SIBO: A guide of Testing and Treatment

SIBO, or Small Intestinal Bacterial Overgrowth, is a condition with an abnormal increase in bacteria in the small intestine.

Testing of SIBO mainly involves a Breath Test. This is the most common method used to diagnose SIBO. It involves drinking a solution containing sugar (usually lactulose or glucose) and then collecting breath samples at specific intervals. The breath samples are analyzed for certain gases (hydrogen and methane) produced by bacteria during the sugar fermentation in the small intestine. Elevated levels of these gases suggest SIBO.

Treatment depends on each patient's condition and has to be personalized. Antibiotics, Probiotics, a Diet Protocol, and/or Other Medications may be used.

Antibiotics are the primary treatment for SIBO. Rifaximin is the most commonly used antibiotic. It is non-absorbable, which means it stays in the gut and targets the bacteria in the small intestine. Other antibiotics, such as metronidazole or neomycin, may also be used in certain cases.

Probiotics are beneficial bacteria that can help restore a healthy balance of gut bacteria. They may be used as adjunctive therapy alongside antibiotics or after antibiotic treatment to prevent recurrence.

Specific dietary changes can help manage symptoms and prevent SIBO recurrence. A low-FODMAP diet, which restricts fermentable carbohydrates that feed gut bacteria, is commonly recommended. However, dietary approaches should be personalized and supervised by a healthcare provider or dietitian.

Depending on individual symptoms and underlying conditions, medications such as prokinetics (to improve gut motility) or medications to manage symptoms like diarrhea or bloating may be prescribed.

After treatment, it is important to monitor symptoms and possibly repeat the breath test to assess treatment effectiveness. Follow-up care may involve adjustments to medication or dietary changes based on individual response and recurrence of symptoms.

It's crucial to work closely with a healthcare provider to diagnose and manage SIBO effectively, as the condition can be complex and may require a tailored approach to treatment.