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Small intestinal bacterial overgrowth (SIBO) is defined as an altered or increased presence of bacteria in the small intestine. (1) SIBO occurs via translocation of the colonic bacteria, and results in an abnormal shift in the relative species of bacteria in the small intestine. The small intestine contains various mechanisms that ordinarily prevent colonization and translocation of colonic bacteria, including an acidic pH, pancreatic enzyme secretion, the intestinal immune system, small intestine peristalsis, and integrity of the ileocecal valve and intestinal wall; a disruption in these mechanisms can facilitate SIBO development. SIBO is not an infection or an overabundance of “bad” bacteria but can instead be thought of as abnormally high numbers of commensal bacteria in the wrong section of the intestine.
Registered dietitian nutritionists (RDNs) play an integral role in the treatment of patients with SIBO, not only in addressing potential nutritional deficiencies and helping manage symptoms, but also communicating evidence-based interventions when it comes to SIBO diagnosis and treatment options
CPE Level: 2
Performance Indicators: 10.4.2, 8.1.4, 8.3.1
- Define current evidence-based practices regarding diagnosis and treatment of SIBO
- Describe non-evidence-based or “myths” about SIBO diagnosis and treatment
- Identify clinical nutrition intervention and management of patients with SIBO