SIBO Associated Conditions
SIBO is associated with many disorders, as a cause, an effect or as a co-existing condition. If you or one of your patients has one of the following conditions, testing for SIBO may be merited. Click links for Studies.
Acne Vulgaris
Acromegaly
Acute Gastroenteritis, study 2, study 3, study 4, study 5, study 6, study 7
Age: Elderly, study 2, study 3, study 4
Children - see Children below
Alcohol Consumption (moderate intake), study 2
Alcoholic Liver Disease (see Liver below)
NEW! Anorexia
Anemia, study 2 (see Pernicious Anemia below)
Amyloidosis
Anxiety, study 2
Atherosclerosis (subclinical)
Atrophic Gastritis, study 2
Autism, study 2
Behçet's disease (intestinal)
Bowel-associated dermatosis-arthritis syndrome, study 1
Burn Injury
Brain Fog, study 2
C. difficele infection (see Acute Gastroenteritis above)
Cancer, study 2, study 3, study 4, study 5
Celiac Disease (see below the list and Tropical Sprue below) study 2, study 3, study 4
Children (Pediatric) study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10, study 11, study 12, study 13,
study 14, study 15, study 16, study 17, study 18, study 19, study 20, study 21, study 22, study 23, study 24, study 25, study 26,
study 27, study 28, study 29, study 30, study 31, study 32, study 33, study 34, study 35, study 36, study 37, study 38
Pediatric Intestinal Failure, study 2
NEW! Cholangitis
Cholestasis (Progressive Familial Intrahepatic)
Chronic Fatigue Syndrome, study 2, study 3, study 4
Chronic Functional Bloating
Chronic Intestinal Pseudo-Obstruction, study 2, study 3, study 4
Chronic Lymphocytic Leukemia
Cirrhosis, study 2, study 3, study 4, study 5, study 6, study 7
COPD (chronic Obstructive Pulmonary Disease)
Coronary Artery Disease, study 2, study 3
Crohn's Disease (see IBD below)
Cronkhite-Canada Syndrome
Cystic Fibrosis, study 2, study 3, study 4, study 5, study 6, study 7, study 8
D-Lactic Acidosis, study 2, study 3, study 4
Deep Vein Thrombosis, study 2
Depression, study 2
Diabetes, study 2, study 3, study 4, study 5 (DM I), study 6, study 7, study 8
Diverticular Disease, study 2, study 3, study 4
Dyspepsia, study 2
Ehlers-Danlos Syndrome, study 2, study 3
Elderly, study 2, study 3, study 4, study 5
Environmental Enteric Dysfunction, study 2
Erosive Esophagitis
Familial Mediterranean Fever (FMF)
Fecal Microbiota Transplantation (FMT)
Fibromyalgia, study 2
Food Poisoning (see Acute Gastroenteritis above)
Fructose Malabsorption, study 2
Gallstones, study 2, study 3, study 4
Gastroparesis, study 2, study 3 , study 4, study 5, study 6
GERD (Gastroesophageal Reflux Disease), GERD & PPI's, study 2
Heart Failure, study 2, study 3
HIV, study 2, study 3
Hepatocellular Carcinoma
Hepatic Encephalopathy (Minimal), study 2, study 3, study 4, study 5
Hepatic Injury
H pylori Infection, study 2, study 3, study 4, study 5
Hypochlorhydria (low stomach acid), study 2, study 3
Hypothyroid/Hashimoto's Throiditis, study 2, study 3, study 4, study 5, study 6
Ileocecal Valve
-Resection, study 2, study 3, study 4,
-Insufficiency, study 2, study 3
IBD (Inflammatory Bowel Disease) see below
-Crohn's, study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9
-Ulcerative Colitis, study 2, study 3
-Both, study 2, study 3
IBS (Irritable Bowel Syndrome), see below list
Interstitial Cystitis
Intestinal ischemia/reperfusion injury
Kidney Stones
Klein-Levin Syndrome
Lactose Intolerance, study 2, study 3, study 4, study 5, study 6
Leaky Gut (Increased Intestinal Permeability), study 2, study 3, study 4
Liver Disease (see also: Cirrhosis, Hepatic and NASH)
Alcoholic Liver Disease
Liver inflammation, study 2, study 3, study 4, study 5
Liver failure
Lyme
Malabsorption Syndrome, study 2, study 3
Malnutrition
Marfan Syndrome, study 2
Mast Cell Activation syndrome (MCAS)
Medications: Proton Pump Inhibitors, study 2, study 3, study 4, study 5, study 6, study 7, study 8
Narcotics/Opioids
NSAIDS
Antibiotics
Total Parenteral Nutrition
Metabolic Syndrome, study 2
Multiple Sclerosis
Muscular Dystrophy (myotonic Type 1)
Myelomeningocele (spina bifida)
