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A break though study has just been published that shows a strong correlation between people found to have small intestinal bacterial overgrowth (SIBO) and coronary artery disease (CAD).  In this study, 1,059 patients were tested using the glucose hydrogen/methane breath test for the presence of SIBO. Positive SIBO patients were compared to SIBO negative patients.  SIBO positive patients had a significantly higher incidence of CAD as well as a higher incidence of diabetes and chronic kidney disease.  The researcher’s conclusion is that patients that test positive for SIBO should consider further assessment for CAD.  The evidence also suggests that indentifying SIBO and subsequently treating and eradicating the bacterial might help people avoid a CAD problem down the road.  Metabolic Solutions offers the home based glucose hydrogen/methane test for $129.00. Check out the link below to the published paper and order your test.

Great article that reviews the prevalence of SIBO and discusses the value of using the hydrogen breath test to detect SIBO, and the importance of testing for both hydrogen and methane gas.  Full text of article available for free.

This study conducted a meta-analysis and systematic review of current evidence to assess the efficacy of probiotics in preventing or treating small intestinal bacterial overgrowth (SIBO). The conclusion was that probiotics supplementation could effectively decontaminate SIBO, decrease H2 concentration, and relieve abdominal pain, but were ineffective in preventing SIBO. To get the described benefits it is important to purchase high quality probiotics with active cultures.

The hydrogen breath test is generally agreed to be the best method to test for small intestinal bacterial overgrowth (SIBO).  However, there was disagreement on the how to the timing of the test, the size of the glucose dose, and how to calculate the result.  To address these problems a group of highly regarded gastroenterologist gathered to come to a consensus of on the best practices.  The group made the following recommendations: 1) the duration of the SIBO test should be 90 minutes, 2) the dose of glucose should be 75 grams, and 3) a change of 10 ppm over baseline for methane gas is a positive result for SIBO.

It is possible that prolonged use of proton pump inhibitors (PPIs) may increase the risk of small intestinal bacterial overgrowth (SIBO). This is because chronic acid suppression may alter the intraluminal environment leading to growth of bacteria in the small intestine. There have been numerous studies that examined the risk of SIBO in adults taking PPIs but the results have been inconclusive. This studies goal was to determine the incidence of SIBO in children who regularly use the PPI’s. The study enrolled 83 children of whom 56 were taking PPI and the rest used as controls.  The result was 9% of the children taking PPI’s tested positive for SIBO while 4% of the controls tested positive for SIBO.  While the study lacked statistical significance the results bear out that SIBO should be at least considered in children taking PPI’s over an extended period of time.

This updated information confirms the important role small intestinal bacterial overgrowth (SIBO)  has in rosacea.   It confirms that the incident of SIBO is very high (46%) but most importantly successful treatment of SIBO with antibiotics like rifaximin leads to clinical remisison that lasted throughout the 3 year follow -up period.

A recent study examined whether Proton Pump Inhibitors (PPI) such as Prilosec, Prevacid, Nexium and Protonix can cause small intestinal bacteria overgrowth.  The concern was that acid blockers change the natural flora of the small intestine leading to bacterial growth.   The conclusion was no – there was no correlation between taking PPI’s and getting SIBO.

Researchers at the Cleveland Clinic just published their findings from a study to determine if there is association between small intestinal bacterial overgrowth (SIBO) and deep vein thrombosis (DVT).    DVT occurs when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs. It can develop if you have certain medical conditions that affect how your blood clots hence why the association with SIBO was examined.  The study enrolled 321 patients.  The subjects were tested using the glucose hydrogen breath test for SIBO.  DVT was confirmed using Dopler ultrasonography. The result was a relatively high correlation between the two conditions.  Further research needs to be done to determine if eradicating SIBO reduces the incidence of DVT – something that would be of great interest to travelers.

Daikenchuto (DKT) is a very popular Japanese herbal medicine that is used to treat gastrointestinal disorders.   Typical of herbs not much scientific evidence can be found to confirm the efficacy of the treatment.  So a study, even if it is small (10 patients) is useful.  In this study, 10 patients were enrolled with chronic constipation and abdominal pain.  The patients were tested using the glucose hydrogen breath test for small intestinal bacterial overgrowth (SIBO) with 4 of them being positive.  After DKT treatment all the patients reported decreased constipation and abdominal pain.  However, it did not eradicate the SIBO.

A research group at the First Moscow State Medical University has reported that they have identified a probiotic that eradicates eradicates small intestinal bacterial overgrowth (SIBO) in patients who also have irritable bowel syndrome (IBS).  The probiotic, available only in Russia, combinated four strains of bacteria and is named Florasan-D. Florasan-D includes a combination of Bifidobacterium bifidum,Bifidobacterium longum, Bifidobacterium infantis and Lactobacillus rhamnosus.