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From the Townsend Letter
February / March 2013

Small Intestine Bacterial Overgrowth:
Often-Ignored Cause of Irritable Bowel Syndrome

by Allison Siebecker, ND, MSOM, LAc, and
Steven Sandberg-Lewis, ND, DHANP

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Page 1, 2, 3, 4

Notes
1.   Peralta S et al. Small intestine bacterial overgrowth and irritable bowel syndrome-related symptoms: experience with Rifaximin.
World J Gastroenterol. 2009 Jun 7;15(21):2628–2631.
2.   Lin HC et al. Small intestinal bacterial overgrowth: a framework for understanding irritable bowel syndrome.
JAMA. 2004 Aug 18;292(7):852–858.
3.   Pyleris E et al. The prevalence of overgrowth by aerobic bacteria in the small intestine by small bowel culture: relationship with irritable bowel syndrome.
Dig Dis Sci. 2012 May;57(5):1321–1329.
4.   Pimentel M et al. The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial.
Ann Intern Med. 2006 Oct 17;145(8):557–563.
5.   Lauritano EC et al. Association between hypothyroidism and small intestinal bacterial overgrowth.
J Clin Endocrinol Metab. 2007 Nov;92(11):4180–4184.
6.   Almeida JA et al. Lactose malabsorption in the elderly: role of small intestinal bacterial overgrowth.
Scand J Gastroenterol. 2008;43(2):146–154.
7.   Klaus J et al. Small intestinal bacterial overgrowth mimicking acute flare as a pitfall in patients with Crohn's Disease.
BMC Gastroenterol. 2009 Jul 30;9:61.
8.   Marie I, Ducrotté P, Denis P, Menard JF, Levesque H. Small intestinal bacterial overgrowth in systemic sclerosis.
Rheumatology (Oxford). 2009 Oct;48(10):1314–1319. Epub 2009 Aug 20.
9.   Rubio-Tapia A et al. Prevalence of small intestine bacterial overgrowth diagnosed by quantitative culture of intestinal aspirate in celiac disease.
J Clin Gastroenterol. 2009 Feb;43(2):157–161.
10. Mancilla AC et al. [Small intestine bacterial overgrowth in patients with chronic pancreatitis].
Rev Med Chil. 2008 Aug;136(8):976–980.
11. Ojetti V et al. Small bowel bacterial overgrowth and type 1 diabetes.
Eur Rev Med Pharmacol Sci. 2009 Nov–Dec;13(6):419–423.
12. Goebel A et al. Altered intestinal permeability in patients with primary fibromyalgia and in patients with complex regional pain syndrome.
Rheumatology (Oxford). 2008 Aug;47(8):1223–1227.
13. Gupta A et al. Role of small intestinal bacterial overgrowth and delayed gastrointestinal transit time in cirrhotic patients with minimal hepatic encephalopathy.
J Hepatol. 2010 Nov;53(5):849–855.
14. Shanab AA et al. Small intestinal bacterial overgrowth in nonalcoholic steatohepatitis: association with toll-like receptor 4 expression and plasma levels of interleukin 8.
Dig Dis Sci. 2011 May;56(5):1524–1534.
15. Weinstock LB, Klutke CG, Lin HC. Small intestinal bacterial overgrowth in patients with interstitial cystitis and gastrointestinal symptoms.
Dig Dis Sci. 2008 May;53(5):1246–1251.
16. Weinstock LB, Walters AS, Restless legs syndrome is associated with irritable bowel syndrome and small intestinal bacterial overgrowth.
Sleep Med. 2011 Jun;12(6):610–613.
17. Parodi A et al. Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication.
Clin Gastroenterol Hepatol. 2008 Jul;6(7):759–764.
18. Husebye E. The patterns of small bowel motility: physiology and implications in organic disease and functional disorders.
Neurogastroenterol Motil. 1999 Jun;11(3):141–161.
