The prolonged use of anti-acid pills can be another promoter of SIBO. Furthermore, hydrogen breath tests should be carried out to exclude the possibility of lactose and fructose intolerance while a stool examination can exclude pancreatic insufficiency and the presence of pathogenic bacteria or parasites. Lab tests are used to rule out diseases such as liver cirrhosis, diabetes, or AIDS, all of which can induce SIBO. For special cases, an MRI may be required. Diagnostic tests for this purpose include gastroscopy (for helicobacter and coeliac diseases), a histological examination for atrophic gastritis, colonoscopy (to exclude malignant or inflammatory stenosis, fistulas, and diverticulitis) and ultra sound examinations of the abdomen. It is necessary to differentially diagnose SIBO due to the general symptoms associated with it and the fact that SIBO can hide other digestive tract diseases. A bacteria value exceeding 10 5/ml is a clear indication of SIBO. In addition to the hydrogen breath test, patients can have secretion from the jejunum examined. For the lactose test, doctors can also check whether the patient is lactose intolerant. If a patient has SIBO, the presence of extra gas is detected through a noticeable increase in hydrogen levels. After drinking a sugar solution, doctors measure hydrogen levels in the patient’s breath four times (during the lactose test, blood sugar levels are also measured). SIBO can be diagnosed via a hydrogen breath test with lactose or glucose. In a nutshell, chronic digestion problems can reduce one’s overall well-being. In extreme cases, pressure on the diaphragm can lead to heart pain, shortness of breath, changes in skin pigment, and even exhaustion. If gas enters the large intestine, it collects and can cause pain on both sides of the ribs. The normal bacterial flora in the small intestine proliferates to an extent which significantly deranges the normal physiological processes of digestion and absorption. Moreover, accelerated peristalsis means that certain fatty acids, vitamin B12 and iron are not well-absorbed and can subsequently lead to fatty stool, weight loss, and a deficiency state.Ĭhronic symptoms such as increased flatulence, colicky abdominal pain, and malabsorption can have a negative impact on a person’s quality of life.īlind loop syndrome is a form of SIBO which ensues after abdominal surgery. Such symptoms can hinder the smooth contraction of digestive tract muscles (peristalsis) and lead to constipation or even diarrhea. The pressure in the stomach resulting from gas can also cause nausea, heartburn, and spastic abdominal pain primarily located near the navel and right lower abdomen. On account of the build-up of gas, someone with SIBO usually feels bloated, experiences excessive flatulence, burps, and has bad breath. Symptoms of SIBO can present 30-90 minutes after eating and they are triggered by bacteria caused malabsorption. Additional mechanisms which prevent the spread of bacteria in the small intestine include immunoglobulins in the mucous membrane, pancreatic juice, and gall bladder bile. Both the ileocecal valve, which separates the small intestine from the large intestine, and peristaltic waves, which ensure that digestive tract muscles contract smoothly, prevent the infiltration of large intestine bacterial flora into the small intestine. These bacteria have numerous physiological functions, one of which is the further digestion of fermented food from the small intestine. The large intestine, on the contrary, houses a thick layer of bacteria consisting of approximately 10 10-10 12 bacteria per milliliter. Bacteria ingested through eating are predominantly killed by gastric acid, which means that only minimal amounts of bacteria are detectable in the small intestine. In its normal physiological state, the small intestine contains a small amount of bacteria, approximately 10 3-10 4 bacteria per milliliter. Small intestinal bacterial overgrowth (SIBO) is a disorder whereby bacteria excessively grows in the small intestine it is not a severe disorder and does not lead to organ damage.
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