SIBO Studies: 2025

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• Overview
• Causes/Risk Factors
• Pathophysiology

• Associated Conditions
• Testing
• Hydrogen Sulfide

• Treatment
• Related

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SIBO Overview

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• Modern concepts of small intestinal bacterial overgrowth.  PMID: 40960427
  • Summary: Newest overview of SIBO, written by Dr. Mark Pimentel
• Small intestinal bacterial overgrowth: from malabsorption to misinterpretation.  PMID: 39804239
• [Small intestine bacterial overgrowth: Myths and realities].  PMID: 39799751

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SIBO Causes/Risk Factors

Diseases:
​  Cystic Fibrosis

• Low Plasma Choline, High Trimethylamine Oxide, and Altered Phosphatidylcholine Subspecies Are Prevalent in Cystic Fibrosis Patients with Pancreatic Insufficiency.  PMID: 40077735

Dyssynergic Defecation

• Dyssynergic Defecation Is Associated With Small Intestinal Bacterial Overgrowth.  PMID: 41204444 
  • Summary: "We found that pelvic floor dysfunction is associated with microbial overgrowth, especially Intestinal Methanogen Overgrowth!" John Damianos via X

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.

  Traumatic Brain Injury

• SEVERE TRAUMATIC BRAIN INJURY (TBI) INDUCED ACUTE SMALL INTESTINAL BACTERIAL OVERGROWTH WITHOUT PROINFLAMMATORY GENE INDUCTION
  • Summary: “Our data showed that severe TBI induced acute SIBO in the absence of proinflammatory gene induction.”
• 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).”

Drugs
  GLP-1 NEW

• Diagnostic Evaluation of an Increased Risk of Developing Small Intestinal Bacterial Overgrowth Associated with Glucagon-like Peptide-1 (GLP-1) Receptor Agonists and Dual GLP-1/GIP Receptor Agonists: A Global Retrospective Multicenter Cohort Analysis.  PMID: 40941750
  • Summary: this is the first large-scale study to identify an increased incidence of SIBO associated with GLP-1/GIP diabetes medications [Ozempic, Mounjaro]. The risk is associated with longer-term use (1 year). 
• GLP-1 Receptor Agonist Use Is Associated with Small Intestinal Bacterial Overgrowth and Intestinal Methanogen Overgrowth. DOI: https://doi.org/10.1177/26345161251353437
  • Summary: “GLP1RA use is associated with SIBO, although diabetes may be a confounder.”
• GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONISTS (GLP-1 RA) AND COMBINED GLP-1 RA + GLUCOSE-DEPENDENT INSULINOTROPIC POLYPEPTIDE THERAPY IS ASSOCIATED WITH DEVELOPING SMALL INTESTINAL BOWEL OVERGROWTH WITHIN A YEAR
  • Summary: Diabetes and weight loss drug usage (Ozempic/Mounjaro) “is associated with the development of SIBO within the first year.”
• ASSOCIATION OF SMALL INTESTINAL BACTERIAL OVERGROWTH WITH TREATMENTS FOR MORBID OBESITY
  • Summary: “there is a significant association of SIBO with GLP-1 agonist use” [Ozempic/Mounjaro] ​​​

  PPI

• Clinical utility of small intestinal bacterial overgrowth (SIBO) testing in guiding management of gas-bloat symptoms after antireflux surgery.  PMID: 40877632
• Pharmacodynamics, pharmacokinetics, interactions with other drugs, toxicity and clinical effectiveness of proton pump inhibitors.  PMID: 40771914
• The Duration of Proton Pump Inhibitor Therapy and the Risk of Small Intestinal Bacterial Overgrowth: A Systematic Review and Meta-Analysis.  PMID: 40649078 
  • Summary: “PPI use significantly increases the risk of SIBO, with longer treatment durations associated with higher odds … each additional month of PPI therapy was associated with a 4% increase in SIBO risk.”​

Surgery

• GAS-BLOAT SYMPTOMS AFTER ANTIREFLUX SURGERY: ASSESSMENT OF THE CLINICAL UTILITY OF SMALL INTESTINAL BACTERIAL OVERGROWTH (SIBO) TESTING RESULTS IN GUIDING POSTOPERATIVE MANAGEMENT.
• Alterations in Gut Microbiota After Upper Gastrointestinal Resections: Should We Implement Screening to Prevent Complications?  PMID: 41155808
  

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SIBO Pathophysiology

• Evaluating the Clinical Relevance of Elevated Mucosal Mast Cells in the Gastrointestinal Tract. PMID: 41474636
• Small intestine bacterial overgrowth breath test does not predict symptom severity in gut-brain interaction disorders: role of anxiety, depression and inflammatory biomarkers.  PMID: 40276984
  • Summary: “Abdominal pain correlated with levels of histamine and ghrelin, while abdominal distension correlated with I-FABP levels [intestinal-fatty acid binding protein].”
• Tracking Anti-cytolethal Distending Toxin B and Anti-vinculin Over Time and Their Roles in Symptoms. PMID: 40319417
• SMALL BOWEL TRANSCRIPTOMICS REVEALS SHARED PROTEOLYTIC DYSREGULATION AND DISTINCT GENE PROFILES IN SMALL INTESTINAL BACTERIAL OVERGROWTH (SIBO) AND INTESTINAL METHANOGEN OVERGROWTH (IMO)
• Small Bowel Transcriptomics Reveals Mitochondrial Pathways and Redox Genes as Key Players in Intestinal Sulfide Overproduction (ISO)
  • Summary: Gene expression in altered in all gas types of SIBO
    • SIBO (hydrogen) and IMO (methane) both show proteolysis dysregulation
    • SIBO pathways lead to immune response
    • IMO affects cell cycle control and antimicrobial properties
    • ISO (hydrogen sulfide) gene changes include:
      • increased oxidation (increased ROS & decreased anti-oxidation), cell death (ferroptosis), mucin (mucus), visceral hypersensitivity (substance P), inflammation, fluid into intestines (diarrhea)
      • decreased immune response and endogenous H2S production
      • changes to motility (downregulated genes associated with motility and transit time)
      • changes occurred even at H2S levels of 1.5-1.9ppm
• A STUDY OF THE HUMAN SMALL INTESTINAL MICROBIOME IN ANTEMORTEM SUBJECTS
• 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: 4015329
  • 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.​

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SIBO Associated Conditions

Bile Acid Dysmetabolism NEW

• ASSOCIATION OF ANORECTAL MANOMETRY MEASUREMENTS AND DYSSYNERGIA WITH HYDROGEN AND METHANE LEVELS IN EXHALED BREATH
  • Summary: “dyssynergia is more prevalent in patients with SIBO and IMO as compared to those with a negative breath test.”
• Bile acid dysmetabolism in Bangladeshi infants is associated with poor linear growth, enteric inflammation, and small intestine bacterial overgrowth.  PMID: 39973996
  

