PathophysiologyĬertain species of bacteria are more commonly found in aspirates of the jejunum taken from patients with bacterial overgrowth. Vitamin B12 is absorbed in the last part of the small bowel, the ileum, and patients who malabsorb vitamin B12 can develop a megaloblastic anemia with large red blood cells. Iron is absorbed in the more proximal parts of the small bowel, the duodenum and jejunum, and patients with malabsorption of iron can develop a microcytic anemia, with small red blood cells. Anemia may occur from a variety of mechanisms, as many of the nutrients involved in production of red blood cells are absorbed in the affected small bowel. Patients with bacterial overgrowth that is longstanding can develop complications of their illness as a result of malabsorption of nutrients. Steatorrhea is a sticky type of diarrhea, where lipids are malabsorbed and spill into the stool. Children with bacterial overgrowth may develop malnutrition have difficulty attaining proper growth. Some patients may develop abdominal discomfort and lose weight. The symptoms of bacterial overgrowth include nausea, bloating, flatus, and chronic diarrhea. Many of the symptoms are due to malabsorption of nutrients due to the effects of bacteria which either metabolize nutrients or cause inflammation of the small bowel impairing absorption. Small bowel bacterial overgrowth syndrome is treated with antibiotics, which may be given in a cyclic fashion to prevent tolerance to the antibiotics.īacterial overgrowth can cause a variety of symptoms, many of which are also found in other conditions, making the diagnosis challenging at times. Risk factors for the development of bacterial overgrowth include the use of medications including proton pump inhibitors, anatomical disturbances in the bowel, including fistulae, diverticula and blind loops created after surgery, and resection of the ileo-cecal valve. The diagnosis of bacterial overgrowth is made by a number of techniques, with the gold standard diagnosis being an aspirate from the jejunum that grows in excess of 10 5 bacteria per millilitre. Patients with bacterial overgrowth typically develop symptoms including nausea, bloating, vomiting and diarrhea, which is caused by a number of mechanisms. Unlike the colon (or large bowel), which is rich with bacteria, the small bowel usually has less than 10 4 organisms per millilitre. Small bowel bacterial overgrowth syndrome ( SBBOS), or small intestinal bacterial overgrowth ( SIBO), also termed bacterial overgrowth is a disorder of excessive bacterial growth in the small intestine. Small bowel bacterial overgrowth syndrome Classification & external resources ICD-10 Small bowel bacterial overgrowth syndrome
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