19. Bures J. 2010 Small intestinal bacterial overgrowth syndrome.
World J Gastroenterol. 2010 Jun 28;16(24):2978–2990.
20. Pyleris E et al. The prevalence of overgrowth by aerobic bacteria in the small intestine by small bowel culture: relationship with irritable bowel syndrome.
Dig Dis Sci. 2012 May;57(5):1321–1329.
21. Williams C et al. Occurrence and significance of gastric colonization during acid-inhibitory therapy. Best Pract Res Clin Gastroenterol. 2001 Jun;15(3):511–521.
22. Machado WM et al. The small bowel flora in individuals with cecoileal reflux.
Arq Gastroenterol. 2008 Jul–Sep;45(3):212–218.
23. Khoshini R, Dai SC, Lezcano S, Pimentel M. A systematic review of diagnostic tests for small intestinal bacterial overgrowth.
Dig Dis Sci. 2008 Jun;53(6):1443–1454.
24. Pimentel M. Gut microbes and irritable bowel syndrome [webcast]. July 20, 2012. GI Health Foundation. http://www.gihealthfoundation.org/coe/ibs/webcast/2012/july/MPimentel/?link=2012/
july/MPimentel&cme_proj_id=12&actionPage=topics/Gut_Microbes_and_
IBS/request-for-credit.cfm?cme_proj_id=12
. (
One link: Three lines) Accessed October 27, 2012.
25. Bouhnik Y et al. Bacterial populations contaminating the upper gut in patients with small intestinal bacterial overgrowth syndrome. Am J Gastroenterol. 1999 May;94(5):1327–1331.
26. Youn YH, Park JS, Jahng JH, et al. Relationships among the lactulose breath test, intestinal gas volume, and gastrointestinal symptoms in patients with irritable bowel syndrome.
Dig Dis Sci. 2011 Jul;56(7):2059–2066. Epub 2011 Jan 15.
27. Elsenbruch S. Abdominal pain in irritable bowel syndrome: a review of putative psychological, neural and neuro-immune mechanisms.
Brain Behav Immun. 2011 Mar;25(3):386–394. Epub 2010 Nov 20.
28. Pimentel M. A New IBS Solution. Sherman Oaks, CA: Health Point Press; 2006.
29. Pimentel M, Mayer AG, Park S, Chow EJ, Hasan A, Kong Y. Methane production during lactulose breath test is associated with gastrointestinal disease presentation.
Dig Dis Sci. 2003 Jan;48(1):86–92.
30. Kunkel D et al. Methane on breath testing is associated with constipation: a systematic review and meta-analysis.
Dig Dis Sci. 2011 Jun;56(6):1612–1618.
31. Pimentel M, Lin HC, Enayati P, et al. Methane, a gas produced by enteric bacteria, slows intestinal transit and augments small intestinal contractile activity.
Am J Physiol Gastrointest Liver Physiol. 2006 Jun;290(6):G1089–G1095. Epub 2005 Nov 17.
32. Chatterjee S et al. The degree of breath methane production in IBS correlates with the severity of constipation.
Am J Gastroenterol. 2007 Apr;102(4):837–841.
33. Singh VV, Toskes PP. Small bowel bacterial overgrowth: presentation, diagnosis, and treatment.
Curr Treat Options Gastroenterol. 2004 Feb;7(1):19–28.
34. DiBaise JK. Nutritional consequences of small intestinal bacterial overgrowth.
Prac Gastroenterol. 2008;69:15–28.
36. Prizont R. Glycoprotein degradation in the blind loop syndrome: identification of glycosidases in jejunal contents.
J Clin Invest. 1981 Feb;67(2):336–344.
37. Lauritano EC, Valenza V, Sparano L, et al. Small intestinal bacterial overgrowth and intestinal permeability.
Scand J Gastroenterol. 2010 Sep;45(9):1131–1132.
38. Resnick C. Nutritional protocol for the treatment of intestinal permeability defects and related conditions. Nat Med J. March 2010.