​Brain Fog

• Brain Fog in Gastrointestinal Disorders: Small Intestinal Bacterial Overgrowth, Gastroparesis, Irritable Bowel Syndrome.  PMID: 39495803

 
Cancer and  Causes: Surgery

• Prevalence and Impact on Quality of Life of Small Intestinal Bacterial Overgrowth (SIBO)-Related Symptoms in Patients with Upper Gastrointestinal Cancer. PMID: 41439939

Celiac Disease

• PREVALENCE OF SMALL INTESTINAL BACTERIAL OVERGROWTH IN CELIAC DISEASE AND ASSOCIATION WITH MARSH SCORE
  • Summary:  Prevalence SIBO in Celiac is 17.6-49.6% (by aspirate) and up to 23.1% (by breath test). SIFO is rare. SIBO does not appear to contribute to damage in treated celiac disease. SIBO should be considered as a cause for persistent symptoms in patients with celiac disease.
• NON-RESPONSIVE CELIAC DISEASE. A PROSPECTIVE COMPARATIVE MULTIDISCIPLINARY EVALUATION TO ELUCIDATE THE CAUSES AND FACTORS LINKED TO ITS PREVALENCE AT A DEDICATED CENTER.
  • Summary: SIBO was found in 3.6% of non-responsive celiac disease

​Children

• Small Intestinal Bacterial Overgrowth in Children with Short Bowel Syndrome.  PMID: 41300666
• Intestinal methanogen overgrowth and its impact on gastrointestinal disorders in children: a retrospective study.  PMID: 41316018
  • Summary: “IMO positivity is prevalent in children with gastrointestinal symptoms, particularly prominent among those with FGID [functional GI disorders]. The IMO positive group exhibited a lower incidence of diarrhea and more frequently demonstrated terminal ileal villous blunting.”
• Small intestinal bacterial overgrowth in children: An expert review by the ESPGHAN Gastroenterology Committee.  PMID: 40731137 
• Enhancing pediatric practice: A comprehensive review on malabsorption in pediatrics for diagnostic and management approach.  PMID: 40769093 
• Exploring small intestinal bacterial overgrowth in functional upper gastrointestinal disorder: A comprehensive case-control study.  PMID: 40881097
• Small Intestinal Bacterial Overgrowth and Pediatric Obesity-A Systematic Review.  PMID: 40362809
  • Summary: “SIBO is frequently observed in obese pediatric populations … These changes contribute to increased intestinal permeability, endotoxemia, and chronic low-grade inflammation.”

Chronic intestinal pseudo-obstruction

• INTERNATIONAL CONSENSUS ON CHRONIC INTESTINAL PSEUDO OBSTRUCTION IN ADULTS
• Hydrogen-Positive Small Intestinal Bacterial Overgrowth (SIBO) in Japanese Patients With Chronic Intestinal Pseudo-Obstruction (CIPO): A Cross-Sectional Study.  PMID: 41209870
  

Common variable immunodeficiency (CVID)

• Gastrointestinal Manifestations of Common Variable Immunodeficiency: A Mentored Review.  PMID: 40455348

Congenital sucrase-isomaltase deficiency

• IS YOUR PATIENT TRULY SUCRASE DEFICIENT? CONFIRMING DISACCHARIDASE DEFICIENCIES ON BIOPSY WITH BREATH TESTING
  • Summary: “Utilizing sucrose as a substrate to simultaneously perform the 13CSBT and Trio-Smart BT for SIBO offers a promising approach to enhance diagnostic accuracy and streamline clinical practice.”
• IS YOUR PATIENT TRULY SUCRASE DEFICIENT? CONFIRMING DISACCHARIDASE DEFICIENCIES ON BIOPSY WITH BREATH TESTING
  • Summary: “Utilizing sucrose as a substrate to simultaneously perform the 13CSBT and Trio-Smart BT for SIBO offers a promising approach to enhance diagnostic accuracy and streamline clinical practice.”

Cystic Fibrosis

• Impact of highly effective modulator therapy on gastrointestinal symptoms and features in people with cystic fibrosis.  PMID: 39341749
• SMALL INTESTINAL BACTERIAL OVERGROWTH IN PEOPLE WITH CYSTIC FIBROSIS: SYSTEMATIC REVIEW.  PMID: 40332310
• Low Plasma Choline, High Trimethylamine Oxide, and Altered Phosphatidylcholine Subspecies Are Prevalent in Cystic Fibrosis Patients with Pancreatic Insufficiency.  PMID: 40077735

Dyssynergic Defecation NEW

• Dyssynergic Defecation Is Associated With Small Intestinal Bacterial Overgrowth.  PMID: 41204444 
  • Summary: "We found that pelvic floor dysfunction is associated with microbial overgrowth, especially Intestinal Methanogen Overgrowth!" John Damianos via X
    

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.

Gastric Bypass

• Alterations in Gut Microbiota After Upper Gastrointestinal Resections: Should We Implement Screening to Prevent Complications?  PMID: 41155808
  

GERD

• Association of gastroesophageal reflux disease with small intestinal bacterial overgrowth: a case-control study.  PMID: 41131458
  
• Clinical utility of small intestinal bacterial overgrowth (SIBO) testing in guiding management of gas-bloat symptoms after antireflux surgery.  PMID: 40877632
• Can Symptoms and Medical History Predict Outcomes for Hydrogen and Methane Breath Testing?  PMID: 40788605
• The Lactulose Breath Test can Predict Refractory Gastroesophageal Reflux Disease by Measuring Bacterial Overgrowth in the Small Intestine.  PMID: 406898
• GAS-BLOAT SYMPTOMS AFTER ANTIREFLUX SURGERY: ASSESSMENT OF THE CLINICAL UTILITY OF SMALL INTESTINAL BACTERIAL OVERGROWTH (SIBO) TESTING RESULTS IN GUIDING POSTOPERATIVE MANAGEMENT.
  • Summary: “SIBO testing and treatment can guide management of persistent gas-bloat symptoms and improve outcomes after ARS.” [anti-reflux surgery]
• GASTROESOPHAGEAL REFLUX DISEASE AND BARRETT'S ESOPHAGUS ARE ASSOCIATED WITH SIGNIFICANT AND UNIQUE ALTERATIONS IN THE SMALL BOWEL MICROBIOME
  • Summary: small intestine microbiome is altered in GERD and Barrett’s esophagus with Barrett’s showing more alteration.
    • Helicobacter was decreased in GERD and even more decreased in Barrett’s
    • In GERD, there was higher Desulfovibrinaceae, Bilophila, Aeromonadaceae, Aeromonas and lower Clostridiaceae
    • “GERD subjects have increased H2S producers”
• 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.”

