Search the Health Library
Get the facts on diseases, conditions, tests and procedures.
I Want To...
Find a Doctor
Find a doctor at The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center or Johns Hopkins Community Physicians.
I Want To...
Find Research Faculty
Enter the last name, specialty or keyword for your search below.
Bacteria growing unchecked in the small intestine can cause small intestine bacterial overgrowth (SIBO). Two natural processes usually control bacterial growth in the gut:
- Motility – the natural action of the gut moving food through the system
- 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
- Cramping pain after meals
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.