Small intestinal bacterial overgrowth in patients with irritable bowel syndrome

Posserud, Iris; Stotzer, Per-Ove; Björnsson, Einar S.; Abrahamsson, Hasse; Simrén, Magnus
June 2007
Gut;Jun2007, Vol. 56 Issue 6, p802
Academic Journal
Background: Small intestinal bacterial overgrowth (SIBO) has been proposed to be common in irritable bowel syndrome (IBS), with altered small-bowel motility as a possible predisposing factor. Aim: To assess the prevalence of SIBO, by culture of small-bowel aspirate, and its correlation to symptoms and motility in IBS. Methods: 162 patients with IBS who underwent small-bowel manometry and culture of jejunal aspirate were included. Cultures from 26 healthy subjects served as controls. Two definitions of altered flora were used: the standard definition of SIBO (⩾105 colonic bacteria/mI), and mildly increased counts of small-bowel bacteria (⩾95th centile in controls). Results: SIBO (as per standard definition) was found in 4% of both patients and controls. Signs of enteric dysmotility were seen in 86% of patients with SIBO and in 39% of patients without SIBO (p=0.02). Patients with SIBO had fewer phase Ill activities (activity fronts) than patients without SIBO (p = 0.08), but otherwise no differences in motility parameters were seen. Mildly increased bacterial counts (⩾5×103/ml) were more common in patients with IBS than in controls (43% vs 12%; p=0.002), but this was unrelated to small intestinal motility. No correlation between bacterial alterations and symptom pattern was observed. Conclusions: The data do not support an important role for SIBO according to commonly used clinical definitions, in IBS. However, mildly increased counts of small-bowel bacteria seem to be more common in IBS, and needs further investigation. Motility alterations could not reliably predict altered small-bowel bacterial flora.


Related Articles

  • Small intestine bacterial overgrowth in patients with irritable bowel syndrome. Carrara, M.; Desideri, S.; Azzurro, M.; Bulighin, G. M.; Di Piramo, D.; Lomonaco, L.; Adamo, S. // European Review for Medical & Pharmacological Sciences;May/Jun2008, Vol. 12 Issue 3, p197 

    Recent investigations in patients with irritable bowel syndrome (IBS) undergoing a breath test (BT) with lactulose, have shown inconclusive results on a possible association between IBS and a small intestine bacterial overgrowth (SIBO), as well as on the effective prevalence of SIBO in IBS...

  • Restless Legs Syndrome in Patients with Irritable Bowel Syndrome: Response to Small Intestinal Bacterial Overgrowth Therapy. Leonard Weinstock; Steve Fern; Stephen Duntley // Digestive Diseases & Sciences;May2008, Vol. 53 Issue 5, p1252 

    Abstract   Background Small intestinal bacterial overgrowth (SIBO) occurs in irritable bowel syndrome (IBS) and fibromyalgia. Since restless legs syndrome (RLS) occurs with fibromyalgia, a link between IBS, SIBO, and RLS was studied. Methods BS patients with abnormal lactulose...

  • Small Intestine Bacterial Overgrowth: Often-Ignored Cause of Irritable Bowel Syndrome. Siebecker, Allison; Sandberg-Lewis, Steven // Townsend Letter;Feb/Mar2013, Issue 355/356, p85 

    The article focuses on a frequently-neglected cause of irritable bowel syndrome (IBS), namely, small intestine bacterial overgrowth. It discusses symptoms of SIBO, including bloating/abdominal gas, flatulence, nausea, heartburn and abdominal pain, and mechanisms by which overgrowth is prevented....

  • Abnormal small-intestinal endocrine cells in patients with irritable bowel syndrome. El-Salhy, Magdy; Vaali, K.; Dizdar, V.; Hausken, T. // Digestive Diseases & Sciences;Dec2010, Vol. 55 Issue 12, p3508 

    Background: General disturbances in gastrointestinal motility have been reported in patients with irritable bowel syndrome (IBS). The gastrointestinal tract hormones play an important role in regulating gastrointestinal motility.Aims: To investigate a possible...

  • Bacteriological Method for Detecting Small Intestinal Hypomotility. Riordan, Stephen M.; McIver, Christopher J.; Walker, Brenda M.; Duncombe, Vic M.; Bolin, Terry D.; Thomas, Mervyn C. // American Journal of Gastroenterology;Nov1996, Vol. 91 Issue 11, p2399 

    Objective: Small intestinal hypomotility is an important cause of small intestinal bacterial overgrowth, yet assessment of small intestinal motility in this setting is problematic. This study was performed to investigate the validity of a bacteriological method for detecting small intestinal...

  • Eradication of Small Intestinal Bacterial Overgrowth Reduces Symptoms of Irritable Bowel Syndrome. Pimentel, Mark; Chow, Evelyn J.; Lin, Henry C. // American Journal of Gastroenterology;Dec2000, Vol. 95 Issue 12, p3503 

    OBJECTIVES: Irritable bowel syndrome is the most common gastrointestinal diagnosis. The symptoms of irritable bowel syndrome are similar to those of small intestinal bacterial overgrowth. The purpose of this study was to test whether overgrowth is associated with irritable bowel syndrome and...

  • Small bowel bacterial overgrowth and type 1 diabetes. OJETTI, V .; PITOCCO, D.; SCARPELLINI, E.; ZACCARDI, F .; SCALDAFERRI, F .; GIGANTE, G.; GASBARRINI, G.; GHIRLANDA, G.; GASBARRINI, A. // European Review for Medical & Pharmacological Sciences;Nov/Dec2009, Vol. 13 Issue 6, p419 

    Background: Gastrointestinal motility disorders are often present in diabetic patients (pts). Such motility dysfunctions have been attributed to autonomic neuropathy. Impaired intestinal motility is often associated with small-bowel bacterial overgrowth (SIBO) but only few studies evaluated the...


    The article defines small intestinal bacterial overgrowth (SIBO) and indicates the probability of SIBO as being a major pathogenic mechanism underlying irritable bowel syndrome (IBS). It reviews several herbs that are recognized as beneficial agents in eradication of non-commensal bacteria,...

  • Results of small intestinal bacterial overgrowth testing in irritable bowel syndrome patients: clinical profiles and effects of antibiotic trial. Majewski, M.; McCallum, R. W. // Advances in Medical Sciences (De Gruyter Open);2007, Vol. 52, p139 

    Purpose: Small intestinal bacterial overgrowth (SIBO) may coexist with irritable bowel syndrome (IBS) and eradication therapy has been reported as effective in reducing IBS symptoms. Aims of this study were to: 1. Assess the clinical profiles of IBS patients, who underwent breath testing with a...


Read the Article


Sign out of this library

Other Topics