SIBO Overview
- Small Intestinal Bacterial Overgrowth PMID: 31536241
- Summary: “Small intestinal bacterial overgrowth (SIBO) is the presence of excess colonic bacteria in the small intestine. These excess organisms result in multiple intestinal symptoms like abdominal pain, bloating, diarrhea, and rarely malabsorption.”
- Detection and therapy of Small Intestinal Bacterial Overgrowth (SIBO) PMID: 41644904
- Mechanisms and pathophysiology leading to development of small intestinal microbial dysbiosis PMID: 41547360
SIBO Causes/Risk Factors
Diseases
Diverticulitis
Surgery
Diverticulitis
- Pockets of Trouble: Diffuse Jejunal Diverticulosis Causing Refractory Intestinal Microbial Overgrowth PMID: 41696667
Surgery
SIBO Pathophysiology
- Small Intestinal Bacterial Overgrowth and Systemic Laboratory Parameters: A Multivariable Cross-Sectional Analysis PMID: 41830029
- Real-world Study of Three-gas Breath Testing Nationwide and the Association With Symptoms PMID: 41671534
- Summary: 3004 subjects completed a Trio-Smart breath test and symptom questionnaire.
- “More subjects reported severe or very severe symptoms for bloating (52.9%) than diarrhea (17.8%), constipation (17.1%), or abdominal pain (17.1%).
- “...highest pain and severity [was] in ISO [hydrogen sulfide] alone.”
- “Glucose appears less sensitive than lactulose, suggesting it could potentially miss some symptomatic patients.”
- Summary: 3004 subjects completed a Trio-Smart breath test and symptom questionnaire.
- Molecular study of the small intestine dysbiosis derived from iron deficiency anaemia PMID: 41862558
- Potential subtype-specific alterations in gut microbiota and branched-chain amino acid metabolism in hydrogen- and methane-predominant small intestinal bacterial overgrowth PMID:41857155
SIBO Associated Conditions
Atopic Disorders NEW
- Possible Crosstalk Between Small Intestinal Bacterial Overgrowth (SIBO) and Atopic Manifestations-A Short Overview PMID: 41752000
- Summary: “The aim of our study was to perform a structured literature search to assess the possible correlation between SIBO and the presentation of atopic disorders. The prevalence of SIBO was highest in patients with BA (60-100%) and FA (50-87.5%), followed by MCAS (30.9%) and CSU (27.9%).”
- Relationship Between Hypothyroidism, Risk of Small Intestinal Bacterial Overgrowth, and Duodenal Microbiome Alterations PMID: 40908532
- Summary: “There is an increased risk of developing SIBO in those with hypothyroid,(32.65%) vs controls (15.17%).However, this risk appears to be mitigated by taking levothyroxine.
- The core small intestine microbiome is altered in hypothyroid (with or without SIBO),containing genus Neisseria, a Gram-negative coliform.
- In those with Hypothyroid and SIBO, klebsiella is also prevalent
- In those without hypothyroid who have SIBO, Escherichia/Shigella is prevalent.”
- Summary: “There is an increased risk of developing SIBO in those with hypothyroid,(32.65%) vs controls (15.17%).However, this risk appears to be mitigated by taking levothyroxine.
- Association of small intestinal bacterial overgrowth with portal hypertension in HCV-related cirrhosis: a cross-sectional study PMID: 41838205
- Mechanism and interventions of the bile acid-gut-liver axis imbalance in the progression of non-alcoholic fatty liver disease PMID: 41856295
- Alterations in Oro-cecal Transit Time and Small Intestinal Microbiota in Minimal Hepatic Encephalopathy with Small Intestinal Bacterial Overgrowth PMID:41769905
- Possible Crosstalk Between Small Intestinal Bacterial Overgrowth (SIBO) and Atopic Manifestations-A Short Overview PMID: 41752000
- Summary: “The aim of our study was to perform a structured literature search to assess the possible correlation between SIBO and the presentation of atopic disorders. The prevalence of SIBO was highest in patients with BA (60-100%) and FA (50-87.5%), followed by MCAS (30.9%) and CSU (27.9%).”
- Possible Crosstalk Between Small Intestinal Bacterial Overgrowth (SIBO) and Atopic Manifestations-A Short Overview PMID: 41752000
- Summary: “The aim of our study was to perform a structured literature search to assess the possible correlation between SIBO and the presentation of atopic disorders. The prevalence of SIBO was highest in patients with BA (60-100%) and FA (50-87.5%), followed by MCAS (30.9%) and CSU (27.9%).”
