Small intestinal bacterial overgrowth: A disorder where an excessive amount of bacteria is found in the small intestine, often leading to loose stools, weight loss, malabsorption and other issues.

Smokers are advised never to smoke for 1-2 hours ahead of testing.
All breath tests depend on the recovery and quantification of an exhaled gas produced by the bacterial metabolism of the ingested substrate.
The development of inexpensive, commercially available gas chromatographs to measure exhaled hydrogen and/or methane has led to the widespread use of breath testing for the diagnosis of bacterial overgrowth.
The two major causes of fatty or malabsorptive diarrhea are impaired digestion of fats because of low pancreatic enzyme levels and impaired absorption of fats because of small bowel disease.
These conditions interfere with the standard processing of fats in the diet.

This is especially important for patients with indigestion and malabsorption.
Although whether antibiotics ought to be a first line treatment is really a matter of debate.

Fecal nitrogen content is increased, serum proteins are low, and this could result in a clinical protein-calorie malnutrition.
•Radiolabeled breath tests using glycocholic acid or xylose have already been used for diagnosis of overgrowth.
Glycocholic acid is released by bacterial deconjugation of radiolabeled bile acids.
Xylose is catabolized by gram-negative aerobes and is absorbed in the proximal small bowel.
Treatment plans include antibiotics to take care of the bacterial overgrowth, management of one’s underlying condition , and nutritional supplementation.
Finally, abnormal connections between the bacteria-rich colon and the tiny bowel can increase the bacterial load in the small bowel.
Patients with Crohn’s disease or other diseases of the ileum may necessitate surgery that removes the ileocecal valve connecting the small and large bowel; this leads to an elevated reflux of bacteria in to the small bowel.

SIBO symptoms may include abdominal bloating, constipation, and nutritional deficiencies.
A variety of conditions could cause SIBO, such as celiac disease, Crohn’s disease, and blind loop syndrome.
22.Ghoshal UC, Ghoshal U, Das K, Misra A. Utility of hydrogen breath tests in diagnosis of small intestinal bacterial overgrowth in malabsorption syndrome and its relationship with oro-cecal transit time.
Utility of hydrogen breath tests in diagnosis of small intestinal bacterial overgrowth in malabsorption syndrome, and its own relationship with oro-cecal transit time.
Treatment strategies should focus on identifying and correcting the main causes, where possible, resolving nutritional deficiencies, and administering antibiotics.

Some experts recommend probiotics as first line therapy with antibiotics being reserved as another line treatment for more severe cases of SIBO.
Prokinetic drugs are additional options but research in humans is limited.
However, if the condition recurs, antibiotics can be given in a cyclical fashion so as to prevent tolerance.
For example, antibiotics could be given for weekly, followed by three weeks off antibiotics, accompanied by another week of treatment.
There’s still limited data to guide the clinician in developing antibiotic approaches for SIBO.
However, concerns exist about the potential risks of long-term broad-spectrum antibiotic therapy.
On the other hand, microorganisms that preferentially metabolize carbohydrates to short-chain essential fatty acids and gas may produce bloating without diarrhea because the metabolic products can be absorbed.

• The prevalence of bacterial overgrowth syndrome varies depending on the population studied and the diagnostic methods used.
• After an overnight fast, set up a baseline hydrogen sample is collected and then 10 g of lactulose, or 50–80 g of glucose, is administered in 120–200 mL of water.
• Patients with bacterial overgrowth that is longstanding can develop complications of these illness due to malabsorption of nutrients.
• Acute bloody diarrhea suggests a bacterial cause like Campylobacter, Salmonella or Shigella or Shiga-toxin E.
• The surplus bacteria often cause diarrhea and may cause weight loss and malnutrition.

When you seek a medical diagnosis, SIBO might not be the first thing your healthcare provider suspects.
If, however, your symptoms and medical history suggest SIBO, your doctor may suggest a breath test to verify it.
This simple, non-invasive test measures hydrogen and/or methane levels in your breath to look for the presence of gas-producing bacteria in your gut.
If your levels are above a certain number, it suggests a good amount of bacteria.
Most episodes of acute diarrhea resolve quickly without antibiotic therapy and with simple dietary modifications.

The treatment for this condition is rehydration and eradication of the underlying bacterial overgrowth using enterally administered antibiotics.
If you have signs or symptoms which are common to small intestinal bacterial overgrowth , make an appointment with your doctor.
After an initial evaluation, you may well be referred to a health care provider who focuses on treatment of digestion disorders .
Sometimes folks have abnormalities of these internal structures that make them vunerable to bacterial overgrowth.
To recognize these abnormalities, doctors take x-rays of the stomach and small intestines after a person drinks a liquid that shows through to x-rays (called an upper gastrointestinal series).
Small intestinal bacterial overgrowth is really a serious condition affecting the tiny intestine.
It occurs when there is an increase in the bacterial population in the small intestine.

• patients with late recurrence, beyond three months, antibiotics are given only with positive carbohydrate breath testing.
• Bacterial overgrowth is a condition of the tiny intestine leading to increased numbers of bowel bacteria.

Recurrent SIBO is treatable either with exactly the same initial or alternating antibiotic.
Bacterial populations contaminating the upper gut in patients with small intestinal bacterial overgrowth syndrome.
Common symptoms of SIBO, including gas and bloating, abdominal pain and distension are uncomfortable enough.
But left unmanaged, SIBO can cause much more serious complications with long-term consequences.
Malabsorption of fats, proteins and carbohydrates can cause malnutrition and vitamin deficiencies.
Specifically, vitamin B12 deficiency can cause nervous system problems and anemia.