From Johns Hopkin's website.
SIBO Symptoms
SIBO is an abnormal number of bacteria in the small intestine that can lead to:
bloating and increased passing of gas (flatulence)
diarrhea or constipation
abdominal pain
nausea
fatigue
In more extreme cases, the small intestine may not be able to absorb nutrients. In these situations, you may also experience weight loss and anemia (iron deficiency).
SIBO Treatment Options
Our specialists understand that there are different levels and types of SIBO. These distinctions matter when determining the most appropriate treatment. Depending on the extent of your condition, treatment may vary. We deliver customized treatment for:
hydrogen-predominant SIBO: The primary treatment is the antibiotic rifaximin.
methane-predominant SIBO: This type of SIBO is harder to treat, and it may take longer to respond to treatment. We use rifaximin plus neomycin for these cases.
recurrent SIBO: We closely monitor you for a recurrence of SIBO. If it happens, you will benefit from our experience treating the disease. We have experience with formulations of antimicrobial herbs, which can be used to treat recurrences and as an alternative for initial treatment of hydrogen- or methane-predominant SIBO.
As part of your treatment, we recommend following a FODMAP (low fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet and consulting with a nutritionist.
What are SIBO risk factors?
Structural or anatomic abnormalities may affect normal movement of the small intestine (motility). Stasis, or lack of movement, can lead to bacterial imbalance. This can occur if you:
have diverticulosis — tiny bulging pouches (diverticula) in the small intestine
had surgery that changed the small intestine’s structure, such as Roux-en-Y gastric bypass surgery, or surgery on the right colon with removal of the ileocecal valve, or surgery on the last part of the small bowel.
have adhesions (scar tissue) that developed after radiation therapy or after multiple abdominal surgeries
have amyloidosis (a buildup of amyloid protein deposits) — deposits can accumulate in the small intestine and change its structure
Use of certain medications could be linked to SIBO. These include:
narcotic medications
anti-spasm medications for irritable bowel syndrome (IBS), such as hyoscyamine or dicyclomine
long-term use of proton pump inhibitors (PPIs) — medications that decrease acid in the stomach to control heartburn
frequent use of antibiotics, which may alter the bacteria in the small bowel
https://www.hopkinsmedicine.org/gastroe ... rowth.html