gastrointestinal disorders
Small Intestinal Bacterial Overgrowth (SIBO)
Treatment of SIBO
Oral antibiotics (various) Dietary modification Treatment of bacterial overgrowth syndrome is with 10 to 14 days of oral antibiotics that cover both aerobic and anaerobic enteric bacteria. Empiric regimens include use of one or two of the following: Amoxicillin/clavulanic acid500 mg 3 times a day Cephalexin250 mg 4 times a day Trimethoprim/sulfamethoxazole 160/800 mg 2 times a day Metronidazole250 to 500 mg 3 or 4 times a day Rifaximin550 mg 3 times a day alone or in combination withneomycin500 mg 2 times a day (usually the combination is used if the methane breath test is positive) Ciprofloxacin500 mg 2 times a day Antibiotic treatment can be cyclic, if symptoms tend to recur, and changed based on culture and sensitivity. Changing antibiotic treatment may be difficult, however, due to coexistence of multiple bacteria. Because bacteria metabolize primarily carbohydrates in the intestinal lumen rather than fats, a diet high in fat and low in carbohydrates and fiber is beneficial. Underlying conditions and nutritional deficiencies (eg, vitamin B12) should be corrected. 