Most patients with SIBO symptoms do not have it.

SIBO, an acronym for intestinal bacterial overgrowth in English, is defined as presence of excessive bacteria in the small intestine which causes a set of nonspecific gastrointestinal symptoms such as bloating, abdominal pain, bloating, flatulence, diarrhea or constipation, which are usually the product of bacterial fermentation of nutrients.

In front of him growing interest in this pathology both among the general population (becoming a fashionable disease among “influencers”) and among health professionals, due to the avalanche of cases seeking consultation, the Spanish Society of Digestive Pathology (SEPD), together with the Spanish Association of Neurogastroenterology and Motility, wrote a positioning article on SIBO and its correct diagnosis.

A paper prepared by doctors Verónica Martín Domínguez, Carolina Malaguellada and Cecilio Santander and published in the Spanish Journal of Digestive Diseases (REED) highlights that Its diagnosis requires appropriate test indication.

and proper collection of samples with the appropriate substrate and interpretation of results by trained and experienced professionals.

“It is important to pay attention to Up to 20% of healthy people without digestive symptoms may test positive for SIBO. – emphasizes Santander, one of the authors, – therefore, the diagnostic effectiveness of the SIBO breath test is achieved with adequate selection of patients with the correct indication.

Thus patients with risk factors for developing SIBO These are those who have had intestinal surgeries or diseases that alter intestinal motility, affect their quality of life, have nutritional deficiencies or severe symptoms, so “the diagnostic method and the substrate used must be carefully chosen,” says Dr. Santander.

The reference diagnostic test for diagnosing SIBO is jejunal aspirate culture, but it is invasive and expensive, so the exhalation test (BAT) is used as an alternative method. In this sense, they recommend “with the collection of samples with an appropriate substrate, preferably glucose,” explains Carolina Malaguellada, co-author of the paper, but with the condition that “TAE for the diagnosis of SIBO be interpreted by specialized medical personnel“, the doctor adds.

Treatment

As for its treatment, it should be based “on improvement of the clinical syndrome, and not limited to a negative breath test result,” adds Veronica Martin, another of the paper’s authors, all by identifying the underlying causes and correcting possible eating behavior. flaws. As for following a diet low in fermentable carbohydrates (Fodmap), these are foods that can help control your symptoms, the doctor notes that “they may temporarily improve bloating and bloating,” but still, since they have very strict diets”Its use is not recommended for treatment.

SIBO,” he concludes.

The document was very well received by doctors who have been monitoring consultations in recent months due to the increase in the number of suspected cases of the disease, but nonspecific symptoms on the one hand, unreliability of the diagnostic test on the other and ineffectiveness of treatment

They turned the situation into a perfect storm, so they demanded a position from scientific societies on this issue.

“I think they took a very rational and sensible position based on current scientific evidence, and that makes some very important points clear. First, SIBO is virtually unknown in the healthy population and clearly positions itself against performing a breath test in patients with nonspecific digestive symptoms. This is a fundamental point. Except, He says that these breath tests are very unreliable and that if you have to do them, it is better to use glucose., which is within the limits of bad, is more reliable. In addition, tests for bacterial overgrowth should only be performed in patients with risk factors predisposing to this disease, and it is recommended to avoid systematic use of antibiotics for functional disorders such as irritable bowel syndrome,” says Miguel Rodriguez Gandia, a digestive system specialist. at the Ramon y Cajal Hospital from Madrid.