This article is part of the IBD Index. Last updated on March 14, 2022.
Small intestinal bacterial overgrowth, or SIBO, is one area of research in the field of intestinal health that has gone from relative obscurity to almost totally mainstream just in the past decade. As research has progressed, the name “overgrowth” has become a bit of a misnomer, with recent evidence indicating that the issue isn’t bacterial overgrowth per se, but rather bacterial dysbiosis in the small intestine.
In any case, SIBO is often identified in patients with IBD*, and can both affect and be affected by other IBD-related disease processes. Therefore, the question of whether and how to treat it is highly relevant. While treatment of SIBO is certainly a lever one can pull that may affect symptoms and overall disease state, SIBO is also often a symptom of other dysfuctions and environmental factors, such that addressing those other factors could resolve the SIBO without explicit treatment. And because testing for and treating SIBO is often quite complicated, it’s best to take it in context and consider whether there are other “no-brainer” levers that could be pulled first.
At this time, I don’t plan to write my own SIBO resource. Instead, I refer you to the writings of my good friend Dr. Lucy Mailing, whose expertise and research acumen I trust implicitly. I’ll also add other resources to this list if/when I find them.
- All about SIBO: Small Intestinal Bacterial Overgrowth, by Lucy Mailing: “This article serves as both an introduction and a comprehensive guide to SIBO, or small intestinal bacterial overgrowth. Whether you’ve never heard of it before or are struggling to treat recurring SIBO, this article is for you. I’ll cover what SIBO is, how to test for it, options for treating overgrowth, and the best strategies for preventing recurrence.”
- What the Latest Research Reveals about SIBO, by Lucy Mailing
*A 2019 review and meta-analysis determined that SIBO is more common in those with IBD compared to healthy controls. However, they used breath testing as the diagnostic tool, a method that has now been called into question. I’m not sure whether we have research proving this association using more accurate diagnostic tools, but regardless, the topic of SIBO is still highly relevant for those with IBD.