Gu Syndrome NEW

• Self-Directed Recovery of Gu Syndrome: Reversal of Multisystem Dysfunction via Microbiome Restoration and Subconscious-Guided Protocols.  PMID: 41246705

Halitosis

• Therapeutic effect of the low FODMAPs diet for refractory halitosis associated with small intestinal bacterial overgrowth.  PMID: 40992384
  
• Extraoral halitosis in functional dyspepsia and its association with small intestinal bacterial overgrowth.  PMID: 39903942

HIV

• Gastrointestinal Dysmotility, Autonomic Function, and Small Intestinal Bacterial Overgrowth Among People With Well-Controlled HIV.  PMID: 40358243

Hypertension (High Blood Pressure)

• Small intestinal bacterial overgrowth as one of the diagnostic markers of hypertension.  PMID: 40813611

Hypothryroid

• Relationship between hypothyroidism, risk of small intestinal bacterial overgrowth, and duodenal microbiome alterations. PMID: 40908532
  • Summary: “SIBO prevalence was higher in the hypothyroid group (32.65%) vs. controls (15.17%).”
  • From "Research Update" section above: “SIBO associated with hypothyroidism may be of a different phenotype than the SIBO in other patients.” And “bacteria found in subjects with hypothyroidism + SIBO differ from those with #SIBO alone, suggesting unique microbial signatures between the two groups” - Dr. Pimentel and Dr. Wei 

IBD (Inflammatory Bowel Disease)

• [Clinical features of ulcerative colitis in patients with small intestinal bacterial overgrowth].  PMID: 40764120
• 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)

• Ileal Biofilms Confirm SIBO-IBS Hypothesis: Comment on PMID 38798120.  PMID: 41133378
• Response to Maximilian and Gasche.  PMID: 41102925
• Survey of Latin American gastroenterologists, specialists in disorders of gut-brain interaction, on the diagnosis and treatment of irritable bowel syndrome in clinical practice.  PMID: 41111058
• Can Symptoms and Medical History Predict Outcomes for Hydrogen and Methane Breath Testing?  PMID: 40788605
• The evolution of irritable bowel syndrome as a group of organic diseases: a narrative review.   PMID: 40823787
  • Summary: “Although existing symptom-based diagnostic criteria for IBS have been useful, they have contributed to a situation whereby current treatments address symptoms, not the underlying causes. Approaching IBS as a constellation of diseases with individual organic bases will allow the development of more precisely targeted and effective treatments.” Amen!
• Impact of Positive Glucose, Lactose, and Fructose Hydrogen Breath Tests on Symptoms and Quality of Life in Irritable Bowel Syndrome.  PMID: 39854015

Intestinal Failure

• Small intestinal bacterial overgrowth and dysbiosis in children with intestinal failure: A descriptive cohort study.  PMID: 40722249
• Updates in Intestinal Failure Management.  PMID: 40364063

Lactose Intolerance

• Response to V. Martín-Dominguez Et Al.: Re-Evaluating the Diagnostic Approach to Lactose Malabsorption.  PMID: 41319163

Liver Disease

• Small Intestinal Bacterial Overgrowth Is a Predictor of Overt Hepatic Encephalopathy in Patients with Liver Cirrhosis.  PMID: 40094949 
• Small intestinal bacterial overgrowth in chronic liver disease: an updated systematic review and meta-analysis of case-control studies.  PMID: 39844931

Long Covid

• BACTERIA-DERIVED HYDROGEN SULFIDE IMPROVES ENDOTOXIN LEVELS IN LONG COVID.

Mood Disorders 

• Small intestine bacterial overgrowth breath test does not predict symptom severity in gut-brain interaction disorders: role of anxiety, depression and inflammatory biomarkers.  PMID: 40276984
  • Summary: “Abdominal pain correlated with levels of histamine and ghrelin, while abdominal distension correlated with I-FABP levels [intestinal-fatty acid binding protein].”​

Obesity

• Small Intestinal Bacterial Overgrowth and Pediatric Obesity-A Systematic Review.  PMID: 40362809
  • Summary: “SIBO is frequently observed in obese pediatric populations … These changes contribute to increased intestinal permeability, endotoxemia, and chronic low-grade inflammation.”
• GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONISTS (GLP-1 RA) AND COMBINED GLP-1 RA + GLUCOSE-DEPENDENT INSULINOTROPIC POLYPEPTIDE THERAPY IS ASSOCIATED WITH DEVELOPING SMALL INTESTINAL BOWEL OVERGROWTH WITHIN A YEAR
  • Summary: Diabetes and weight loss drug usage (Ozempic/Mounjaro) “is associated with the development of SIBO within the first year.”
• ASSOCIATION OF SMALL INTESTINAL BACTERIAL OVERGROWTH WITH TREATMENTS FOR MORBID OBESITY
  • Summary: “there is a significant association of SIBO with GLP-1 agonist use” [Ozempic/Mounjaro]

Pancreatitis

• Gastrointestinal Symptom Burden After Total Pancreatectomy with Islet Autotransplantation, A Prospective Observational Cohort Study.  PMID: 41172147
  
• The intricate interplay between acute pancreatitis and small intestinal bacterial overgrowth: Unraveling the unknown.  PMID: 40664102 Review.

Parkinson’s Disease

• Management of Gastrointestinal Symptoms in Parkinson's Disease.  PMID: 40823476
• HYDROGEN SULFIDE INCREASES IN PARKINSON'S DISEASE ON LACTULOSE BREATH TESTING
  • Summary: “The prevalence of H2S SIBO is higher in PD [Parkinson’s Disease] when compared with HC [healthy controls].”
    

PPI

• Proton pump inhibitors are not associated with an increased risk of Clostridioides difficile infection: a systematic review and meta-analysis of randomized controlled trials.  PMID: 41047657

Pouchitis

• PREOPERATIVE SMALL INTESTINAL BACTERIAL OVERGROWTH AND ITS ASSOCIATION WITH POUCHITIS IN ILEAL POUCH ANAL ANASTOMOSIS PATIENTS, A PROPENSITY SCORE MATCHED COHORT STUDY

Restless Legs Syndrome

• Analysis of gut microbiota in Restless Legs Syndrome: searching for a metagenomic signature.   PMID: 41378921

Rosacea

• The exposomal imprint on rosacea: More than skin deep.  PMID: 41081484
• [Prevalence and risk of small intestinal bacterial overgrowth in patients with rosacea: A systematic review and meta-analysis].  PMID: 40778919
  • Summary: There is a 3.5 x higher risk of developing SIBO in patients with rosacea

