U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination
  • The following term was not found in MedGen: M3.op'op.

Small intestinal bacterial overgrowth

MedGen UID:
1708316
•Concept ID:
C3160854
•
Disease or Syndrome
Synonyms: SIBO; small intestinal bacterial overgrowth
 
HPO: HP:0033163
Monarch Initiative: MONDO:0400000

Definition

An increased number and/or abnormal type of bacteria in the small bowel. Small intestinal bacterial overgrowth has been defined as the presence of greater than one hundred thousand bacteria (i.e. colony-forming units, CFU) per mL of proximal jejunal aspiration. The normal value is ten thousand or few CFU/ml. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVSmall intestinal bacterial overgrowth

Professional guidelines

PubMed

ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth.
Pimentel M, Saad RJ, Long MD, Rao SSC
Am J Gastroenterol 2020 Feb;115(2):165-178. doi: 10.14309/ajg.0000000000000501. PMID: 32023228
CLINICAL PRACTICE GUIDELINES FOR THE PERIOPERATIVE NUTRITION, METABOLIC, AND NONSURGICAL SUPPORT OF PATIENTS UNDERGOING BARIATRIC PROCEDURES - 2019 UPDATE: COSPONSORED BY AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY, THE OBESITY SOCIETY, AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY, OBESITY MEDICINE ASSOCIATION, AND AMERICAN SOCIETY OF ANESTHESIOLOGISTS - EXECUTIVE SUMMARY.
Mechanick JI, Apovian C, Brethauer S, Garvey WT, Joffe AM, Kim J, Kushner RF, Lindquist R, Pessah-Pollack R, Seger J, Urman RD, Adams S, Cleek JB, Correa R, Figaro MK, Flanders K, Grams J, Hurley DL, Kothari S, Seger MV, Still CD
Endocr Pract 2019 Dec;25(12):1346-1359. Epub 2019 Nov 4 doi: 10.4158/GL-2019-0406. PMID: 31682518
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article

Recent clinical studies

Etiology

Small intestinal bacterial overgrowth: current update.
Zafar H, Jimenez B, Schneider A
Curr Opin Gastroenterol 2023 Nov 1;39(6):522-528. Epub 2023 Sep 18 doi: 10.1097/MOG.0000000000000971. PMID: 37751393
Epidemiology of small intestinal bacterial overgrowth.
Efremova I, Maslennikov R, Poluektova E, Vasilieva E, Zharikov Y, Suslov A, Letyagina Y, Kozlov E, Levshina A, Ivashkin V
World J Gastroenterol 2023 Jun 14;29(22):3400-3421. doi: 10.3748/wjg.v29.i22.3400. PMID: 37389240Free PMC Article
Small Intestinal Bacterial Overgrowth.
Bushyhead D, Quigley EM
Gastroenterol Clin North Am 2021 Jun;50(2):463-474. Epub 2021 Apr 23 doi: 10.1016/j.gtc.2021.02.008. PMID: 34024452
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article
The Spectrum of Small Intestinal Bacterial Overgrowth (SIBO).
Quigley EMM
Curr Gastroenterol Rep 2019 Jan 15;21(1):3. doi: 10.1007/s11894-019-0671-z. PMID: 30645678

Diagnosis

Small intestinal bacterial overgrowth: current update.
Zafar H, Jimenez B, Schneider A
Curr Opin Gastroenterol 2023 Nov 1;39(6):522-528. Epub 2023 Sep 18 doi: 10.1097/MOG.0000000000000971. PMID: 37751393
Small Intestinal Bacterial Overgrowth.
Bushyhead D, Quigley EM
Gastroenterol Clin North Am 2021 Jun;50(2):463-474. Epub 2021 Apr 23 doi: 10.1016/j.gtc.2021.02.008. PMID: 34024452
ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth.
Pimentel M, Saad RJ, Long MD, Rao SSC
Am J Gastroenterol 2020 Feb;115(2):165-178. doi: 10.14309/ajg.0000000000000501. PMID: 32023228
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article
The Spectrum of Small Intestinal Bacterial Overgrowth (SIBO).
Quigley EMM
Curr Gastroenterol Rep 2019 Jan 15;21(1):3. doi: 10.1007/s11894-019-0671-z. PMID: 30645678

Therapy

Small intestinal bacterial overgrowth: current update.
Zafar H, Jimenez B, Schneider A
Curr Opin Gastroenterol 2023 Nov 1;39(6):522-528. Epub 2023 Sep 18 doi: 10.1097/MOG.0000000000000971. PMID: 37751393
Efficacy of an Irritable Bowel Syndrome Diet in the Treatment of Small Intestinal Bacterial Overgrowth: A Narrative Review.
Wielgosz-Grochowska JP, Domanski N, Drywień ME
Nutrients 2022 Aug 17;14(16) doi: 10.3390/nu14163382. PMID: 36014888Free PMC Article
Small Intestinal Bacterial Overgrowth.
Bushyhead D, Quigley EM
Gastroenterol Clin North Am 2021 Jun;50(2):463-474. Epub 2021 Apr 23 doi: 10.1016/j.gtc.2021.02.008. PMID: 34024452
ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth.
Pimentel M, Saad RJ, Long MD, Rao SSC
Am J Gastroenterol 2020 Feb;115(2):165-178. doi: 10.14309/ajg.0000000000000501. PMID: 32023228
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article

