SIBO

SIBO can cause GI and non-GI symptoms including food sensitivities (especially to fermentable carbohydrates and gluten), skin issues (rosacea, eczema, urticaria, dermatitis herpetiformis), and mood disturbances (anxiety, depression, brain fog, fatigue). These symptoms often improve with SIBO treatment.

Common Food sensitivities and intolerances

Fermentable carbohydrates
Gluten sensitivity
Histamine intolerance

Skin manifestations

Rosacea: Strongly associated with SIBO; eradication improves rosacea in many patients
Eczema and urticaria
Dermatitis herpetiformis

Mood and cognitive symptoms

Anxiety and depression
Brain fog and cognitive impairment
Fatigue

Mechanisms linking SIBO to non-GI symptoms

Malabsorption
Immune activation
Gut–brain axis

SIBO – Occurs when bacteria colonize the small intestine, where they ferment carbohydrates and produce gas, causing bloating, diarrhea, and malabsorption. Factors include slowed transit (gastroparesis, diabetes, scleroderma, hypothyroidism) , structural defects (strictures, fistulas, diverticula, blind loops, bariatric surgery) , and reduced gastric acid (PPIs, gastrectomy) . Immune deficiency , chronic pancreatitis, and celiac disease also increase risk . Diagnosis is by breath testing; management targets the cause, corrects deficiencies, and uses antimicrobials.

Impaired motility: Slowed or abnormal motility allows bacterial stasis and overgrowth .
Anatomic abnormalities
Reduced gastric acid: hypochlorhydria
Immune deficiency

Several conditions and factors predispose to SIBO; Gastroparesis, diabetes, scleroderma, hypothyroidism, Strictures, fistulas, diverticula, blind loops, bariatric surgery, Chronic PPI use, gastrectomy, IgA deficiency, CVID, Chronic pancreatitis, and Celiac disease

Consequences of SIBO can include

Malabsorption: Fat, carbohydrate, and protein malabsorption leading to steatorrhea, weight loss, and nutritional deficiencies (vitamin B12, fat-soluble vitamins) .
Gastrointestinal symptoms: Bloating, abdominal distension, diarrhea, abdominal pain, and flatulence .
Systemic effects: Bacterial translocation, endotoxemia, and immune activation contributing to chronic inflammation and metabolic complications .
Treat underlying causes: Address motility, anatomic, or immune drivers to prevent relapse .

SIBO results from impaired motility, anatomic abnormalities, reduced gastric acid, and immune deficiency, leading to malabsorption, gas, and inflammation; management targets the cause, corrects deficiencies, and uses antimicrobials .

**This is for educational purposes only. Talk to your provider about specific health concerns.