​​Scleroderma

• Nutritional Status and Dietary Challenges in Patients with Systemic Sclerosis: A Comprehensive Review.  PMID: 41097221
• Prevalence, clinical characteristics, and hospital course of systemic sclerosis-associated pseudo-obstruction.  PMID: 41032167
• The efficacy of probiotics, prebiotics or synbiotics in scleroderma: A systematic review.  PMID: 40311922
• Anti-cytolethal distending toxin antibodies in systemic sclerosis: associations with gastrointestinal disease and immune dysregulation.  PMID: 4063769

Short Bowel Syndrome

• Small Intestinal Bacterial Overgrowth in Children with Short Bowel Syndrome.  PMID: 41300666
• Current treatment options for adult patients with short gut syndrome: Do prebiotics, probiotics, and synbiotics play a role?  PMID: 40344579

SIFO (Fungal/Yeast Overgrowth)

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• Self-Directed Recovery of Gu Syndrome: Reversal of Multisystem Dysfunction via Microbiome Restoration and Subconscious-Guided Protocols.  PMID: 41246705
• Small Intestinal Bacterial and Fungal Overgrowth: Health Implications and Management Perspectives. PMID: 40284229

Traumatic Brain Injury

• SEVERE TRAUMATIC BRAIN INJURY (TBI) INDUCED ACUTE SMALL INTESTINAL BACTERIAL OVERGROWTH WITHOUT PROINFLAMMATORY GENE INDUCTION
  • Summary: “Our data showed that severe TBI induced acute SIBO in the absence of proinflammatory gene induction.”
• 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).” 

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SIBO Testing

• Frequent errors in the interpretation of breath tests in patients with suspected small intestinal bacterial overgrowth (SIBO).  PMID: 40503974
• Implementation of a digital tool to assist physicians during breath tests for SIBO: Impact on diagnostic accuracy, report quality and physician workload.  PMID: 41110827
• Response to V. Martín-Dominguez Et Al.: Re-Evaluating the Diagnostic Approach to Lactose Malabsorption.  PMID: 41319163
• Hypersensitivity to the lactulose nutrient challenge test in irritable bowel syndrome - a non-invasive test of meal-related symptoms.  PMID: 41247041
• Evacuation Dysfunction Does Not Impact Breath Test Results. PMID: 41388564
• Diagnostic Evaluation of Small Intestinal Microbial Overgrowth: A Cross-Sectional Comparison of Glucose and Lactulose Breath Tests. PMID: 41464822 Free PMC article.
• Gas-tly Interpretations: A Case-Based Approach to the Nuances of SIBO Breath Testing. PMID: 40307658
• AN INTEGRATIVE APPROACH TO IMPROVE 3 GAS BREATH TESTS USING PATIENT SYMPTOM PROFILE BY MACHINE LEARNING
  • Summary: Breath test study with trio-smart on gas types and their associated symptoms and symptom severity
    • Hydrogen sulfide drives diarrhea in all gas types
    • Methane drives constipation, in absence of hydrogen sulfide
    • Hydrogen sulfide is associated with severe diarrhea, pain and urgency
    • Combinations of gases are associated with the overall greatest symptom severity
    • When all 3 gases are positive (hydrogen + methane + hydrogen sulfide) there is a mixed pattern of both constipation and diarrhea
    • Hydrogen + Methane combination only has constipation when hydrogen sulfide is absent
    • Thoughts: if hydrogen and methane are both positive on a 2-test, but there is diarrhea – there is likely hydrogen sulfide
• LACTULOSE BREATH TESTING IS MORE OFTEN POSITIVE AND ASSOCIATED WITH SYMPTOMS COMPARED TO GLUCOSE IN A NATIONWIDE STUDY OF KIT-BASED THREE-GAS BREATHING
  • Summary: Breath test study with trio-smart comparing lactulose to glucose
    • Lactulose testing for hydrogen (SIBO) was positive more often versus glucose and correlated with symptoms (aka glucose has more false negatives)
• REAL WORLD STUDY OF THREE-GAS BREATH TESTING NATIONWIDE AND THE ASSOCIATION WITH SYMPTOMS
  • Summary:
    • Bloating is the most common reason for SIBO testing
    • Methane is associated with greater constipation severity and any level of constipation meant a mean methane ≥ 10ppm
    • Hydrogen sulfide (H2S) was associated with a greater severity of diarrhea, pain, and urgency and subjects with the most severe diarrhea had the highest H2S levels
• ENDOSCOPIC-ASSISTED GLUCOSE BREATH TEST FOR EVALUATING DISTAL SMALL INTESTINAL BACTERIAL OVERGROWTH: CORRELATION OF NUCLEAR IMAGING AND BREATH TEST
• HOW RELIABLE ARE BREATH TESTS FOR SIBO AND IMO? A CRITICAL EVALUATION IN HEALTHY CONTROLS
• COMPARISON OF GLUCOSE AND LACTULOSE BREATH TEST PERFORMANCES IN PATIENTS WITH BLOATING AND CONSTIPATION
• DIURNAL, AGE-, AND SEX-RELATED VARIATIONS IN HYDROGEN AND METHANE EXCRETION AS DETECTED BY A HAND-HELD PERSONAL GAS ANALYZER
• BASELINE SPOT BREATH HYDROGEN (H2) WAS ASSOCIATED WITH BLOATING SEVERITY AND FODMAPS RESTRICTION RESPONSE IN PATIENTS WITH DISORDERS OF GUT-BRAIN INTERACTION (DGBI)
• ADVANCING INTESTINAL METHANOGEN OVERGROWTH MANAGEMENT WITH LONGITUDINAL BREATH METHANE SAMPLING
  • Summary: Methane-SIBO/IMO case study with new handheld, at-home breath testing device “OMED Health Breath Analyzer, a portable system for analyzing hydrogen and methane levels in breath.“
• DISTINCT BREATH GAS PROFILES IN RESPONSE TO COMMONLY CONSUMED FERMENTABLE CARBOHYDRATES
  • Summary: Foodmarble test of 4 food intolerances: lactose, fructose, sorbitol and inulin
    • Shorter/simpler carbohydrates like fructose, produce earlier hydrogen peaks vs. complex carbs, like inulin
    • “Sorbitol elicited the highest hydrogen positivity rate (53.8%), followed by inulin (38.9%), fructose (28.2%), and lactose (23.9%)”
    • “Methane (CH4/) responses were less distinct than hydrogen responses, with lower peak CH4 concentrations and less dynamic changes”
• SMART UNDERWEAR: A NOVEL WEARABLE FOR LONG-TERM MONITORING OF GUT MICROBIAL GAS PRODUCTION VIA FLATUS WITH IMPLICATIONS FOR IBS SYMPTOM ASSESSMENT
  • Summary: The Chuckle Award! Gas measuring underwear device for use in IBS/FODMAP studies.
    • “Smart Underwear is a snap-on device compatible with any underwear style… that enables long-term, continuous monitoring of gut microbial gas production through real-time detection of hydrogen in flatus during daily activities. … it detected increased microbial activity following inulin consumption in 94.7% of participants.”
• Usefulness of a Digital Tool to Improve Methodology and Reporting of Breath Tests for Small Intestinal Bacterial Overgrowth.  PMID: 40013842
  • Summary: “The use of a web-based digital tool specifically developed to assist the entire BT process appears to improve accuracy and quality of reports.”
• Development of a Transcriptional Biosensor for Hydrogen Sulfide that Functions under Aerobic and Anaerobic Conditions  PMID: 40027654​

