• SIBO is a common problem of celiac disease that can cause gas, bloating, and diarrhea. SIBO is known to damage the lining of the small intestine. 1
  • SIBO appears to be caused by the intestines moving too slowly or irregularly. Decreased function of the immune system also appears to play a role. When these problems occur, they allow large numbers of "bad" bacteria to grow in the FIRST part of the small intestine 1 where they normally do not grow.
  • Bad bacteria and other organisms also digest and use up vitamins, starches, protein and fat before the body can use them.
  • Left untreated, SIBO can result in persistent damage to the villi, leading to vitamin deficiencies and elevations in celiac antibody levels. 2,3,4
  • Diet changes, as well as antibiotics and probiotics, can be used alone or together to treat SIBO. 5


  • SIBO is a common problem seen in celiac disease.
  • The symptoms of SIBO are the same as those of celiac disease.
  • If you carefully follow the gluten-free diet and have these symptoms, talk to your doctor about getting tested for SIBO.


  1. Leffler D. Small Intestinal Bacterial Overgrowth. In Real Life with Celiac Disease: Troubleshooting and Thriving Gluten-Free . Eds. Dennis M, Leffler D. AGA Press. Bethesda, MD, 2010.
  2. Ghoshal UC, Ghoshal U, Misra A, Choudhuri G. Partially responsive celiac disease resulting from small intestinal bacterial overgrowth and lactose intolerance. BMC Gastroenterol 2004;4:10.
  3. Tursi A, Brandimarte G, Giorgetti G. High prevalence of small intestinal bacterial overgrowth in celiac patients with persistence of gastrointestinal symptoms after gluten withdrawal. Am J Gastroenterol2003;98:839-43.
  4. Leffler DA, Dennis M, Hyett B, Kelly E, Schuppan D, Kelly CP. Etiologies and predicators of diagnosis in nonresponsive celiac disease. Clin Gastroenterol Hepatol 2007;5:445-50.
  5. Small Intestinal Bacterial Overgrowth. Accessed April 13, 2011.

Revision Date: 8-23-12 
Author: Melinda Dennis, MS, RD, LDN and Annie Peer 
Editors: Suzanne Simpson, RD and Rupa Mukherjee, MD

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