Bacterial overgrowth syndrome (SIBO): what is it, causes, symptoms, treatment, diagnosis, forms, complications, prevention

The intestines of a healthy person contain a number of microorganisms that ensure the proper functioning of the gastrointestinal tract and the digestion of food. If the number of such bacteria exceeds the permissible limits or pathogenic microflora starts in the organs, they diagnose the syndrome of bacterial overgrowth in the small intestine. This condition causes unpleasant symptoms, becomes the cause of vitamin deficiency, metabolic disorders. If untreated, it causes inflammatory diseases of other organs.

Definition

The small intestine of any person is inhabited by microorganisms that are necessary for normal digestion. The natural flora (which consists of bacteria) performs important functions in the human body:

1. Production of substances necessary for the body - nutrients, fatty acids, some vitamins, for example B9.
2. Protection of the body from harmful microorganisms.
3. Stimulates the immune system.
4. Maintain gut health. Scientists have proven that if the microflora is eliminated from the small intestine, the number of villi on the membrane will decrease, and their quality will deteriorate, the regeneration of organ tissues and its protective function will decrease. At the same time, all functions are restored when microorganisms are introduced into the intestines.
5. Stimulation of metabolic processes.
6. The assimilation of drugs. The mechanism of action of some medications is based precisely on the interaction with the intestinal flora.

Microflora usually does not grow more than the permissible levels due to the natural defense mechanism of the digestive tract. Reproduction is prevented by gastric juice, mucus, bile, enzymes, etc.

Bacterial overgrowth syndrome is a condition in which abnormal growth of the natural intestinal microflora is observed in the small intestine or pathogenic microorganisms are found. Also, the disease is diagnosed if the number of bacteria increases in the large intestine.

In the Russian literature, the syndrome of bacterial growth in the small intestine is often called dysbiosis.

The threshold for diagnosis is 100,000 bacteria per ml. In this case, the ratio of lactobacilli and bifidobacteria is violated.

Microorganisms begin to secrete an excessive amount of toxins, which seep into the capillary network of the small intestine through the mucosal membrane. This leads to the development of an inflammatory process, an increase in the secretion of cytokines, and the migration of immune cells. Parietal, cavity digestion is disturbed, the absorption of cleavage products into the blood is inhibited.

The bacteria also consume the vitamins and minerals the body needs. Deficiency of these elements develops.

According to statistics, bacterial overgrowth syndrome occurs in healthy people of any age (including children) in 20% of cases. In patients of gastroenterologists, pathology is found in 22-88% of cases. In situations where surgical intervention in the gastrointestinal tract is indicated, its total spread (up to 95%) is characteristic.

Symptoms

The syndrome of bacterial overgrowth in the small intestine can be asymptomatic for a long time. However, more often the pathological condition is accompanied by some signs:

1. Abdominal discomfort. It is expressed in bloating, flatulence, spasmodic pains, belching. Symptoms are persistent or intermittent. Aggravated by the use of alcohol, excessive amounts of food.
2. Stool disorder. Usually expressed as diarrhea. The feces are yellowish or light brown without impurities. Sometimes diarrhea is combined with periods of constipation.
3. Nausea. After eating, vomiting is possible, which does not bring relief.
4. Lack of appetite. Dramatic weight loss.
5. Deterioration of the general condition of the body due to anemia. Pallor of the skin, brittle hair and nails, increased fatigue, weakness.
6. Selenium deficiency symptoms. Dryness and redness of the skin.
7. Decreased vision due to vitamin A deficiency.
8. Muscle cramps caused by a lack of potassium.
9. Violation of the sensitivity of the skin, tingling of the extremities. Symptoms are associated with vitamin B12 deficiency.

All or only some of the symptoms described may be present. More often, there are signs characteristic of irritable bowel syndrome. In advanced cases, symptoms of a deficiency of vitamins and minerals appear, which also affect other organs.

Forms of the disease

The syndrome of bacterial overgrowth in the small intestine is classified according to the types of prevailing flora:

• aerobic;
• anaerobic;
• opportunistic flora.

