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In a healthy small intestine live comparatively few bacteria; most of the gut flora sits in the large intestine. If there are too many bacteria in the small intestine, this is called SIBO (small intestinal bacterial overgrowth). The term often comes up when bloating persists despite a conscious diet. Here are the most important points in brief.
Possible complaints
- bloating and fullness, often soon after eating
- abdominal pain or cramps
- diarrhea, constipation or alternation between them
- intolerance of several food groups
- sometimes tiredness or weight loss in pronounced cases
These signs are nonspecific. They also occur with irritable bowel syndrome, intolerances or celiac disease, which should be ruled out medically. More on digestive complaints and on bloating despite a healthy diet.
Possible risk factors
- slowed gut motility, for example with diabetes or an underactive thyroid
- operations on the gastrointestinal tract, adhesions, pouches (diverticula)
- long-term use of acid-reducing medication
- chronic bowel diseases
The breath test
In the hydrogen and methane breath test you drink a sugar solution after preparation. Bacteria ferment the sugar, producing gases that are exhaled and measured. An early rise can point to overgrowth.
- Preparation: set by the laboratory, usually an adjusted diet the day before and fasting. Please follow the instructions exactly, otherwise results are unusable.
- Medication: Antibiotics and some laxatives can distort the result. Discuss this beforehand.
- Limits: Fast gut transit can make the test falsely positive, slow transit falsely negative. The test is one building block, not a verdict.
Who treats it?
Whether and how to treat is decided by your doctor, possibly with antibiotics. A adjusted diet can be discussed alongside. Very strict diets over the long term are not advisable because they can lead to nutrient gaps and should not be done without supervision.
Support at Natura Heilpraxis
We discuss history and earlier findings, decide together whether a breath test work-up makes sense, and on request support you with nutrition counseling and the Gut & Digestion support program. A stool examination can also provide additional clues. This support does not replace a medical examination or therapy.
Frequently asked questions
Which symptoms can occur with SIBO?
Commonly described are bloating, fullness soon after eating, abdominal pain, diarrhea or constipation and sometimes intolerance of several food groups. The complaints are nonspecific, however, and also occur with other conditions.
How does a breath test proceed?
After a preparation phase (adjusted diet, fasting) you drink a sugar solution, usually lactulose or glucose. Over two to three hours your breath is examined for hydrogen and methane at regular intervals. An early rise can point to overgrowth.
How reliable is the test?
It depends on preparation, the sugar used and gut transit. With fast transit the test can be falsely positive, with slow transit falsely negative. Complaints, history and result are therefore judged together.
Who treats SIBO?
Treatment, which can include antibiotics, belongs in medical hands. On request we complement with nutrition counseling and support but do not replace medical therapy.
All questions & answers in the guide →
Professionally responsible: Yesha Karmeli, naturopathic practitioner (Heilpraktiker), Natura Heilpraxis Berlin. This text provides general information and does not replace individual advice.
