Small bowel bacterial overgrowth: presentation, diagnosis, and treatment

Curr Gastroenterol Rep. 2003 Oct;5(5):365-72. doi: 10.1007/s11894-003-0048-0.


Small bowel bacterial overgrowth (SBBO) syndrome is associated with excessive numbers of bacteria in the proximal small intestine. The pathology of this condition involves competition between the bacteria and the human host for ingested nutrients. This competition leads to intraluminal bacterial catabolism of nutrients, often with production of toxic metabolites and injury to the enterocyte. A complex array of clinical symptoms ensues, resulting in chronic diarrhea, steatorrhea, macrocytic anemia, weight loss, and less commonly, protein-losing enteropathy. Therapy is targeted at correction of underlying small bowel abnormalities that predispose to SBBO and appropriate antibiotic therapy. The symptoms and signs of SBBO can be reversed with this approach.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / diagnosis*
  • Bacterial Infections / therapy*
  • Homeostasis
  • Humans
  • Intestine, Small / microbiology*
  • Malabsorption Syndromes / diagnosis*
  • Malabsorption Syndromes / microbiology*
  • Malabsorption Syndromes / therapy*
  • Nutritional Support
  • Probiotics / therapeutic use
  • Syndrome


  • Anti-Bacterial Agents