Small Bowel Bacterial Overgrowth usually occurs when there is a significant increase in the number of bacteria that are supposed to be in small quantities, This often happens due to health problems that cause blockages or gaps in the intestines, a disorder that slows their movement, or other reasons, making it a conducive environment to the growth and proliferation of bacteria. (1)


If Small Bowel Bacterial Overgrowth (SIBO) continues without treatment, it can cause very uncomfortable bowel symptoms, vitamin deficiencies, and malnutrition due to the bacteria competing for consumed food. (1)


Strategies for treating Small Bowel Bacterial Overgrowth

The treatment goals include: (2)


  • Eliminate excessive bacteria numbers with antibiotics.
  • Compensate for vitamin and mineral deficiencies using nutritional supplements.
  • Cure the causing problem (if possible).


Antibiotics

Antibiotics are the primary and first-line treatment for Small Bowel Bacterial Overgrowth (SIBO). The treatment typically lasts for 7–10 days and may extend up to 14 days. If symptoms persist or return after the first course, the doctor may recommend continuing the antibiotics for a longer period or repeating the treatment—either with the same antibiotic or with alternative options.


There are usually multiple antibiotic options available for treating bacterial overgrowth in the gut, including Rifaximin and Probiotic therapy for beneficial bacteria.






Information: Probiotic supplements can help treat bacterial overgrowth in the intestine, but there is no proven evidence of their effectiveness.



Vitamins and supplements

It is also an important part of the treatment, which usually given to the patient Intramuscular injections of vitamin B12 and any other supplements depending on his deficiency, such as calcium, iron, magnesium, vitamin D, and others. (5)


Diet modification

Bacteria in the small intestine compete with the body to absorb carbohydrates from food, which can lead to uncomfortable symptoms, such as bloating and gas. (6)


Therefore, the goal of dietary modification is to reduce the amount of carbohydrates in the diet, such as the FODMAP diet, and to reduce fiber intake as well, to help alleviate bowel symptoms. (6)


In general, these nutritional tips may help relieve the symptoms of Small Bowel Bacterial Overgrowth: (6)


  • Reducing carbohydrates and high fiber: Such as potatoes, corn, broccoli, cabbage, whole grains, legumes, etc.
  • Avoid sugars: Of all kinds, whether sweets, drinks, baked goods, or dried fruits.
  • Focus on proteins and healthy fats: Such as poultry, meat, eggs, and healthy fats such as olive oil, nuts, and others.
  • Choose lactose-free dairy products: Because the intestine may be damaged and unable to digest the lactose, sugar found in dairy. (5)


After a period of avoiding specific types of foods, you can start reintroducing them gradually and observe how the body reacts to each reintroduced food. If any uncomfortable symptoms return, you should stop consuming that food.


Treatment of the Underlying Cause

If possible, it is better to treat the underlying cause of Small Bowel Bacterial Overgrowth (SIBO) to resolve the issue and prevent its recurrence. For example, gaps or blockages might be resolved through surgery, while a motility disorder might require medications to stimulate bowel movement. (5)






At Al-Ahli Hospital, we provide comprehensive solutions for all digestive system disorders, from accurate diagnosis to effective treatment, ensuring the best healthcare for each patient.



References