There are also four stages of bacterial overgrowth syndrome. However, this division is conditional:

1. First stage. A slight increase in the bacterial component in the small intestine. There are usually no symptoms at this stage.
2. Second stage. Harmful and conditionally pathogenic microflora is increased to critical limits, the number of beneficial bacteria is reduced. The first symptoms appear - flatulence, abdominal discomfort, loose stools.
3. Third stage. There is an active growth of pathogenic bacterial forms. The intestinal walls become inflamed, diarrhea becomes chronic.
4. Stage four. The number of beneficial bacteria in the small intestine is significantly lower than pathogenic bacteria, the presence of fungi is possible. A person experiences symptoms associated with a deficiency of nutrients, anemia.

Sources of the disease

A person is born with an absolutely sterile intestine, during the first hour of life, the small and large intestines are inhabited by bacterial forms necessary for full digestion. Over the next three weeks, their number will return to normal.

Excessive reproduction of intestinal microflora is impeded by defense mechanisms, which include:

• gastric juice;
• a number of enzymes;
• bile, etc.

Small intestine bacterial overgrowth develops when the defense mechanism fails.

The main reason is the ingress of bacterial forms from the large intestine into the small intestine. Less commonly, an organ becomes infected with anaerobic and aerobic pathogens.

The following factors can provoke a pathological process in the small intestine:

1. Problems with motility of the gastrointestinal tract. In this case, bacterial overgrowth syndrome develops due to prolonged stagnation substances in the small intestine, which creates optimal conditions for the accelerated reproduction of pathogenic microflora. Deterioration in motor function occurs with chronic constipation, in people suffering from diabetes mellitus, with duodenostasis, gastrostasis.
2. Problems with cavity digestion. Occur with atrophic gastritis, pancreatitis, pathologies of the biliary tract, after stomach surgery.
3. Surgical intervention. The syndrome of bacterial overgrowth occurs during small intestinal anastomosis, accompanied by the migration of bacteria from the large intestine to the small intestine. The cause of the problem is vagotomy, blind loop, cholecystectomy.
4. Taking certain medications. More often, the syndrome of bacterial overgrowth develops when taking antibacterial agents that inhibit the beneficial bifido and lactobacilli in the small intestine. The problem arises when using drugs that adversely affect intestinal motility (opioid analgesics, antidepressants, ganglion blockers).
5. Insufficiency of the ileocecal valve. With bauginitis, inflammation develops, which is accompanied by incomplete closure of the valve and the movement of intestinal contents in the opposite direction. This problem is caused by tumors of the ileocecal angle and insufficiency of the Bauhinia valve.
6. Immunosuppressive conditions. For example, AIDS, undergoing chemotherapy, etc.
7. Pathology of the biliary tract.
8. Malignant and benign neoplasms in the intestine and in the lymph nodes surrounding it.
9. Extreme weight loss. The rapid development of bacterial flora in the small intestine is facilitated by strict diets and the use of weight loss products.
10. Food allergies. At risk are people with lactose intolerance and disaccharidase deficiency.

Diagnostics

If you suspect a syndrome of bacterial overgrowth in the small intestine, you should consult a gastroenterologist. At the first stage, the doctor asks the person about the disturbing symptoms, gets acquainted with the medical record.

For the final diagnosis, laboratory and instrumental studies will be needed. To identify the syndrome of bacterial overgrowth, the following tests are taken:

1. Glucose breath test. It is carried out on an empty stomach. The patient takes a deep breath, holds his breath and exhales into a special device. Then he drinks a glucose solution and repeats the action with the device. The specialist measures the trajectory of the hydrogen values ​​at intervals of half an hour. If they are enlarged, then there are problems with the small intestine.
2. Breath test with xylose. It is carried out in the same way as the previous analysis, but instead of glucose, xylose is used. Measure the indicators of carbon dioxide. With bacterial overgrowth in the small intestine, they will be altered.
3. Sowing of the aspirated masses of the small intestine. The analysis allows you to determine the type of pathogenic bacterial masses.
4. Coprogram. In overgrowth syndrome, particles of fat and undigested food are found in the material.
5. General blood analysis. The advanced syndrome of bacterial overgrowth in the small intestine is characterized by the presence of anemia and inflammation.
6. Blood chemistry. With the disease, a positive result of C-reactive protein is observed, an increase in the level of ALT and AST.

