Small bowel bacterial overgrowth (SBBO) occurs when there is a build-up of too much bacteria in the small bowel.
The Small Intestines
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SBBO is often caused by an abnormality in the small bowel. Food is not able to flow properly though the intestines. Conditions that may cause this include:
Factors that may increase your chance of SBBO include:
Other risk factors include:
Any condition that affects how food moves through the small bowel may increase the risk of SBBO.
SBBO may cause:
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include
The goals are to:
Antibiotics are often prescribed to treat SBBO. Usually treatment is temporary, but in some cases you may need to take antibiotics for a longer period.
To make sure that you get the proper nutrients, you may need to:
In some cases, tube feeding is needed with a special formula.
For severe cases, surgery may be needed. This is done to correct an abnormality in the small bowel.
Gastro—American Gastroenterological Association
National Digestive Diseases Information Clearinghouse
Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
Bacterial overgrowth syndrome. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/gastrointestinal_disorders/malabsorption_syndromes/bacterial_overgrowth_syndrome.html. Updated May 2014. Accessed September 29, 2014.
Bures J, Cyrany J, Kohoutova D, et al. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol. 2010;16(24):2978–2990.
Lactose and glucose hydrogen breath test. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/health/diagnostics/hic_Lactose_and_Glucose_Hydrogen_Breath_Test. Accessed September 29, 2014.
Lin H. Small intestinal bacterial overgrowth. JAMA. 2004;292(7):852-858.
Parrish C. Nutritional consequences of small intestinal bacterial overgrowth. University of Virginia, School of Medicine website. Available at: http://www.medicine.virginia.edu/clinical/departments/medicine/divisions/digestive-health/nutrition-support-team/nutrition-articles/DiBaiseArticle.pdf. Published December 2008. Accessed September 29, 2014.
Short bowel syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 6, 2014. Accessed September 29, 2014.
Vanderhoof J, Young R. Bacterial overgrowth. The Oley Foundation website. Available at: http://www.oley.org/lifeline/bacter.html. Accessed September 29, 2014.
Vanderhoof J, Young R, Murray N, Kaufman SS. Treatment strategies for small bowel bacterial overgrowth in short bowel syndrome. J Pediatr Gastroenterol Nutr. 1998;27(2):155-160.
Last reviewed August 2014 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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