The Center For
Small Intestinal Bacterial Overgrowth

Specializing in the diagnosis, treatment, and determination of the underlying cause of small intestinal bacterial overgrowth or SIBO.

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What We Do

We specialize in the diagnosis, treatment, and determination of the underlying cause of small intestinal bacterial overgrowth or SIBO.

What Is SIBO?

The condition often presents with symptoms like nausea, increased & often foul gas, bloating, abdominal distention, crampy abdominal pain, and diarrhea or constipation.

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Diagnosing SIBO

The diagnosis is made with a Lactulose breath test done in our office. The patient arrives in a fasting state overnight after following a restricted diet for twenty four hours.

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Treating SIBO

Treatment is a specific non-absorbable antibiotic for hydrogen producers and a combination of this antibiotic and another poorly absorbed antibiotic for methane producers.

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What Is SIBO?

The condition often presents a confusing constellation of symptoms to the healthcare provider such as nausea (especially in the young), increased and often foul smelling gas, bloating, abdominal distention, crampy abdominal pain, as well as diarrhea or constipation. SIBO is often confused with Irritable Bowel Syndrome type C or D (for constipation or diarrhea). The vast majority of patients who present to our office with the diagnosis of IBS have underlying SIBO.

The condition exists in three forms, Hydrogen producers, Methane producers, or a combination of both. The Hydrogen producers typically clinically present with gas, bloating and diarrhea while the methane producers have predominately constipation, gas, and bloating. The gas production type is determined by the type of bacterial overgrowth present in the small bowel.

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How Do We Diagnose SIBO?

The diagnosis is made with a Lactulose breath test done in our office. The patient arrives in a fasting state overnight after following a restricted diet for twenty four hours. A baseline breath sample is obtained and measurement of hydrogen and methane is performed. The patient then drinks a solution of Lactulose ( a type of non-absorbed sugar) and samples of breaths are taken every twenty minutes for analysis.

A rise of twenty parts per million is a positive test. In our experience, neither the magnitude nor the rate of rise of the value correlate with the severity of a patient’s symptoms especially in the young.

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Treating SIBO?

Treatment is a specific non-absorbable antibiotic for hydrogen producers and a combination of this antibiotic and another poorly absorbed antibiotic for methane producers. Other antibiotics can be used but in our experience resistance to the antibiotics develops, side effects are more frequent, and results are not as satisfactory. Most importantly, once a diagnosis of SIBO is made a thorough investigation is begun to determine the cause. This is necessary due to the high relapse rate especially with Hydrogen producers.

Several subsequent tests are employed for this evaluation. Our center offers this testing at our Newtown, Ct. office.

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