SIBO Syndrome K58.-

Small intestinal bacterial overgrowth (SIBO) is a common clinical picture. The non-specific symptoms are similar to those of irritable bowel syndrome, which is why it is often difficult to differentiate. SIBO is one of the most overlooked and underdiagnosed diseases.

The pathogenesis of irritable bowel syndrome (IBS), which was previously thought to be largely psychogenic in origin, is now understood to be multifactorial. One reason for the symptoms is intestinal dysbiosis, including bacterial overgrowth in the small intestine (SIBO).

The gold standard for the diagnosis of SIBO is quantitative culture from the jejunal aspirate. In the meantime, non-invasive hydrogen breath tests have become established as a diagnostic method. Although the glucose-hydrogen breath test is highly specific, its sensitivity is low; in contrast, the early peak criteria of the lactulose-hydrogen breath test are very non-specific.

Between 4% and 78% of patients with IBS and between 1% and 40% of controls have SIBO. These large differences in prevalence may be due to differences in the population, the diagnostic criteria for IBS and, most importantly, the methods used to diagnose SIBO.

Pyoderma faciale: Pyoderma faciale is associated with SIBO (and other inflammatory bowel diseases - IBD -) (Dessoukey MW et al. 1996, Fowler E et al. 2019).

Rosacea: Rosacea is associated with various gastrointestinal disorders, including inflammatory bowel disease, celiac disease, irritable bowel syndrome, gastroesophageal reflux disease, Helicobacter pylori (HP) infection and small intestinal bacterial overgrowth (SIBO) (Wang FY et al. 2021).

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