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Current Gastroenterology Reports
Published in: Current Gastroenterology Reports 2/2016

01-02-2016 | Neurogastroenterology and Motility Disorders of the Gastrointestinal Tract (S Rao, Section Editor)

How to Test and Treat Small Intestinal Bacterial Overgrowth: an Evidence-Based Approach

Authors: Ali Rezaie, Mark Pimentel, Satish S. Rao

Published in: Current Gastroenterology Reports | Issue 2/2016

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Abstract

Small intestinal bacterial overgrowth (SIBO) is characterized by an excessive amount of bacteria in the small intestine and a constellation of symptoms that include bloating, pain, gas, and diarrhea. Although known for many decades, there is a lack of consensus and clarity regarding the natural history and methods for its diagnosis. Several tests have been proposed, including the glucose breath test, lactulose breath test, small intestinal aspiration and culture, and others. However, there is a lack of standardization of these tests and their interpretation. Treatment of SIBO remains empirical; generally, broad spectrum antibiotics are recommended for 2 weeks (amoxicillin, rifaximin, ciprofloxacin, etc.) but evidence for their use is fair. Clearly, there is a strong need to develop a systematic approach for the management of SIBO and to perform multicenter clinical trials for the treatment of SIBO. In this review, we will discuss the current evidence for the diagnosis and treatment of SIBO, which includes (1) elimination/modification of the underlying causes, (2) induction of remission (antibiotics and elemental diet), and (3) maintenance of remission (promotility drugs, dietary modifications, repeat or cyclical antibiotics).
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Metadata
Title
How to Test and Treat Small Intestinal Bacterial Overgrowth: an Evidence-Based Approach
Authors
Ali Rezaie
Mark Pimentel
Satish S. Rao
Publication date
01-02-2016
Publisher
Springer US
Published in
Current Gastroenterology Reports / Issue 2/2016
Print ISSN: 1522-8037
Electronic ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-015-0482-9

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