Overview
SIBO occurs when bacteria normally found in the large intestine migrate to the small intestine, causing fermentation, malabsorption, and inflammation. It is strongly associated with IBS, motility disorders, diabetes, and food poisoning.
Symptoms
• Excessive bloating (especially after meals)
• Gas
• Abdominal discomfort
• Diarrhea or constipation
• Nausea
• Food intolerance
• Fatigue
• Unintentional weight loss
Causes
• Low stomach acid
• Slow motility
• IBS
• Diabetes
• Adhesions
• Chronic constipation
• Food poisoning
• Medications (PPIs)
Diagnosis
• Hydrogen/methane breath test
• Small bowel aspirate (rare)
Treatment
• Antibiotics (rifaximin ± neomycin)
• Herbal antimicrobials
• Low-FODMAP or low fermentation diets
• Motility agents
• Probiotics in select cases
Self-Management
Tracking bloating patterns, meal responses, and bowel habits helps identify flare triggers and food intolerances.