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Methane

• Intestinal methanogen overgrowth and its impact on gastrointestinal disorders in children: a retrospective study.  PMID: 41316018
  • Summary: “IMO positivity is prevalent in children with gastrointestinal symptoms, particularly prominent among those with FGID [functional GI disorders]. The IMO positive group exhibited a lower incidence of diarrhea and more frequently demonstrated terminal ileal villous blunting.”
• A NOVEL MICROBIOME THERAPY, CS-06 (METHYLENETETRAHYDROMETHANOPTERIN DEHYDROGENASE [MTD] BLOCKER), REDUCES METHANE PRODUCTION IN STOOL CULTURE AND IMPROVES THE PHENOTYPE IN A RAT MODEL OF CONSTIPATION
  • Summary: new treatment CS-06 significantly reduces methane (CH4) and constipation
    • 5 mg CS-06 reduced CH4 levels by 42% and 72% after 4 hours in human stool
    • 10 mg CS-06 reduced CH4 to 0 ppm in 24 hours in rat stool
    • In rats with CH4 overproduction & constipation, 10 mg CS-06 x 10 days reduced methane and constipation
    • Mechanism: blocks an enzyme (MTD) that makes methane from hydrogen
• REDUCTION OF BREATH METHANE LEVELS CORRELATES WITH FECAL ABUNDANCE OF METHANOBREVIBACTER SMITHII FOLLOWING TWO-WEEKS OF EXCLUSIVE ORAL ELEMENTAL DIET: A PROSPECTIVE CLINICAL TRIAL
  • Summary: Elemental diet (mBiota) is successful for methane-SIBO/IMO
    • 2 weeks of mBiota elemental diet reduced M. smithii levels, methane levels and symptoms
    • Symptoms decreased were: pain/discomfort, bloating/distention, constipation, flatulence, fatigue, diarrhea, urgency and brain fog

• ADVANCING INTESTINAL METHANOGEN OVERGROWTH MANAGEMENT WITH LONGITUDINAL BREATH METHANE SAMPLING
  • Summary: Methane-SIBO/IMO case study with new handheld, at-home breath testing device “OMED Health Breath Analyzer, a portable system for analyzing hydrogen and methane levels in breath.“
• DELAYED SMALL BOWEL TRANSIT BASED ON SCINTIGRAPHY IS ASSOCIATED WITH METHANE-PREDOMINANT SMALL INTESTINAL BACTERIAL OVERGROWTH
  • Summary: Slow small intestine motility was correlated with methane SIBO/IMO.
• RISK FACTORS, CLINICAL PRESENTATIONS, AND TREATMENT OUTCOMES IN PATIENTS WITH SMALL INTESTINAL BACTERIAL OVERGROWTH (SIBO) AND SIBO WITH INTESTINAL METHANOGEN OVERGROWTH (IMO): A 10-YEAR RETROSPECTIVE STUDY
• FECAL MICROBIOME RICHNESS AND EVENNESS ARE REDUCED AND THE RELATIVE ABUNDANCE OF FIRMICUTES SPECIES IS INCREASED IN PATIENTS WITH INTESTINAL METHANOGEN OVERGROWTH
• INTESTINAL METHANOGEN OVERGROWTH SIGNIFICANTLY DECREASES FOOD INTOLERANCE BREATH TESTING SENSITIVITY
• Age-related dynamics of predominant safetyic archaea in the human gut microbiome. PMID: 4018125

Hydrogen Sulfide

• The Role of Bacteria-Derived Hydrogen Sulfide in Multiple Axes of Disease.  PMID: 40244174
• PRESENTATION AND TREATMENT OUTCOMES IN SMALL INTESTINAL BACTERIAL OVERGROWTH WITH HYDROGEN SULFIDE AND CONCOMITANT GASES
  • Summary: “The recognition of H2S as a measurable indicator for SIBO and subsequent addition to breath testing [via Trio-Smart] captures a whole new subgroup of patients with H2S-dominant SIBO who would have been missed in the past.”
• HYDROGEN SULFIDE INCREASES IN PARKINSON'S DISEASE ON LACTULOSE BREATH TESTING
  • Summary: “The prevalence of H2S SIBO is higher in PD [Parkinson’s Disease] when compared with HC [healthy controls].”​

• Development of a Transcriptional Biosensor for Hydrogen Sulfide that Functions under Aerobic and Anaerobic Conditions  PMID: 40027654​

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SIBO Treatment 

• Biofilm Disruption Enhances Antimicrobial Therapy for Small Intestinal Bacterial Overgrowth and Intestinal Methanogen Overgrowth.  PMID: 41394228
  • Summary: new article from my friend Michael Ruscio
     “Adding a biofilm disruptor to herbal antimicrobials was associated with significantly greater reductions in hydrogen and methane gas levels. Larger prospective, controlled studies are needed to validate these findings and clarify the potential role of biofilm disruptors in the management of SIBO/IMO.”
• Comparative efficacy of diverse therapeutic regimens for small intestinal bacterial overgrowth: a systematic network meta-analysis. PMID: 41394885
• Effect, Tolerability, and Safety of Exclusive Palatable Elemental Diet in Patients with Intestinal Microbial Overgrowth. PMID: 40189034 [mBiota Elemental]
• The Safety of Pharmacotherapy for Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis. PMID: 40471839
• Should We Treat SIBO Patients? Impact on Quality of Life and Response to Comprehensive Treatment: A Real-World Clinical Practice Study.  PMID: 40219008
• REAL WORLD EXPERIENCE WITH A MULTI-ENZYME SUPPLEMENT TARGETING KEY FODMAPS IN PATIENTS WITH IBS
  • Summary: FODZYME supplement significantly improved IBS symptoms, with 72.1% having improvement in bloating, 69.5% having improvement in diarrhea, 67.3% in constipation, and 57.4% in abdominal pain
    • FODZYME or (exclusive pricing at Fullscript)
• Drugs for irritable bowel syndrome.  PMID: 39912839
• Comparison chart: Safety of drugs for IBS in pregnancy and lactation.  PMID: 39912840
• Comparison chart: Some drugs for irritable bowel syndrome with diarrhea (IBS-D).  PMID: 39912844

