A Simple Guide to Small Intestinal Bacterial Overgrowth, Diagnosis, Treatment and Related Conditions

By Kenneth Kee

This book describes Small Intestinal Bacterial Overgrowth, Diagnosis and Treatment and Related Diseases

Small intestinal bacterial overgrowth (SIBO) is a serious disorder affecting the small intestine.

It happens when bacteria that normally grow in other parts of the intestines begin growing in the small intestine.

That produces pain and diarrhea.

It can also cause malnutrition as the bacteria begin to use up the body’s nutrients.

In contrast to the colon, the concentration of the bacteria in the small intestine rarely surpasses 1000 organisms/mL.

Gastric acid secretion and intestinal motility restrict the overgrowth of bacteria in the small intestine.

When these protective mechanisms against excessive bacterial growth do not succeed, small intestinal bacterial overgrowth (SIBO) can manifest.

Due to its increased awareness and understanding, SIBO is now often regarded in most doctors’ differential diagnosis in patients with non-specific gastrointestinal complaints.

SIBO is not well understood.

It can happen when:

1. The small bowel has anatomical abnormalities
2. The pH changes in the small bowel
3. The immune system is not working properly
4. The muscular activity of the small intestine malfunctions, which indicates that food and bacteria are not removed from the organ

SIBO is linked with different disorders such as:

1. Viral gastroenteritis or a stomach bug
2. Celiac disease
3. Crohn’s disease
4. Hypochlorhydria or low stomach acid levels
5. Gastroparesis
6. Nerve damage
7. Cirrhosis
8. Portal hypertension
9. Irritable bowel syndrome
10. Certain gastric bypass procedures
11. Surgeries that cause strictures or adhesions

Risk factors

Having a chronic disorder or surgery that affects the gastrointestinal (GI) tract can put the patient at risk of SIBO.

Certain diseases and chronic disorders can also increase the risk such as:

1. Crohn’s disease
2. Diabetes
3. Scleroderma
4. HIV
5. Parkinson’s disease
6. Hypothyroidism
7. Medicines that slow down the gut, such as narcotics

The natural cause of small intestinal bacterial overgrowth is complicated.

There are many significant host defense mechanisms against bacterial overgrowth.

When these defensive barriers do not succeed, SIBO happens.

Upon ingestion of food, the gastric acids and bile destroy and prevent bacteria from passing through the intestines.

Disorders that produce achlorhydria are linked with SIBO.

Also, proteolytic enzymes digest and degrade bacteria in the intestines.

Chronic pancreatic insufficiency is linked with SIBO.

Migrating motor complex is accountable for peristalsis and cleansing the small intestine.

SIBO is linked with disorders of abnormal gastrointestinal motility such as:

1. Irritable bowel syndrome,
2. Narcotic use,
3. Post-radiation enteropathy,
4. Hypothyroidism,
5. Diabetes mellitus, and
6. Scleroderma.

An intact ileocecal valve and antegrade motility stop retrograde translocation of colonic bacteria.

Anatomical abnormalities cause stasis of the bowels which may predispose to SIBO.

1. Bowel strictures,
2.Small intestinal diverticulosis,
3. Post-operative adhesions,
4. Gastric bypasses with blind intestinal loops and
5. Ileocecal resection.

Lastly, immunoglobin A stops bacterial proliferation and maintains intestinal immunity.

The symptoms of small intestinal bacterial overgrowth involve a combination of abdominal discomfort with bloating, flatulence, or chronic watery diarrhea.

A breath test is a frequent test for diagnosing SIBO.

Rarely a jejunal aspirate culture is done.

SIBO can be treated with a combination of antibiotics and diet modifications.

TABLE OF CONTENT
Introduction
Chapter 1 Small Intestinal Bacterial Overg

• Language: English
• Publisher: Kenneth Kee
• Release date: Apr 15, 2021
• ISBN: 9781005310066

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

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