If you suspect a syndrome of bacterial overgrowth in the small intestine, instrumental diagnostics are used:

1. Intestinoscopy. A device with a camera is inserted into the small intestine to study its mucous membrane and take the contents for further research.
2. Small bowel biopsy. Particles of tissue from the mucous membrane of the small intestine are taken. In the presence of bacterial overgrowth syndrome, altered and atrophied villi are found.
3. X-ray or Ultrasound organs of the digestive tract. Used to identify the cause of the disease.

Treatment

The treatment of bacterial overgrowth in the small intestine is based on drug therapy. The following drugs are prescribed:

1. Antibiotics They are chosen depending on the type of pathogenic microflora. Prescribe drugs such as Rifaximin, Amoxicillin, Tetracycline hydrochloride.
2. Probiotics and prebiotics. The drugs allow you to restore the amount of bifidobacteria and lactobacilli necessary for normal digestion. Some products contain cultures that have a depressing effect on pathogenic microflora. These drugs include Bifikol, Colibacterin.
3. Vitamins, iron preparations, mineral complexes. Appointed when a deficiency of essential substances is detected.

With the syndrome of bacterial overgrowth in the small intestine, the use of sodium-calcium and hydrocarbonate-chloride waters is useful. Means slow down intestinal motility, normalize metabolism.

They use folk recipes:

1. Serum. It is taken orally to treat dysbiosis.
2. Kefir. 80 ml of kefir is warmed to room temperature and injected into the rectum using an enema.
3. Blueberry jelly. Grind 1 tbsp. l. berries and 1 tbsp. l starch. Dilute with 1 glass of warm water. The resulting mass is mixed with another glass of water and brought to a boil. Drink the product warm.
4. Aloe juice. A tablespoon of the remedy is taken for bloating and diarrhea.
5. Chamomile. Pour a cup of boiling water for 2 tsp. l. dried chamomile and let it brew for 30 minutes. Drink instead of tea for abdominal pain, bloating, sour belching, nausea.

Complications and possible consequences

More often, a negative consequence of bacterial overgrowth syndrome is a deficiency of iron, B vitamins, electrolytes, minerals, and protein. There are disturbances from the nervous system, the occurrence of edema, anemia, ascites.

In patients with gastritis, in 4% of cases, the syndrome of bacterial overgrowth in the small intestine causes inflammatory processes. Development of pyelonephritis, mesenteric adenitis is possible. In rare cases, complications occur in the form of sepsis, peritonitis, steatohepatitis, intrahepatic cholestasis.

Prophylaxis

Compliance with the rules of prevention will help avoid the development of bacterial overgrowth syndrome and its relapses.

The basic rules are as follows:

• the fight against excess weight;
• balanced diet;
• adherence to the diet;
• maintaining a drinking balance;
• timely treatment of diseases of the digestive tract;
• playing sports;
• strengthening the immune system.

The syndrome of bacterial overgrowth in the small intestine is a common disease characterized by the proliferation of intestinal microflora or the development of pathogenic organisms. It develops independently or against the background of other diseases. Correct therapy allows you to quickly cope with the disease, but without timely treatment, serious complications are possible.

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Sources:

• https://econet.ru/articles/185488-sindrom-izbytochnogo-bakterialnogo-rosta-kak-s-nim-borotsya
• https://yandex.ua/turbo/vseojkt.ru/s/lechenie/chto-takoe-sindrom-izbyitochnogo-bakterialnogo-rosta-i-nuzhno-li-ego-lechit
• https://yandex.ua/turbo/ilive.com.ua/s/health/sindrom-izbytochnogo-bakterialnogo-rosta-v-kishechnike_126621i15938.html
• https://internist.ru/publications/detail/sindrom-izbytochnogo-bakterialnogo-rosta-%E2%80%93-sovremennye-podhody-k-diagnostike-i-lecheniyu
• https://gastro-ufa.ru/clinic/articles/test-na-sibr
• https://www.lvrach.ru/2017/02/15436660