Antibiotics

• Clinical Trial: Rifaximin Versus Low FODMAP Diet in Irritable Bowel Syndrome.  PMID: 41098003
  • Summary: “rifaximin led to significantly earlier individual symptom improvement [vs. Low FODMAP Diet] at Week 2, including global symptoms (90.0% vs. 72.0), bloating (84.0% vs. 58.0%) and abdominal pain (80.0% vs. 58.0%).
  • “SIBO eradication was observed in 63.6% (rifaximin) and 50.0% (LFD). Adherence was significantly better with rifaximin (95.9% vs. 77.8%
• Impact of four-week rifaximin treatment on abdominal symptoms, psychological state and gut microbiome in diarrhea-predominant irritable bowel syndrome: a pilot study.  PMID: 41110752
• Rifaximin improves anxiety- and depression-like behaviors in rats by regulating NPY in the colon and mPFC.  PMID: 41430083
  • Summary: In an animal model, rifaximin has an anti-anxiety and anti-depressant effect.
    “its mechanism may be related to the rifaximin's regulation on NPY [neuropeptide Y] mediated gut-brain axis between colon and mPFC [medial prefrontal cortex in the brain].
• [Study on the efficacy of combination therapy with rifaximin and Saccharomyces boulardii CNCM I-745 in patients with small intestinal bacterial overgrowth associated with long-term use of proton pump inhibitors].  PMID: 40884341
  • Summary: Florastor (Saccharomyces boulardii CNCM I-745) + Rifaximin was more effective than Rifaximin alone for SIBO eradication, symptom relapse, and quality of life, in patients with PPI-associated SIBO.
• Lycium barbarum Glycopeptide Alleviates Neomycin-Induced Ototoxicity by Inhibiting Tryptophan Hydroxylase-Mediated Serotonin Biosynthesis.  PMID: 40135846
  • Lycium barbarum is also known as goji berries
• LOW- AND HIGH-DOSE RIFAXIMIN VERSUS LOW-DOSE RIFAXIMIN COMBINED WITH N-ACETYLCYSTEINE FOR TREATING DIARRHEA-PREDOMINANT IRRITABLE BOWEL SYNDROME: A DOUBLE-BLIND, RANDOMIZED PROOF-OF-CONCEPT TRIAL
  • Summary: 1st human study on Rifaximin + NAC [in a special complexed preparation] for SIBO
    • Low dose Rifaximin + NAC (Rifaximin 200 mg + NAC 600 mg) 3 x day x 2 weeks is superior to Rifaximin alone for SIBO
      • there were greater reductions in gas, including significant reduction in hydrogen sulfide
      • with improvements in bloating, diarrhea, pain, IBS severity and mucus
    • Rifaximin +NAC did not disrupt the microbiome
      • “Similar to previous rifaximin studies, there was no major disruption of the microbiome in any of the groups.” 
• Rifaximin as a Therapeutic Ally in the Modulation of Dysbiosis: A Narrative Review of Its Applicability in Gastrointestinal Disorders.  PMID: 40530108
• 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.

Herbal Antibiotics

• ​
• Chronic administration of berberine attenuates depressive-like behavior in rats subjected to chronic unpredictable mild stress combined with ACTH treatment: Role of nitrergic system. PMID: 41429409
  • Summary: animal model - “berberine treatment may exert its antidepressant-like and memory-enhancing effects, at least in part, by attenuating hypothalamic-pituitary-adrenal (HPA) axis hyperactivity, potentially through the involvement of nitrergic signaling.”
• Therapeutic effects of olive leaf tea (Olea europaea L.) on gastrointestinal symptoms and body composition in adults with small intestinal bacterial overgrowth.  PMID: 40917089
  • Summary: 2 months of olive leaf tea (1.7 g leaf powder/250 mL hot water x 7-10 minutes) 2 x day, had a significant decrease in symptoms, gas peak and mean levels (hydrogen and methane), with 88% glucose test normalization rate.

Fecal Micobiota Transplantation (FMT)

• Advances in capsule-based fecal microbiota transplantation: clinical applications and innovations.  PMID: 41331614

Probiotics

• Probiotic Blend of Lactobacillus acidophilus LA-5 and Bifidobacterium animalis ssp. Lactis BB-12 in Non-constipated Irritable Bowel Syndrome: A Double-Blind Randomized Placebo-Controlled Trial.  PMID: 41255078
• [Study on the efficacy of combination therapy with rifaximin and Saccharomyces boulardii CNCM I-745 in patients with small intestinal bacterial overgrowth associated with long-term use of proton pump inhibitors].  PMID: 40884341
  • Summary: Florastor (Saccharomyces boulardii CNCM I-745) + Rifaximin was more effective than Rifaximin alone for SIBO eradication, symptom relapse, and quality of life, in patients with PPI-associated SIBO.
• 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.

Prokinetics

• Iberogast in functional dyspepsia: yesterday, today, and tomorrow - a narrative review of a multitarget phytomedicine.  PMID: 41319263
  • Summary: “Iberogast remains an evidence-based phytomedicine with a favorable safety profile, filling therapeutic gaps in FD by targeting motility, hypersensitivity, inflammation, and barrier function.”
• Effect of STW 5-II (Iberogast-N) on Tolerance to Gastric Gas in Patients With Functional Dyspepsia. The IBO-2 Study.  PMID: 40684457
  • Summary: Gas was infused into the stomach of dyspepsia and bloating patients - gas evacuation was faster and gas retention was less in those on Iberogast.
• Mechanistic Insights Into Prucalopride's Role in Irritable Bowel Syndrome Treatment: Schwann-like Enteric Glial Cells as Therapeutic Targets.  PMID: 40609660
  • Summary: “the findings…suggest that prucalopride may act on Schwann-like enteric glial cells to promote neurogenesis, thereby restoring neuronal populations and potentially modulating visceral sensitivity. This regenerative effect offers a comprehensive therapeutic approach for IBS, targeting not only motility dysfunction but also underlying neuronal deficits.”