NASH/ NAFLD (non-alcoholic steatohepatitis/fatty liver disease), study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10, study 11, study 12, study 13, study 14, study 15, study 16, study 17, study 18, study 19, study 20, study 21, study 22
Obesity, study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10
Osteoporosis/Osteopenia, study 2
Pancreatitis, study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10
NEW! Pancreatic Insufficiency
NEW! Pancreatic Carcinoma
Parasites, study 2
Parkinson's, study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10, study 11, study 12, study 13, study 14
Pernicious Anemia, study 2
Pneumatosis Cystoides (secondary)
NEW! Polyderma Faciale
Postural Orthostatic Tachycardia Syndrome (POTS), study 2, study 3
Post-Infectious IBS (see Acute Gastroenteritis above)
Prostatitis (chronic)
Psoriasis, study 2, study 3
Radiation Enteropathy
Restless Leg Syndrome, study 2, study 3, study 4, study 5
Rheumatoid Arthritis, study 2
Rosacea, study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10
Scleroderma (Systemic Sclerosis), study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10
NEW! Sexual Dysfunction
Short Bowel Syndrome, study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10, study 11, study 12,
study 13, study 14, study 15, study 16
Spinal Cord Injury
Surgery: Abdominal, study 2
Bariatric, study 2, study 3, study 4, study 5
Blind Loop
Cholecystectomy, study 2, study 3
Hysterectomy
Ileoecal Valve Resection (see Ileoecal Valve above)
Gastrectomy, study 2
Post Colon Cancer, study 2
Post Esophageal and Gastric Cancer
Traveler's Diarrhea (see Acute Gastroenteritis above)
Tropical Sprue, study 2, study 3, study 4, study 5
Ulcerative Colitis (see IBD above & below)
Visceral Fat
Vitamin K-responsive coagulopathy
Vitamin Deficiency:
Vitamin B12 deficiency
Vitamin K2 deficiency, study 2
Vitamin A, E & K deficiency (fat soluble)
Whipple's Disease
Acne Vulgaris
Acromegaly
Acute Gastroenteritis, study 2, study 3, study 4, study 5, study 6, study 7
Age: Elderly, study 2, study 3, study 4
Children - see Children below
Alcohol Consumption (moderate intake), study 2
Alcoholic Liver Disease (see Liver below)
NEW! Anorexia
Anemia, study 2 (see Pernicious Anemia below)
Amyloidosis
Anxiety, study 2
Atherosclerosis (subclinical)
Atrophic Gastritis, study 2
Autism, study 2
Behçet's disease (intestinal)
Bowel-associated dermatosis-arthritis syndrome, study 1
Burn Injury
Brain Fog, study 2
C. difficele infection (see Acute Gastroenteritis above)
Cancer, study 2, study 3, study 4, study 5
Celiac Disease (see below the list and Tropical Sprue below) study 2, study 3, study 4
Children (Pediatric) study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10, study 11, study 12, study 13,
study 14, study 15, study 16, study 17, study 18, study 19, study 20, study 21, study 22, study 23, study 24, study 25, study 26,
study 27, study 28, study 29, study 30, study 31, study 32, study 33, study 34, study 35, study 36, study 37, study 38
Pediatric Intestinal Failure, study 2
NEW! Cholangitis
Cholestasis (Progressive Familial Intrahepatic)
Chronic Fatigue Syndrome, study 2, study 3, study 4
Chronic Functional Bloating
Chronic Intestinal Pseudo-Obstruction, study 2, study 3, study 4
Chronic Lymphocytic Leukemia
Cirrhosis, study 2, study 3, study 4, study 5, study 6, study 7
COPD (chronic Obstructive Pulmonary Disease)
Coronary Artery Disease, study 2, study 3
Crohn's Disease (see IBD below)
Cronkhite-Canada Syndrome
Cystic Fibrosis, study 2, study 3, study 4, study 5, study 6, study 7, study 8
D-Lactic Acidosis, study 2, study 3, study 4
Deep Vein Thrombosis, study 2
Depression, study 2
Diabetes, study 2, study 3, study 4, study 5 (DM I), study 6, study 7, study 8
Diverticular Disease, study 2, study 3, study 4
Dyspepsia, study 2
Ehlers-Danlos Syndrome, study 2, study 3
Elderly, study 2, study 3, study 4, study 5
Environmental Enteric Dysfunction, study 2
Erosive Esophagitis
Familial Mediterranean Fever (FMF)
Fecal Microbiota Transplantation (FMT)
Fibromyalgia, study 2
Food Poisoning (see Acute Gastroenteritis above)
Fructose Malabsorption, study 2
