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The Small Intestines  
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Definition  

Small bowel bacterial overgrowth (SBBO) occurs when there is a build-up of too much bacteria in the small bowel.

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Causes  

SBBO is often caused by an abnormality in the small bowel. Food is not able to flow properly though the intestines. Conditions that may cause this include:

  • Birth defect
  • Injury
  • Surgery
  • Conditions (eg, digestive disorder)
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Risk Factors  

Examples of conditions that may increase the risk of SBBO include:

Other risk factors include:

  • Intestinal surgery (eg, removal of part of the small intestine )
  • An obstruction in the small intestine
  • Weakened immune system
  • Being elderly (more likely to have conditions like diverticulitis)

Any condition that affects how food moves through the small bowel may increase the risk of SBBO.

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Symptoms  

Not all patients with SBBO will have symptoms. But symptoms may include:

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Diagnosis  

SBBO can be difficult to diagnose. The symptoms may be similar to other conditions. Your doctor will:

  • Ask about your symptoms and medical history
  • Do a physical exam
  • Order tests, such as:
    • Blood tests to detects nutritional deficiencies (eg, anemia , B12 deficiency )
    • Breath tests—involves fasting, eating some type of sugar, and then exhaling into a bag; the sample is analyzed to find out if there are levels of certain gases
    • Culture of intestinal fluid (aspirate)—a catheter is used to get a sample of fluid from the small bowel
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Treatment  

The goals are to:

  • Reduce the levels of harmful bacteria in the small bowel
  • Treat the underlying condition

Medications  

Antibiotics are often prescribed to treat SBBO. Usually treatment is temporary. But, in some cases, you may need to take antibiotics for a longer period.

Nutritional Support  

To make sure that you get the proper nutrients, you may need to:

  • Work with a dietitian
  • Follow a special diet (eg, carbohydrate-restricted diet)
  • Take supplements (eg, iron , vitamin B12 )
  • Take probiotics

In some cases, tube feeding is needed with a special formula.

Surgery  

For severe cases, surgery may be needed. This is done to correct an abnormality in the small bowel.

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Prevention  

If you have any of the conditions that are linked to SBBO, get proper treatment. This may reduce your chance of having a build-up of bacteria in the small bowel.