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What is small intestinal bacterial overgrowth (SIBO) ?

The small bowel, also known as the small intestine, is the section of the gastrointestinal tract that connects the stomach with the colon. The main purpose of the small intestine is to digest and absorb food into the body. The small intestine is approximately 21 feet in length and begins in the duodenum (into which food from the stomach empties), followed by the jejunum, and then the ileum (which empties the food that has not been digested into the large intestine or colon).

The entire gastrointestinal tract, including the small intestine, normally contains bacteria. The number of bacteria is greatest in the colon and much lower in the small intestine. Moreover, the types of bacteria within the small intestine are different than the types of bacteria within the colon.

Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria are present in the small intestine and the types of bacteria in the small intestine resemble more the bacteria of the colon than the small intestine Small intestinal bacterial overgrowth (SIBO) is also known as small bowel bacterial overgrowth (SBBO).

Small Bowel Malabsorption Syndrome Surgery Delhi India, Short Bowel Syndrome

Symptoms of Small Intestine Cancer

  • No early symptoms
  • Gastrointestinal bleeding
  • Blood in stool
  • Black stool
  • Fatigue

Forms Of Inflammatory Bowel Disease (IBD)

There are two major forms of inflammatory bowel disease (IBD); Crohn's disease and ulcerative colitis.

1. Crohn's disease : -

Crohn's disease appears to be increasing in frequency. It is more common in Caucasians compared to individuals of African of Asian descent. It appears to be most common in some individuals of Jewish descent. Crohn's disease can become evident at any age. However, there appear to be two peaks at which patients develop significant symptoms, in the mid-20s and after 50 years of age. The cause of Crohn's disease is unknown. An infection may be involved.

There appears to be a genetic susceptibility and environmental factors may be involved. Patients who smoke tend to have more active Crohn's disease. Crohn's disease affect the gastrointestinal tract from the mouth to the anus. It occurs most commonly in the lower part of the small intestine (the terminal ileum), and the colon. It is characterized by inflammation of the bowel wall, which becomes chronic to the extent that fibrosis or scarring occurs.

2. Ulcerative Colitis : -

Just like some people get arthritis which is an inflammation of the joints, it is also possible to get inflammation of the colon. Inflammation of the colon (large intestine) is called colitis. Germs can cause colitis. Poor blood supply can cause colitis. Some medications can cause colitis. However, in most cases, the cause of colitis is not known.

When no other cause can be found for the inflammation, it falls into either one of two categories, ulcerative colitis or Crohn's colitis (Crohn's disease of the colon). Diet and psychological factors do not cause ulcerative colitis or Crohn's colitis. No germs have been found to cause these conditions. Colitis is not infectious; it cannot be passed from one person to another like the flu or a common cold.

Ulcerative colitis causes inflammation only in the mucosal (superficial) lining of the colon. It does not affect the small intestine or the stomach. Ulcerative colitis generally starts in the rectum and spreads from the rectum toward the first part of the colon in a steady progression.


The treatment of celiac sprue is to remove all gluten from the diet. Even small amounts of gluten can prevent a clinical response. It is important for the patient to become very familiar with gluten free products. Information is available in celiac disease support groups as well as a web page for celiac disease. Some patients may not respond to a gluten free diet and need other treatment, such as steroids. Failure to respond to a gluten free diet and/or steroids should always raise the suspicion of another diagnosis.

Patients on gluten free diets should have supplements of vitamins, particularly vitamin D, folic acid, and iron. These may need to be given by injection if they cannot be absorbed in the oral form.

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