- 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
TAKE HOME MESSAGE:
- 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.
- 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.
- 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.
- 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.
- 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.
- Small Intestinal Bacterial Overgrowth. MedicineNet.com. http://medicinenet.com/script/main/art.asp?articlekey=55091. 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