Gallstones, study 2, study 3, study 4
Gastroparesis, study 2, study 3 , study 4, study 5, study 6
GERD (Gastroesophageal Reflux Disease), GERD & PPI's, study 2
Heart Failure, study 2, study 3
HIV, study 2, study 3
Hepatocellular Carcinoma
Hepatic Encephalopathy (Minimal), study 2, study 3, study 4, study 5
Hepatic Injury
H pylori Infection, study 2, study 3, study 4, study 5
Hypochlorhydria (low stomach acid), study 2, study 3
Hypothyroid/Hashimoto's Throiditis, study 2, study 3, study 4, study 5, study 6
Ileocecal Valve
-Resection, study 2, study 3, study 4,
-Insufficiency, study 2, study 3
IBD (Inflammatory Bowel Disease) see below
-Crohn's, study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9
-Ulcerative Colitis, study 2, study 3
-Both, study 2, study 3
IBS (Irritable Bowel Syndrome), see below list
Interstitial Cystitis
Intestinal ischemia/reperfusion injury
Kidney Stones
Klein-Levin Syndrome
Lactose Intolerance, study 2, study 3, study 4, study 5, study 6
Leaky Gut (Increased Intestinal Permeability), study 2, study 3, study 4
Liver Disease (see also: Cirrhosis, Hepatic and NASH)
Alcoholic Liver Disease
Liver inflammation, study 2, study 3, study 4, study 5
Liver failure
Lyme
Malabsorption Syndrome, study 2, study 3
Malnutrition
Marfan Syndrome, study 2
Mast Cell Activation syndrome (MCAS)
Medications: Proton Pump Inhibitors, study 2, study 3, study 4, study 5, study 6, study 7, study 8
Narcotics/Opioids
NSAIDS
Antibiotics
Total Parenteral Nutrition
Metabolic Syndrome, study 2
Multiple Sclerosis
Muscular Dystrophy (myotonic Type 1)
Myelomeningocele (spina bifida)
NASH/ NAFLD (non-alcoholic steatohepatitis/fatty liver disease), study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10, study 11, study 12, study 13, study 14, study 15, study 16, study 17, study 18, study 19, study 20, study 21, study 22
Obesity, study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10
Osteoporosis/Osteopenia, study 2
Pancreatitis, study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10
NEW! Pancreatic Insufficiency
NEW! Pancreatic Carcinoma
Parasites, study 2
Parkinson's, study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10, study 11, study 12, study 13, study 14
Pernicious Anemia, study 2
Pneumatosis Cystoides (secondary)
NEW! Polyderma Faciale
Postural Orthostatic Tachycardia Syndrome (POTS), study 2, study 3
Post-Infectious IBS (see Acute Gastroenteritis above)
Prostatitis (chronic)
Psoriasis, study 2, study 3
Radiation Enteropathy
Restless Leg Syndrome, study 2, study 3, study 4, study 5
Rheumatoid Arthritis, study 2
Rosacea, study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10
Scleroderma (Systemic Sclerosis), study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10
NEW! Sexual Dysfunction
Short Bowel Syndrome, study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10, study 11, study 12,
study 13, study 14, study 15, study 16
Spinal Cord Injury
Surgery: Abdominal, study 2
Bariatric, study 2, study 3, study 4, study 5
Blind Loop
Cholecystectomy, study 2, study 3
Hysterectomy
Ileoecal Valve Resection (see Ileoecal Valve above)
Gastrectomy, study 2
Post Colon Cancer, study 2
Post Esophageal and Gastric Cancer
Traveler's Diarrhea (see Acute Gastroenteritis above)
Tropical Sprue, study 2, study 3, study 4, study 5
Ulcerative Colitis (see IBD above & below)
Visceral Fat
Vitamin K-responsive coagulopathy
Vitamin Deficiency:
Vitamin B12 deficiency
Vitamin K2 deficiency, study 2
Vitamin A, E & K deficiency (fat soluble)
Whipple's Disease
Irritable Bowel Syndrome (IBS)
Drs. Pimentel and Lin originated the theory that SIBO is an underlying cause of IBS. As with all theories, there is debate and controversy about this idea, with many who agree and many who do not. One thing is certainly clear, the symptoms of SIBO overlap with those of IBS and a large percentage of IBS sufferers test positive for SIBO. One study by Dr Pimentel and team, showed SIBO in up to 84% of IBS patients, though the percentage has been lower in other studies, with an average of 60%. The vast majority of SIBO studies are on IBS.
