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Small Bowel Bacterial Overgrowth
(SBBO; Bacterial Overgrowth, Small Bowel; Small Intestine Bacterial Overgrowth; SIBO; Bacterial Overgrowth, Small Intestine)
by Rebecca J. Stahl, MA
Small bowel bacterial overgrowth (SBBO) occurs when there is a build-up of too much bacteria in the small bowel.
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:
Risk Factors TOP
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.
If you have any of the conditions that are linked to SBBO, get proper treatment. This may reduce your chance of having a build-up of bacteria in the small bowel.
American Gastroenterological Association
National Institute of Diabetes and Digestive and Kidney Diseases
Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
Bacterial overgrowth syndrome. Merck Manual Professional Version website. Available at:
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Updated May 2016. Accessed October 3, 2017.
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: https://my.clevelandclinic.org/health/articles/lactose-and-glucose-hydrogen-breath-test. Accessed October 3, 2017.
Lin H. Small intestinal bacterial overgrowth. JAMA. 2004;292(7):852-858.
Short bowel syndrome. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated May 6, 2014. Accessed October 3, 2017.
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 September 2017 by EBSCO Medical Review Board Daus Mahnke, MD
Last Updated: 9/30/2013
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