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Small Intestine Bacterial Overgrowth (SIBO)

Bacteria growing unchecked in the small intestine can cause small intestine bacterial overgrowth (SIBO). Two natural processes usually control bacterial growth in the gut:

  1. Motility – the natural action of the gut moving food through the system
  2. Hydrochloric acid – made by the stomach, this usually controls the growth of bacteria

There are several reasons why patients can get SIBO. At Johns Hopkins, we evaluate more than 600 SIBO cases a year and treat patients using a combination of traditional and alternative therapies.

For patients who have had bariatric surgery, SIBO can be a real concern. This has to do with what happens to the anatomy of the digestive tract after weight-loss surgery.

Why SIBO occurs in post-bariatric surgery patients

During a certain type of bariatric surgery, the small intestine is divided. Two limbs, or pouches, are created. One of these is like a dead end, known as a blind loop, and bacteria can collect there. If food gets stuck in this blind loop, it begins to ferment, causing bacterial overgrowth.

Symptoms of SIBO

Patients with SIBO can experience the following symptoms:

  • Excessive bloating
  • Gas
  • Cramping pain after meals
  • Diarrhea

Diagnosis of SIBO

At Johns Hopkins, we use breath testing to diagnose SIBO. You will drink a sugar solution and then breathe into a breathalyzer. If the bacteria are fermenting in your small intestine, they will come out in your breath, and your doctors can confirm SIBO.

Treatment of SIBO

Antibiotics are usually necessary to treat the bacterial overgrowth. At Johns Hopkins, we have found that herbal treatments can be effective in treating SIBO. Your doctors may prescribe probiotics and work with you to avoid preventing a recurrence.


Our team of weight loss specialists can provide you with the information and training you need to reach your goals and enjoy a lifetime of healthy weight. Call 410-583-LOSE (5673) today to schedule your consultation or request more information by using our secure online form

The Johns Hopkins Digestive Weight Loss Center is part of the Johns Hopkins University School of Medicine, Division of Gastroenterology and Hepatology.


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