Small Intestinal Bacterial Overgrowth: Nutritional Implications, Diagnosis, and Management

Gastroenterol Clin North Am. 2018 Mar;47(1):193-208. doi: 10.1016/j.gtc.2017.09.008. Epub 2017 Dec 7.


Small intestinal bacterial overgrowth (SIBO), characterized by the presence of excessive bacteria in the small intestine, is typically described as a malabsorptive syndrome occurring in the context of gut stasis syndromes. SIBO is now considered to be a disorder associated with diverse clinical conditions without classic risk factors for SIBO and a cause of several nonspecific gastrointestinal and nongastrointestinal symptoms. Because there is currently no gold standard for diagnosing SIBO, its prevalence and role in the pathogenesis of other diseases remain uncertain; as does optimal treatment of patients with relapsing symptoms.

Keywords: Antibiotic; Breath test; Diagnosis; Malabsorption; Small bowel aspirate; Small intestinal bacterial overgrowth; Treatment.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bacteriological Techniques
  • Blind Loop Syndrome / complications
  • Blind Loop Syndrome / diagnosis*
  • Blind Loop Syndrome / physiopathology
  • Blind Loop Syndrome / therapy*
  • Breath Tests
  • Diet
  • Dietary Supplements
  • Digestion
  • Gastrointestinal Microbiome*
  • Gastrointestinal Motility
  • Humans
  • Intestinal Absorption
  • Malabsorption Syndromes / microbiology
  • Micronutrients / metabolism


  • Anti-Bacterial Agents
  • Micronutrients