Prognosis

Epidemiology of small intestinal bacterial overgrowth.
Efremova I, Maslennikov R, Poluektova E, Vasilieva E, Zharikov Y, Suslov A, Letyagina Y, Kozlov E, Levshina A, Ivashkin V
World J Gastroenterol 2023 Jun 14;29(22):3400-3421. doi: 10.3748/wjg.v29.i22.3400. PMID: 37389240Free PMC Article
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article
Coeliac disease.
Glissen Brown JR, Singh P
Paediatr Int Child Health 2019 Feb;39(1):23-31. Epub 2018 Aug 13 doi: 10.1080/20469047.2018.1504431. PMID: 30099930
Lactose Intolerance in Adults: Biological Mechanism and Dietary Management.
Deng Y, Misselwitz B, Dai N, Fox M
Nutrients 2015 Sep 18;7(9):8020-35. doi: 10.3390/nu7095380. PMID: 26393648Free PMC Article
Small intestinal bacterial overgrowth syndrome.
Bures J, Cyrany J, Kohoutova D, Förstl M, Rejchrt S, Kvetina J, Vorisek V, Kopacova M
World J Gastroenterol 2010 Jun 28;16(24):2978-90. doi: 10.3748/wjg.v16.i24.2978. PMID: 20572300Free PMC Article

Clinical prediction guides

AGA Clinical Practice Update on Evaluation and Management of Belching, Abdominal Bloating, and Distention: Expert Review.
Moshiree B, Drossman D, Shaukat A
Gastroenterology 2023 Sep;165(3):791-800.e3. Epub 2023 Jul 13 doi: 10.1053/j.gastro.2023.04.039. PMID: 37452811
Alternative Treatment Approaches to Small Intestinal Bacterial Overgrowth: A Systematic Review.
Nickles MA, Hasan A, Shakhbazova A, Wright S, Chambers CJ, Sivamani RK
J Altern Complement Med 2021 Feb;27(2):108-119. Epub 2020 Oct 19 doi: 10.1089/acm.2020.0275. PMID: 33074705
Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management.
Rao SSC, Bhagatwala J
Clin Transl Gastroenterol 2019 Oct;10(10):e00078. doi: 10.14309/ctg.0000000000000078. PMID: 31584459Free PMC Article
Coeliac disease.
Glissen Brown JR, Singh P
Paediatr Int Child Health 2019 Feb;39(1):23-31. Epub 2018 Aug 13 doi: 10.1080/20469047.2018.1504431. PMID: 30099930
Lactose Intolerance in Adults: Biological Mechanism and Dietary Management.
Deng Y, Misselwitz B, Dai N, Fox M
Nutrients 2015 Sep 18;7(9):8020-35. doi: 10.3390/nu7095380. PMID: 26393648Free PMC Article

Recent systematic reviews

Show Me What You Have Inside-The Complex Interplay between SIBO and Multiple Medical Conditions-A Systematic Review.
Sroka N, Rydzewska-Rosołowska A, Kakareko K, Rosołowski M, Głowińska I, Hryszko T
Nutrients 2022 Dec 24;15(1) doi: 10.3390/nu15010090. PMID: 36615748Free PMC Article
Efficacy of rifaximin in treating with small intestine bacterial overgrowth: a systematic review and meta-analysis.
Wang J, Zhang L, Hou X
Expert Rev Gastroenterol Hepatol 2021 Dec;15(12):1385-1399. Epub 2021 Nov 26 doi: 10.1080/17474124.2021.2005579. PMID: 34767484
Alternative Treatment Approaches to Small Intestinal Bacterial Overgrowth: A Systematic Review.
Nickles MA, Hasan A, Shakhbazova A, Wright S, Chambers CJ, Sivamani RK
J Altern Complement Med 2021 Feb;27(2):108-119. Epub 2020 Oct 19 doi: 10.1089/acm.2020.0275. PMID: 33074705
Probiotics for Preventing and Treating Small Intestinal Bacterial Overgrowth: A Meta-Analysis and Systematic Review of Current Evidence.
Zhong C, Qu C, Wang B, Liang S, Zeng B
J Clin Gastroenterol 2017 Apr;51(4):300-311. doi: 10.1097/MCG.0000000000000814. PMID: 28267052
Systematic review with meta-analysis: rifaximin is effective and safe for the treatment of small intestine bacterial overgrowth.
Gatta L, Scarpignato C
Aliment Pharmacol Ther 2017 Mar;45(5):604-616. Epub 2017 Jan 12 doi: 10.1111/apt.13928. PMID: 28078798Free PMC Article

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Consumer resources

    Reviews

    Related information

    • PMC Articles
      Related information in PubMed Central Links
    • PubMed
      Related literature resources in PubMed

    Recent activity

    Clear Turn Off Turn On

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...