Diet: FODMAP Diet

• Therapeutic effect of the low FODMAPs diet for refractory halitosis associated with small intestinal bacterial overgrowth.  PMID: 40992384
• Clinical Trial: Rifaximin Versus Low FODMAP Diet in Irritable Bowel Syndrome.  PMID: 41098003
  • Summary: “rifaximin led to significantly earlier individual symptom improvement [vs. Low FODAM Diet] at Week 2, including global symptoms (90.0% vs. 72.0), bloating (84.0% vs. 58.0%) and abdominal pain (80.0% vs. 58.0%).
  • “SIBO eradication was observed in 63.6% (rifaximin) and 50.0% (LFD). Adherence was significantly better with rifaximin (95.9% vs. 77.8%
• Impact of Short Duration FODMAP Restriction on Breath Gases and Gastrointestinal Symptoms.  PMID: 40622403
• Impact of low-FODMAP diet on symptom relief in irritable bowel syndrome patients.  PMID: 41338949
• Modification of the Low FODMAP Diet Is Feasible in the Treatment of Irritable Bowel Syndrome: A Randomised Crossover Study.  PMID: 41278484 Free PMC article.
• Development and Validation of a Self-Administered Simplified Food Frequency Questionnaire for FODMAP Intake Evaluation (FFQ-FODMAP-BE).  PMID: 41091284
• Implementing a Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Diet in Asia: Addressing Cultural, Clinical and Practical Challenges.  PMID: 41077745 Free
• Targeting Irritable Bowel Syndrome Through Diet and Mechanism-Based Therapies: A Pathophysiological Approach.  PMID: 41305645
• An online low-FODMAP educational intervention improves physical and psychological symptoms of irritable bowel syndrome. PMID: 41406439
• A study on the utility of inflammatory biomarkers in primary care irritable bowel syndrome: a sub analysis of the DOMINO randomized trial. PMID: 41436948
• Unlocking the potential of the low FODMAP diet: comprehensive insights into clinical efficacy, microbiome modulation, and beyond.  PMID: 40497754 
• Assessing the Impact of the Low-FODMAP Diet on IBS Management in Asian Countries: A Systematic Review and Meta-Analysis of Evidence.  PMID: 40715773 
• Low FODMAP Diets in Populations with IBS: Modifying Western Concepts to Eastern Populations.  PMID: 40913725
• Impacts of the Long-Term Low-FODMAP Diet in Patients With Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.  PMID: 40735813  
• A 12-Week Strict Low FODMAP Diet Reduces the Severity Levels of Fatigue, Depression, Anxiety, and Inattention in Patients with Irritable Bowel Syndrome.  PMID: 40654377
• Increase in circulating GLP-1 following low FODMAP diet in irritable bowel syndrome patients.  PMID: 40880735
  • Summary: In IBS patients, a 12-week low FODMAP diet, decreased IBS symptoms and body weight, and increased GLP-1 levels (from average 3.3 pM to 3.6 pM).
• Impact of Short Duration FODMAP Restriction on Breath Gases and Gastrointestinal Symptoms.  PMID: 40622403
  • Summary: 1-week low FODMAP diet reduced bloating, abdominal pain, flatulence, methane and hydrogen.
• Effects of Probiotics and Diet Management in Patients With Irritable Bowel Syndrome: A Systematic Review and Network Meta-analysis.  PMID: 39862384
• Dietary Intake, Symptom Control and Quality of Life After Dietitian-Delivered Education on a FODMAP Diet for Irritable Bowel Syndrome: A 7-Year Follow Up.  PMID: 40589416
• Dietary fermentable polyols fuel gut inflammation through M1 macrophage polarization and gut microbiota.  PMID: 40678521
• The Ten Dietary Commandments for Patients with Irritable Bowel Syndrome: A Narrative Review with Pragmatic Indications.  PMID: 40806081
• Effects of a polyphenol-rich extract blend, probiotics, and hydrolyzed fiber on quality of life and gut health markers in patients with irritable bowel syndrome-A randomized, double-blind, placebo-controlled trial.  PMID: 40693198
• Remission of irritable bowel syndrome with lifestyle medicine.  PMID: 40735575
• Microwave irradiation benefits fructan degradation in sourdough steamed cake by tunning the β-fructosidase FosE-substrate interaction.  PMID: 40120306
  • Summary: Microwave heating activates β-fructosidase FosE enzyme in sourdough cake, which breaks down Fructans (lowering the fructan amount of sourdough). This enzyme is secreted by L. paracasei in sourdough.
• Self-Reported Food Triggers and Food Fears Impact Nutrient Intake and Quality of Life in Patients with Irritable Bowel Syndrome and Functional Dyspepsia.  PMID: 40709425 ​
• Nutritional Approach to Small Intestinal Bacterial Overgrowth: A Narrative Review. PMID: 40362719
  • Summary: I was very pleased to see this article discussing the importance of low-fermentation diets for SIBO – great job from the team at University Complutense Madrid!
    • “Nutrition and diet therapy play a pivotal role in SIBO management, not only in alleviating symptoms but also in preventing relapses.”
    • “This diet [low FODMAP] relieves discomfort, abdominal distension, gas production, and diarrhea. Such symptomatic relief can help patients halt the weight loss caused by chronic diarrhea and, more importantly, improve their mood, energy levels, and quality of life.”
    • “In terms of diet therapy, individualization is paramount.”
• Predicting response to the low FODMAP diet in irritable bowel syndrome: Current evidence and clinical considerations.  PMID: 40419398
• Unlocking the potential of the low FODMAP diet: comprehensive insights into clinical efficacy, microbiome modulation, and beyond.  PMID: 40497754 Review.
• The effect of low-FODMAP diet on patients with irritable bowel syndrome.  PMID: 40350523
• Clinical Trial: A Mediterranean Low-FODMAP Diet Alleviates Symptoms of Non-Constipation IBS-Randomized Controlled Study and Volatomics Analysis.  PMID: 40362860
• Efficacy of dietary interventions in irritable bowel syndrome: a systematic review and network meta-analysis.  PMID: 40258374
• Dietary Therapy in Irritable Bowel Syndrome].  PMID: 40276825
• Diet, nutraceuticals, and lifestyle interventions for the treatment and management of irritable bowel syndrome.  PMID: 40346863 Review.
• [Food intolerances: more often suspected than confirmed].  PMID: 40336389
• Effects of dietary FODMAP content on the faecal microbiome and gastrointestinal physiology in healthy adults: a randomised, controlled cross-over feeding study.  PMID: 40270118
• Efficacy of Mediterranean Diet vs. Low-FODMAP Diet in Patients With Nonconstipated Irritable Bowel Syndrome: A Pilot Randomized Controlled Trial.  PMID: 40273380
• Leptin and PAI-1 Levels Are Decreased After a Dietary Intervention in Patients with Irritable Bowel Syndrome.  PMID: 40429752
• PSYLLIUM DELAYS COLONIC FERMENTATION OF INULIN AS ASSESSED BY A NOVEL GAS SENSING CAPSULE: A RANDOMISED PLACEBO-CONTROLLED TRIAL OF METHYLCELLULOSE VERSUS PSYLLIUM OR MALTODEXTRIN CONTROL
• IMPACT OF A LOW FODMAP DIET ON NUTRITIONAL STATUS AND GASTROINTESTINAL SYMPTOMS IN PATIENTS WITH IRRITABLE BOWEL SYNDROME AND IDIOPATHIC CHRONIC ULCERATIVE COLITIS: A RANDOMIZED CLINICAL TRIAL
• FEASIBILITY AND EFFICACY OF DIGITALLY DELIVERED DIETARY TREATMENT FOR IRRITABLE BOWEL SYNDROME: A PILOT STUDY
• FODMAP REINTRODUCTION IN CLINICAL PRACTICE: SURVEYING THE GAPS AND OPPORTUNITIES
• LOW FODMAP EXPOUNDED: A NEW ELUCIDATION ON PATIENT ATTITUDES, CHALLEGES AND OUTCOMES
• THE IMPACT OF DIETARY FIBRES ON GUT BARRIER INTEGRITY, MICROBIAL INTERACTIONS AND NEUROENDOCRINE SIGNALLING IN IRRITABLE BOWEL SYNDROME
• DIET & LIFESTYLE INTERVENTIONS UTILIZED FOR IBS: INSIGHTS FROM A SURVEY AMONG HEALTHCARE PROVIDERS
• GI SYMPTOM-RELATED ANXIETY DRIVES RESTRICTIVE EATING IN IBS, LEADING TO GUT MICROBIOME ALTERATIONS AND POTENTIAL NEGATIVE EFFECTS ON GUT HEALTH
• THE CHATBOT-ASSISTED VS. BRIEF DIETARY ADVICE IN FODMAPS RESTRICTION PHASE IN PATIENTS WITH BLOATING: RANDOMIZED CONTROLLED TRIAL
• LOW FODMAP DIET ATTENUATES THE SYMPTOMS AND ALTERS BRAIN ACTIVITY IN NON-CONSTIPATED IBS PATIENTS: FINAL REPORT FROM A RANDOMIZED CONTROLLED TRIAL
• DOMINO DIET APPLICATION SHOWS SIGNIFICANT SYMPTOM IMPROVEMENT IN TERTIARY CARE IBS
  • Summary: The DOMINO diet, a less strict diet than traditional Low FODMAP diet, which is administered through an APP, performed well for IBS.
• METHYLCELLULOSE FIBER GELS ARE AS EFFECTIVE AS PSYLLIUM IN REDUCING COLONIC GAS AFTER INGESTING INULIN AND ARE ASSOCIATED WITH HIGHER WATER CONTENT IN SMALL BOWEL AND COLON – A POTENTIAL AID TO SYMPTOM RELIEF FOR IBS WITH CONSTIPATION
  • Summary: Both psyllium and methylcellulose (MC) inhibited large intestine fermentation but MC is better for IBS-constipation.
• PAN-COLONIC LOW-AMPLITUDE INTERRUPTED PRESSURIZATIONS INDUCED BY INTRACOLONIC FRUCTANS INFUSION IN HEALTHY SUBJECTS
  • Summary: Fructans (FOS) can lead to decreased gas transit.
• Low-FODMAP Diet for Irritable Bowel Syndrome: Insights from Microbiome.  PMID: 39940404
• FODMAP Profile of Wholegrain Pasta.  PMID: 40002111
• The effects of low FODMAP diet on gut microbiota regulation: A systematic review and meta-analysis. PMID: 40035292 
• The Efficacy of the Low-FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) Diet in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.  PMID: 39917138
• Elimination Diets.  PMID: 38261686 
• Relationship Between FODMAP Diet and Irritable Bowel Syndrome: A Mendelian Randomization Study. PMID: 39968214 
• Successful Strategy in Creating Low-FODMAP Wholegrain Bread-Simple and Global.  PMID: 39856969
• The low FODMAP diet in adolescents functional abdominal in a non-guided setting: a prospective multicenter cohort study.  PMID: 39934502
• IBS and IBD-One Letter, Much Pain, Few Treatments.  PMID: 39953184 
• Biotechnological Tools for the Production of Low-FODMAP Wholegrain Wheat and Rye Cookies and Crackers.  PMID: 40002026 
• A Bifunctional "Two-in-One" Array for Simultaneous Diagnosis of Irritable Bowel Syndrome and Identification of Low-FODMAP Diets.  PMID: 39785268
• Low FODMAP diet in children with functional abdominal pain disorders. Is it always worth trying?: Low FODMAP diet in children with functional abdominal pain disorders.  PMID: 39988545
• Nutritional Interventions in Adult Patients With Irritable Bowel Syndrome: An Umbrella Review of Systematic Reviews and Meta-analyses of Randomized Clinical Trials.  PMID: 39110917
• Case Series: Management of Exercise-Associated Gastrointestinal Symptoms in Endurance Athletes Using a High-Carbohydrate Low-FODMAP Therapeutic Intervention.  PMID: 40049175
• Irritable bowel syndrome, the gut microbiome, and diet.  PMID: 39968682
• DIAGNOSIS AND TREATMENT OF SMALL INTESTINAL BACTERIAL OVERGROWTH: AN OFFICIAL POSITION PAPER FROM THE BRAZILIAN FEDERATION OF GASTROENTEROLOGY.  PMID: 39968993
• Nutrition Interventions in the Treatment of Endometriosis: A Scoping Review.  PMID: 39696836
• Energy metabolism and the intestinal barrier: implications for understanding and managing intestinal diseases.  PMID: 39959156 
• Effects of Probiotics and Diet Management in Patients With Irritable Bowel Syndrome: A Systematic Review and Network Meta-analysis.  PMID: 39862384
• Is there a sex difference in response to FODMAP diet group education for IBS? A clinical practice service evaluation.  PMID: 40094779