See Dr Pimentel's:
Book/website- A New IBS Solution
Article- Irritable Bowel Syndrome: Bacterial Overgrowth--What's Known and What to Do (abstract)
Interview- Interview with Dr Pimentel from Sophie Lee's site: ibstales.com
See Dr Lin's:
Article - SIBO: A Framework for Understanding IBS
See Dr Weinstock's You Tube Video:
SIBO and Irritable Bowel Syndrome (IBS)
SIBO & IBS Studies by year:
2015: study 1, study 2, study 3, study 4
2016: study 1, study 2, study 3, study 4
2017: study 1, study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10, study 11, study 12
2018: study 1, study 2, study 3, study 4, study 5, study 6, study 7, study 8
See Dr Pimentel's:
Book/website- A New IBS Solution
Article- Irritable Bowel Syndrome: Bacterial Overgrowth--What's Known and What to Do (abstract)
Interview- Interview with Dr Pimentel from Sophie Lee's site: ibstales.com
See Dr Lin's:
Article - SIBO: A Framework for Understanding IBS
See Dr Weinstock's You Tube Video:
SIBO and Irritable Bowel Syndrome (IBS)
SIBO & IBS Studies by year:
2015: study 1, study 2, study 3, study 4
2016: study 1, study 2, study 3, study 4
2017: study 1, study 2, study 3, study 4, study 5, study 6, study 7, study 8, study 9, study 10, study 11, study 12
2018: study 1, study 2, study 3, study 4, study 5, study 6, study 7, study 8
Inflammatory Bowel Disease (IBD)- Crohn's and Ulcerative Colitis
SIBO has been linked in research with IBD (particularly Crohn's Disease- see below) but most notably, the predominant users of the Specific Carbohydrate Diet (SCD), a dietary treatment for SIBO are those with IBD. Several of the authors of SCD cookbooks were Ulcerative Colitis patients who state they cured themselves using the SCD.
See a study here
Crohn's and SIBO
SIBO has been reported in 25% of Crohn's Disease patients. Dr Shafran reported in 2005 that 78% of Crohn's Disease patients had a 70-point improvement and a 59% remission rate after treatment with Rifaximin, the antibiotic used to treat SIBO. A more recent 2010 study from Dr Shafran reported a 70% remission rate from Rifaximin therapy.
See more Crohn's studies linked in above main list.
See a study here
Crohn's and SIBO
SIBO has been reported in 25% of Crohn's Disease patients. Dr Shafran reported in 2005 that 78% of Crohn's Disease patients had a 70-point improvement and a 59% remission rate after treatment with Rifaximin, the antibiotic used to treat SIBO. A more recent 2010 study from Dr Shafran reported a 70% remission rate from Rifaximin therapy.
See more Crohn's studies linked in above main list.
Celiac Disease
Celiac disease is thought to be caused by an auto-immune response to gluten, but before the discovery of gluten in 1952, Dr Sidney V Haas proposed the theory of SIBO as the cause in his book The Management of Celiac Disease. He was influenced by the complete cure of celiac children he treated with his Specific Carbohydrate Diet (SCD) which goes beyond gluten-free to a grain-free diet. Elaine Gottschall discussed her support of Dr Haas's theory and her disagreement with the belief that gluten is the culprit in a chapter of her book, Breaking the Vicious Cycle. Read her article Whatever Happened to the Cure for Celiac Disease. Fascinating new information has been discovered relating to gluten and celiac disease in recent years, particularly the role of zonulin, discovered by Dr Fasano and team. How all of this fits together is not clear.
What is clear is that many Celiacs also have SIBO. Studies show this is prevalent in those who still have persistent or partial symptoms after gluten avoidance. Since bacteria eat the starch contained in all grains, SIBO offers an explanation why avoiding all grains, not just gluten grains, helps these patients. SIBO has also been suggested as an alternative explanation for latent celiac, where gliadin antibodies are elevated but little to no change is observed in the small intestine.
What is clear is that many Celiacs also have SIBO. Studies show this is prevalent in those who still have persistent or partial symptoms after gluten avoidance. Since bacteria eat the starch contained in all grains, SIBO offers an explanation why avoiding all grains, not just gluten grains, helps these patients. SIBO has also been suggested as an alternative explanation for latent celiac, where gliadin antibodies are elevated but little to no change is observed in the small intestine.
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