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Small Intestinal Bacterial Overgrowth

  • Eamonn M. M. QuigleyEmail author
Chapter

Abstract

Small intestinal bacterial overgrowth (SIBO) was described many years ago as an important cause of maldigestion and malabsorption among individuals who had undergone upper gastrointestinal surgery or had some other major anatomical anomaly or motility disorder of the small intestine. More recently the definition of SIBO has been extended to a much larger patient population – individuals who would otherwise be classified as a functional gastrointestinal disorder but who have tested positive for SIBO, usually on the basis of a breath test. This extension of the concept of SIBO is problematic as it assumes that the available tests to diagnose SIBO are accurate, which they are not. The challenges that the diagnosis and management of this disorder pose will be explored.

Keywords

Small intestinal bacterial overgrowth Microbiota Breath hydrogen test Jejunal aspiration Irritable bowel syndrome  Rifaximin 

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Essential Readings

  1. Rezaie A, Buresi M, Lembo A, Lin H, McCallum R, Rao S, Schmulson M, Valdovinos M, Zakko S, Pimentel M. Hydrogen and methane-based breath testing in gastrointestinal disorders: the North American consensus. Am J Gastroenterol. 2017;112:775–84. Though its recommendations are not without its critics, this recent consensus document discusses the current status of breath testing in some detailCrossRefGoogle Scholar
  2. Ford AC, Spiegel BM, Talley NJ, Moayyedi P. Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2009;7:1279–86. The most complete assessment of the role of SIBO in irritable bowel syndromeCrossRefGoogle Scholar
  3. Gatta L, Scarpignato C. Systematic review with meta-analysis: rifaximin is effective and safe for the treatment of small intestine bacterial overgrowth. Aliment Pharmacol Ther. 2017;45:604–16. A detailed assessment of the impact of rifaximin in SIBOCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of GastroenterologyHouston Methodist HospitalHoustonUSA

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