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Related

• Real-World Evidence of the Long-Term Clinical Utility of a Vibrating Capsule in the Management of Chronic Idiopathic Constipation.  PMID: 40920213
  • Summary: Frequency, stool consistency, and straining improved.
    “VC [vibrating capsule] seems both effective and safe for long-term treatment of chronic constipation with diarrhea being notably uncommon. 4.6%…reported feeling a sensation of vibration, 1.8% reported abdominal pain and 0.64% reported diarrhea.”>Vibrant Gastro
• European Consensus on Functional Bloating and Abdominal Distension-An ESNM/UEG Recommendations for Clinical Management.  PMID: 40844856
• Irritable Bowel Syndrome.  PMID: 30521231
• Irritable Bowel Syndrome.  PMID: 40789179
• Common misconceptions and controversies in the management of irritable bowel syndrome.  PMID: 40281279
• An evidence-based update on the diagnosis and management of irritable bowel syndrome.  PMID: 39835671
• Amoxicillin Clavulanate  PMID: 30844191
  • Summary: “the efficacy of amoxicillin-clavulanate in treating SIBO approximates 50%.”
• Vinculin: A new target for the diagnosis and treatment of disease. PMID: 39863082

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WHAT IS SIBO SYMPTOMS CAUSES SIBO & IBS TESTING TREATMENT SIBO DIET COURSES

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