39. Eisenmann A et al. Implementation and interpretation of hydrogen breath tests.
J Breath Res. 2008 Dec;2(4):046002.
40. Quigley EM, Quera R. Small intestinal bacterial overgrowth: roles of antibiotics, prebiotics, and probiotics.
Gastroenterology. 2006 Feb;130(2 Suppl 1):S78–S90.
41. Quin Tron Instrument Company Inc.
Quin Tron Catalog and Information. 2012:22.
42. Gottschall E.
Breaking the Vicious Cycle. Baltimore, ON: Kirkton Press Ltd.; 1994.
43. Campbell-McBride N.
Gut and Psychology Syndrome. Cambridge: Medinform Publishing; 2004.
44. Ong DK, Mitchell SB, Barrett JS, et al. Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome.
J Gastroenterol Hepatol. 2010 Aug;25(8):1366–1373.
45. Nieves R, Jackson RT. Specific carbohydrate diet in treatment of inflammatory bowel disease.
Tenn Med. 2004 Sep;97(9):407.
46. Choung RS, Ruff KC, Malhotra A, et al. Clinical predictors of small intestinal bacterial overgrowth by duodenal aspirate culture.
Aliment Pharmacol Ther. 2011 May;33(9):1059–1067. doi: 10.1111/j.1365-2036.2011.04625.x. Epub 2011 Mar 13.
47. Staudacher HM, Whelan K, Irving PM, Lomer MC. Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome.
J Hum Nutr Diet. 2011 Oct;24(5):487–495. doi:10.1111/j.1365-277X.2011.01162.x. Epub 2011 May 25.
48. Pimentel M, Constantino T, Kong Y, Bajwa M, Rezaei A, Park S. A 14-day elemental diet is highly effective in normalizing the lactulose breath test.
Dig Dis Sci. 2004 Jan;49(1):73–77.
49. Scarpignato C, Pelosini I. Experimental and clinical pharmacology of rifaximin, a gastrointestinal selective antibiotic.
Digestion. 2006;73 Suppl 1:13–27. Epub 2006 Feb 8.
50. Lombardo L, Foti M, Ruggia O, Chiecchio A. Increased incidence of small intestinal bacterial overgrowth during proton pump inhibitor therapy.
Clin Gastroenterol Hepatol. June 2010;8(6):504–508.
51. Pimentel M, Lembo A, Chey WD, et al.; TARGET Study Group. Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med. 2011 Jan 6;364(1):22–32.
52. Yang J, Lee HR, Low K, Chatterjee S, Pimentel M. Rifaximin versus other antibiotics in the primary treatment and retreatment of bacterial overgrowth in IBS.
Dig Dis Sci. 2008 Jan;53(1):169–74. Epub 2007 May 23.
53. Debbia EA, Maioli E, Roveta S, Marchese A. Effects of rifaximin on bacterial virulence mechanisms at supra- and sub-inhibitory concentrations.
J Chemother. 2008 Apr;20(2):186–194.
54. Mencarelli A, Renga B, Palladino G, et al. Inhibition of NF-kb by a PXR-dependent pathway mediates counter-regulatory activities of rifaximin on innate immunity in intestinal epithelial cells.
Eur J Pharmacol. 2011 Oct 1;668(1–2):317–324. Epub 2011 Jul 26.
55. Low K, Hwang L, Hua J, Zhu A, Morales W, Pimentel M. A combination of rifaximin and neomycin is most effective in treating irritable bowel syndrome patients with methane on lactulose breath test.
J Clin Gastroenterol. 2010 Sep;44(8):547–550.
56. Logan AC, Beaulne TM. The treatment of small intestinal bacterial overgrowth with enteric-coated peppermint oil: a case report.
Altern Med Rev. 2002 Oct;7(5):410–417.
57. Pimentel M, Morales W, Lezcano S, Sun-Chuan D, Low K, Yang J. Low-dose nocturnal tegaserod or erythromycin delays symptom recurrence after treatment of irritable bowel syndrome based on presumed bacterial overgrowth.
Gastroenterol Hepatol (N Y). 2009 Jun;5(6):435–442.
58. Pimentel M. An evidence-based treatment algorithm for IBS based on a bacterial/SIBO hypothesis: Part 2.
