Small Intestinal Bacterial Overgrowth

Abstract

In summary, SIBO is the condition which may cause a wide range of clinical and nutritional manifestations. Clinical suspicion must be high in patients with disorders that disrupt the small intestine's normal defenses against SIBO. There is a growing body of evidence to suggest that the prevalence of SIBO is higher in the elderly. Though an association between SIBO and IBS has been suggested, the available evidence is not conclusive. There is no currently available test which can be considered an adequate gold standard for the diagnosis of SIBO. Small bowel culture is highly specific but lacks sensitivity, particularly for distal SIBO. Carbohydrate breath tests are noninvasive and simple to perform but lack standardization and have not been adequately validated as a reliable surrogate means of identifying SIBO. Therapy of SIBO consists of antibiotics to decontaminate the small intestine, nutritional support to address the consequences of longstanding SIBO and when possible, correction of the underlying cause of SIBO. © 2010 Blackwell Publishing Ltd.