1 However, many patients with a wide range of GI conditions and symptoms have increased bacterial counts in the small intestine compared with healthy controls and older age also correlates with rising counts of small intestinal strict anaerobes, although total bacterial counts generally remain below 10 5 CFU/mL. The most commonly cited definition is quantitative: 10 5 or more colony-forming units per millilitre (CFU/mL) of bacteria grown from a small intestinal aspirate. As a result, its true prevalence and relationship with other clinical disorders remain uncertain.
There is no consensus as to a definition for SIBO. Novel diagnostic options are needed to supplement or replace available tests. Proton nuclear magnetic resonance spectroscopy, electronic nose technology and/or field asymmetric ion mobility spectrometry may represent better investigative options for the condition. Accurate diagnosis of SIBO requires identification of bacterial species growing inappropriately within the small intestine and symptom response to antibiotics. ResultsĪll of the available methods to test for SIBO have inherent limitations and no ‘gold-standard’ diagnostic test for the condition exists. Search terms included free text words and combinations of the following terms ‘small intestinal bacterial overgrowth’, ‘small bowel bacterial overgrowth’, ‘diagnostic tests’, ‘treatment’, ‘antibiotics’, ‘probiotics’, ‘metabonomics’, ‘proton nuclear magnetic resonance spectroscopy’, ‘electronic nose’ and ‘field asymmetric ion mobility spectrometry’. MethodsĪ literature search was performed on MEDLINE, EMBASE and Web of Science for English articles and abstracts. To review the diagnostic options for SIBO and present new investigative options for the condition. The symptoms and signs of small intestinal bacterial overgrowth (SIBO) are often identical to a variety of diseases and can lead to diagnostic confusion.
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