DOI link for Bacterial Overgrowth
Bacterial Overgrowth book
Small intestine bacterial overgrowth (SIBO) is defined as a condition in which abnormally large numbers of bacteria are resident in the small intestine. SIBO is fairly rare, although its true prevalence and relationship to specific diseases and symptoms, such as irritable bowel syndrome, is in dispute. Conditions that predispose to bacterial overgrowth include the use of acid reducing medications, diabetes, surgery, obstruction, chronic renal failure, resection of the ileocecal valve, chronic pancreatitis, and intestinal dysmotility. Hydrogen and methane breath tests are most commonly used and are based on the premise that nonabsorbed carbohydrate is fermented by bacteria in the gut lumen, generally anaerobic bacteria in the colon. Most clinicians accept the following double peak description as a positive breath test: an early elevation in breath hydrogen/methane that signals bacteria in the small bowel and a later, second peak that marks metabolism of the carbohydrate by cecal bacteria.