- Enteropathogenic Escherichia coli and Bacterial Overgrowth Co-infection Exacerbating Immune Checkpoint Inhibitor-Induced Colitis PMID: 41822656
- Gastrointestinal involvement in systemic sclerosis: A spotlight on small bowel involvement, complications and management PMID: 41620350
SIBO Testing
- Using breath tests in gastroenterology: Clear and reliable practitioner guide in 2025 PMID: 41793388
- Real-world Study of Three-gas Breath Testing Nationwide and the Association With Symptoms PMID: 41671534
- Summary: 3004 subjects completed a Trio-Smart breath test and symptom questionnaire.
- “More subjects reported severe or very severe symptoms for bloating (52.9%) than diarrhea (17.8%), constipation (17.1%), or abdominal pain (17.1%).
- “...highest pain and severity [was] in ISO [hydrogen sulfide] alone.”
- “Glucose appears less sensitive than lactulose, suggesting it could potentially miss some symptomatic patients.”
- Summary: 3004 subjects completed a Trio-Smart breath test and symptom questionnaire.
- Bloating and Breath Tests: A Pragmatic Approach PMID: 41685789
Methane
Hydrogen Sulfide
SIBO Treatment
Antibiotics
- Amoxicillin Clavulanate PMID: 30844191
- Summary: “The success rate of Amoxicillin Clavulanate antibiotic for SIBO is only 50%, much lower then for Rifaximin.”
- Rifaximin's therapeutic spectrum: approved indications and experimental insights into emerging uses PMID: 41729463
- Difficulties in diagnosing a pediatric patient with small intestinal bacterial overgrowth PMID: 41779466
- Prucalopride, a serotonin type 4 receptor agonist, induces fast anxiolytic/antidepressant effects and concomitant changes in the gut microbiota PMID: 41639084
- Summary: “Prucalopride (motegrity) showed rapid (within 7 days) anti-anxiety and anti-depression effects and restored Ruminococus levels in the microbiota, in this animal study.”
Diet
FODMAP
- NEW Effectiveness of the low FODMAP diet in patients with irritable bowel syndrome and small intestine bacterial overgrowth syndrome PMID: 41684777
- Summary: The first FODMAP diet study for SIBO!
Ninety eight patients with either IBS, SIBO or IMO (methane SIBO), completed an unvalidated questionnaire. The greatest effect was reduced bloating.
Unfortunately, results are clouded by the fact that 90.8%of participants took antibiotics before starting the diet (which treat SIBO and reduce symptoms independantly) and thus antibiotics predicted a better response to the diet.
- Summary: The first FODMAP diet study for SIBO!
- The Low-FODMAP Diet in Clinical Practice: Evidence-Based Indications, Implementation, and Interprofessional Care PMID: 32965895
- An umbrella review of meta-analyses on the low-FODMAP diet in IBS PMID: 41550863
- The Associations of Sucrase-Isomaltase Hypomorphic Variants With Long-Term Outcomes and Dietary Intake in an Australian Irritable Bowel Syndrome Population Educated on the FODMAP Diet: A Cross-Sectional and Retrospective Study PMID: 41546858
- Nutritional Management of Irritable Bowel Syndrome PMID: 41754216
- An online low-FODMAP educational intervention improves physical and psychological symptoms of irritable bowel syndrome PMID: 41406439
- Effects of a Personalised FODMAP Diet Versus the National Institute for Health and Care Excellence (NICE) Dietary Advice on Symptom Control in Patients With Irritable Bowel Syndrome: Randomised Clinical Trial PMID: 41784137
- Justification for the use of a FODMAP diet in patients with irritable bowel syndrome: focus on small intestinal disaccharidase activity PMID: 41801027
- Involvement of Eosinophil-Driven Intestinal Immune Activation in Different Irritable Bowel Syndrome Subtypes and in the Response to a FODMAP Lowering Diet: A Post Hoc Analysis of the Randomized Controlled DOMINO Trial PMID: 41670574
Related
- Slow Transit Constipation: Pathophysiological Perspectives and Management Updates PMID: 41646037
- Small Intestinal Fungal Overgrowth Mimicking a Surgical Abdomen and Presenting as Bowel Obstruction: A Case Report and Literature Review PMID: 41853095
- The antiparasitic drug Nitazoxanide enhances the susceptibility of Candida albicans to fluconazole PMID: 41547717
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