN, ESPEN, and ESPGHAN: Part 2: Screening, Special Populations, Nutritional Goals, Supportive Care, Primary Care Perspective. PMID: 40088199
[Clinical challenge 2. Digestive. Intestinal dysmotility beyond small intestine bacterial overgrowth. The challenge of meeting nutritional requirements]. PMID: 40008640
Influence of menstrual cycle and oral contraception on taxonomic composition and gas production in the gut microbiome PMID: 40153295
- Summary: This study explored “the relationship of OC [oral contraception] use and the microbiome to gas production, which can cause symptoms“.
  “We found a strong correlation between H2 [hydrogen] and CH4 [methane] concentrations and an interaction between OC [oral contraception] use and the menstrual cycle on H2 and CH4 production. We also identified several taxa associated with both high levels of H2 and CH4 production and OC use.” Microbial richness was greater on day 21 vs day 2 of cycle.

Associated Conditions
NEW Bile Acid Dysmetabolism

Cystic Fibrosis

Endometriosis

High prevalence of small intestinal bacterial overgrowth and intestinal methanogen overgrowth in endometriosis patients: A case-control study. PMID: 39959963
- Summary: high prevalence of SIBO in Endometriosis, especially methane with increased prevalence of constipation, dizziness and acid reflux, although some have hydrogen and diarrhea.

GERD

Correlation Between Gastroesophageal Reflux Disease and Small Intestinal Bacterial Overgrowth: Analysis of Intestinal Microbiome and Metabolic Characteristics. PMID: 39780983
- Summary: “GERD is strongly linked to SIBO, especially in patients with a positive CH4 [methane] breath test. The gut microbiota in GERD and SIBO patients differs from healthy individuals, with bacteroides uniformis as a key marker.”

Halitosis

IBD (Inflammatory Bowel Disease)

Prevalence and predictors of small intestinal bacterial overgrowth in inflammatory bowel disease: a meta-analysis PMID: 39906350
- Summary: “Nearly one-third of IBD patients present with SIBO, and the odds of SIBO in IBD was increased by 5.25-fold compared with healthy controls. Lower BMI, bloating, flatulence, history of abdominal surgery, and structuring… were predictors of SIBO in IBD patients.”

IBS (Irritable Bowel Syndrome)

Liver Disease

Traumatic Brain Injury

Traumatic Brain Injury and Gut Microbiome: The Role of the Gut-Brain Axis in Neurodegenerative Processes. PMID: 40087204
- Summary: “Damage to the CNS associated with TBI leads to GI dysmotility, which promotes small intestinal bacterial overgrowth (SIBO).”

Testing

Hydrogen Sulfide

Treatment

Antibiotics

DIAGNOSIS AND TREATMENT OF SMALL INTESTINAL BACTERIAL OVERGROWTH: AN OFFICIAL POSITION PAPER FROM THE BRAZILIAN FEDERATION OF GASTROENTEROLOGY PMID: 39968993
- Summary:“Treatment with rifaximin is effective in most cases of SIBO, while systemic antibiotics like metronidazole and ciprofloxacin are alternatives. ...Long-term follow-up is essential due to the recurrence rate, which is common in SIBO patients.”

Comparison of Rifaximin Monotherapy and Rifaximin Combined with Probiotics in Patients with Irritable Bowel Syndrome: A Randomized Controlled Trial. PMID: 40077633
- Summary: “Rifaximin combined with probiotics was superior to rifaximin monotherapy in patients with IBS. … The multi-strain probiotic contained six strains: Lactobacillus gasseri, Lactobacillus rhamnosus, Bifidobacterium longum, Bifidobacterium breve, Bifidobacterium bifidum, and Bifidobacterium lactis at a dose of 1 × 1010 CFUs”, taken as 1/day x 28 days. Rifaximin was taken x 14 days.

Probiotics

A Comprehensive Review of the Usefulness of Prebiotics, Probiotics, and Postbiotics in the Diagnosis and Treatment of Small Intestine Bacterial Overgrowth. PMID: 39858825
Comparison of Rifaximin Monotherapy and Rifaximin Combined with Probiotics in Patients with Irritable Bowel Syndrome: A Randomized Controlled Trial. PMID: 40077633
- Summary: “Rifaximin combined with probiotics was superior to rifaximin monotherapy in patients with IBS. … The multi-strain probiotic contained six strains: Lactobacillus gasseri, Lactobacillus rhamnosus, Bifidobacterium longum, Bifidobacterium breve, Bifidobacterium bifidum, and Bifidobacterium lactis at a dose of 1 × 1010 CFUs”, taken as 1/day x 28 days. Rifaximin was taken x 14 days.

Diet: FODMAP Diet

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