SIBO Syndrome K58.-

The pathogenesis of irritable bowel syndrome (IBS), which was previously thought to be largely psychogenic in origin, is now understood to be multifactorial. One cause of the symptoms is intestinal dysbiosis, including small intestinal bacterial overgrowth (SIBO).

Quantitative culture of jejunal aspirate is considered the gold standard for diagnosing SIBO. Noninvasive hydrogen breath tests have since become the established diagnostic method. Although the glucose-hydrogen breath test is highly specific, its sensitivity is low; in contrast, the early-peak criteria of the lactulose-hydrogen breath test are very nonspecific; see also under “H₂ breath test.” 

Currently, there are noAMWF guidelines for SIBO, although parts of the irritable bowel syndrome guideline contain recommendations. Guidelines can be found in the American College of Gastroenterology (ACG) guidelines (Pimentel M et al. 2020).

Treatment for small-intestinal dysbiosis depends on the stage and extent of the dysbiosis.

In addition to conventional and herbal antibiotics, appropriate foods, diets,probiotics, and prebiotics, as well as prokinetic agents, are particularly worth mentioning. 

Recommended diets include, for example, thelow-FODMAP diet and special carbohydrate diets, particularly those that exclude fermentable carbohydrates. 

Between 4% and 78% of patients with irritable bowel syndrome and between 1% and 40% of control subjects have SIBO. These wide variations in prevalence may be due to differences in the population, the diagnostic criteria for irritable bowel syndrome, and, above all, the methods used to diagnose SIBO.

Pyoderma faciale: Pyoderma faciale has been associated with SIBO (and other chronic inflammatory bowel diseases—IBD) (Dessoukey MW et al. 1996, Fowler E et al. 2019).

Rosacea: Rosacea is associated with various gastrointestinal disorders, including inflammatory bowel diseases, celiac disease, irritable bowel syndrome, gastroesophageal reflux disease, Helicobacter pylori (HP) infection, and small intestinal bacterial overgrowth (SIBO) (Wang FY et al. 2021).

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