Am J Gastroenterol. 2010 Jun;105(6):1227–30.
59. Ploesser J, Weinstock LB, Thomas E. Low Dose Naltrexone: Side Effects and Efficacy in Gastrointestinal Disorders.
International Journal of Pharmaceutical Compounding; March 2010.
60. Manabe N, Rao AS, Wong BS, Camilleri M. Emerging pharmacologic therapies for irritable bowel syndrome.
Curr Gastroenterol Rep. 2010 Oct;12(5):408–16.
61. Gibson PR, Shepherd SJ. Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach.
J Gastroenterol Hepatol. 2010 Feb;25(2):252–8. Review.
62. Bowman, G. The Gut, the Brain and the Functional GI Disorders. Functional Gastroenterology Seminar: Level 1. Winter 2010, p. 19. 
63. Gabrielli M, Lauritano EC, Scarpellini E, Lupascu A, Ojetti V, Gasbarrini G, Silveri NG, Gasbarrini A. Bacillus clausii as a treatment of small intestinal bacterial overgrowth.
Am J Gastroenterol. 2009 May;104(5):1327–8. Epub 2009 Apr 7.
64. Soifer LO, Peralta D, Dima G, Besasso H. Comparative clinical efficacy of a probiotic vs. an antibiotic in the treatment of patients with intestinal bacterial overgrowth and chronic abdominal functional distension: a pilot study.
Acta Gastroenterol Latinoam. 2010 Dec;40(4):323–7.
65. Schiffrin EJ, Parlesak A, Bode C, Bode JC, van't Hof MA, Grathwohl D, Guigoz Y. Probiotic yogurt in the elderly with intestinal bacterial overgrowth: endotoxaemia and innate immune functions.
Br J Nutr. 2009 Apr;101(7):961–6.
66. Ruland J. Return to homeostasis: downregulation of NF-κB responses.
Nat Immunol. 2011 Jun 19;12(8):709–14. doi: 10.1038/ni.2055.
67. Al-Sadi RM, Ma TY. IL-1beta causes an increase in intestinal epithelial tight junction permeability.
J Immunol. 2007 Apr 1;178(7):4641–9.
68. Csaki C, Mobasheri A, Shakibaei M. Synergistic chondroprotective effects of curcumin and resveratrol in human articular chondrocytes: inhibition of IL-1beta-induced NF-kappaB-mediated inflammation and apoptosis.
Arthritis Res Ther. 2009;11(6):R165. Epub 2009 Nov 4.
69. Chou J, Tabrizi R, Pimentel M, Sokol T. S1326 Presumed IBS Subjects With Short Remission After Antibiotic Therapy Often Have Secondary Causes for Their Symptoms.
Gastroenterology, Volume 138, Issue 5, Supplement 1 , Pages S–229, May 2010.

Allison Siebecker, ND, MSOM, LAc
Steven Sandberg-Lewis, ND, DHANP
NCNM Clinic
3025 SW Corbett Ave.
Portland, Oregon 97211

Allison SiebeckerAllison Siebecker, ND, MSOM, LAc, is a graduate of NCNM, where she specializes in treating SIBO in her private practice. She is the author of an educational website on SIBO, is currently writing a book on SIBO, and teaches continuing education to physicians on SIBO and related topics. In 2005, Dr. Siebecker received the Best in Naturopathy award from the Townsend Letter for her article "Traditional Bone Broth in Modern Health and Disease." Visit her educational website at www.siboinfo.com.

Steven Sandberg-Lewis
Steven Sandberg-Lewis, ND, DHANP, is a graduate of NCNM, where he practices, supervises student shifts, and has been professor of gastroenterology since 1996. In 2009, Dr Sandberg-Lewis received the Best in Naturopathy award from the Townsend Letter for his article "Hiatal Hernia Syndrome" and honorable mention in 2011 for his article "Proton Pump Inhibitors – A Risky Experiment?" His textbook, Functional Gastroenterology, is available at www.ncnm.edu/bookstore.

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