Bacterial proliferation syndrome in the small intestine, also known by the acronym SBID, or SIBO, is a condition in which there is excessive development of bacteria in the small intestine, reaching values similar to the amount of bacteria present in the large intestine.
While bacteria are important for food digestion and nutrient absorption, when they are overuse they can cause intestinal problems, resulting in symptoms such as excess gas, constant swollen stomach sensation, abdominal pain and constant diarrhea, for example. In addition, by altering the absorption of nutrients in some people, it can cause malnutrition, even if the person is eating properly.
- This syndrome is curable and can be treated.
- In many cases.
- With changes in diet and lifestyle.
- But it can also include the use of antibiotics prescribed by the gastroenterologist.
The excessive presence of bacteria in the small intestine can cause symptoms such as:
Although the syndrome can cause periods of diarrhea and constipation, it is more common for a person to have chronic diarrhea.
In the most severe cases of SBID, the gut may lose some of its ability to absorb nutrients and therefore a situation of malnutrition may occur, even if the person eats properly, when this happens, the person may experience excessive fatigue, weight loss. and even anemia.
The most common way to confirm the diagnosis of bacterial overgrowth syndrome in the small intestine is to perform a breath test, in which the amount of hydrogen and methane present in the exhaled air is evaluated. This is because the excess bacteria in the small intestine releases this type of gas in a greater quantity than is considered normal. Therefore, the breath test is a non-invasive and non-direct way to identify a possible case of SBID.
To perform this test, you need to fast for 8 hours and then go to the clinic to exhale into a tube. Subsequently, the technician delivers a special liquid that must be drunk, and thereafter, the other exhalations are collected in new tubes every 2-3 hours.
Generally, people with SBIDs experience higher amounts of hydrogen and methane in the air that has expired over time, and when that happens, the result is considered positive; However, if the test is inconclusive, your doctor may order more tests, including a sample. liquid in the small intestine, to assess the amount of bacteria in the lab.
Causes that can cause SBIDs include changes in stomach acid production, anatomical abnormalities of the small intestine, changes in small bowel pH, changes in the immune system, changes in gastrointestinal motility, changes in enzymes and diner bacteria.
This syndrome can also be related to the use of certain medications, such as proton pump inhibitors, anti-motility agents, and certain antibiotics.
In addition, this syndrome can be related to certain diseases, such as viral gastroenteritis, celiac disease, Crohn’s disease, low levels of stomach acid, gastroparesis, nerve damage, cirrhosis, portal hypertension, irritable bowel syndrome, bypass procedures or certain surgeries, for example. .
Treatment of this syndrome should be guided by a gastroenterologist, however, it may also be necessary to follow up with a nutritionist. In fact, treatment may include:
The first step in the treatment of SBID is to control the amount of bacteria in the small intestine, and therefore it is necessary to use an antibiotic, prescribed by the gastroenterologist, but which is usually ciprofloxacin, metronidazole or rifaximine.
Although in most cases the antibiotic can be used in pill form, when the syndrome results in malnutrition or dehydration, it may be necessary to stay in the hospital for a few days, receive IVs, or take medication. parenteral nutrition, which takes place directly in the vein.
A diet capable of curing SBID is not yet known, however, there are some dietary changes that seem to relieve symptoms, such as:
In addition, several doctors also indicate that following a FODMAP-like diet, which eliminates foods that ferment in the gut and are therefore less absorbed, may be ideal for quickly relieving symptoms. Learn how to create a FODMAP feed.
Although more studies are still needed to prove their efficacy, the use of probiotics appears to help the gut to rebalance its natural flora, thereby reducing excess bacteria.
However, probiotics can also be ingested naturally from food, through fermented foods such as yogurt, kefir or kimchi, for example.