Symptoms, causes, treatment, and diet

Small intestinal bacterial overgrowth (SIBO) occurs when large numbers of bacteria colonize the small intestine. It can cause bloating, diarrhea, or constipation. Treatment options include antibiotics, fecal transplant, and dietary changes.

Bacteria are essential to the digestive system, in the form of the gut microbiome. This is mostly present in the large intestine, but the small intestine does not contain many bacteria.

Gastric secretions and the forward movement of food through the digestive system prevent too many bacteria from growing in the small intestine. However, if these functions do not work effectively, bacteria can multiply.

The small intestine is not able to handle high numbers of bacteria. When a person eats, these bacteria begin to ferment the food. In some people, this causes symptoms.

SIBO appears to be related to irritable bowel syndrome (IBS). People with IBS are more likely to have SIBO than the rest of the population. However, not everyone with an IBS diagnosis tests positive for SIBO.

In this article, we discuss the symptoms, risk factors, and complications of SIBO. We also look at the best diets to relieve the symptoms.

The symptoms of SIBO can vary from person to person, depending on how mild or severe the overgrowth of bacteria is and whether someone has any coexisting conditions.

However, the symptoms may include:

• bloating
• diarrhea
• constipation
• unexplained vitamin deficiencies, especially a vitamin B12 deficiency

The type of microbe that is overgrowing may also determine the symptoms. Research suggests that hydrogen-producing bacteria are more associated with diarrhea, while methane-producing species are more associated with constipation.

Doctors are not always sure what causes SIBO. So far, researchers have identified the following factors that may contribute to SIBO:

• Low motility: Usually, the intestines push food and bacteria through the digestive tract, which prevents too much bacteria from accumulating in the small intestine. However, if someone has low motility, this mechanism slows down, allowing food to ferment in the small intestine.
• Dysbiosis: Dysbiosis is when a person’s microbiome becomes imbalanced, containing too many harmful species of microbes or not enough beneficial species. Research into how different species of microorganisms influence digestion is still ongoing, but previous studies suggest that people with IBS often have less diversity, fewer beneficial species, and higher amounts of methane-producing species in their microbiome, which can slow motility.
• Hypochlorhydria: This term describes low levels of stomach acid. When someone does not have sufficient stomach acid, it may be possible for bacteria to migrate further up the digestive tract than usual, as the environment is not acidic enough to kill them. Researchers believe that people who take proton pump inhibitors (PPIs), have autoimmune gastritis, or have undergone a gastrectomy have an increased risk of hypochlorhydria and SIBO. However, there is a lack of conclusive evidence on this, and low motility may be a more important risk factor.
• Structural differences: Sometimes, SIBO occurs because a person has structural differences in the digestive tract. Examples include small bowel diverticulosis, fistulas, and a shortened colon. According to a 2018 study, people who have undergone a colectomy are more at risk of developing SIBO.
• Alcohol abuse: Excessive alcohol consumption can damage the microbiome, leading to dysbiosis, damage to the intestinal walls, and inflammation.

People with certain underlying conditions are more likely than other people to get SIBO. These people include those with:

• hypothyroidism
• diabetes
• Parkinson’s disease
• short bowel syndrome
• amyloidosis
• systemic sclerosis
• chronic kidney failure

SIBO is also more common in older adults, possibly due to slower digestive motility. There is a higher prevalence among females, too, but the reasons for this are unclear.

A small 2017 study found that people with obesity were 11 times more likely to have SIBO than those without obesity. It is unclear why this was the case, as the risk was higher in participants who had healthy digestive motility and pH levels. More research is necessary to understand the link.

A doctor will diagnose SIBO by asking about a person’s symptoms and medical history. They may feel the abdomen for signs of excess gas or bloating. If they suspect SIBO, they will recommend testing.

Breath testing

A lactulose breath test measures the concentration of hydrogen and methane in a person’s breath. The results of this test can confirm a SIBO diagnosis and reveal the extent of the overgrowth. They also show whether the overgrowth consists mainly of hydrogen- or methane-producing microbes.

A person has to fast for 24 hours before the test. They then drink a sugary solution containing lactulose, which is a sugar that only gut bacteria can break down.

When bacteria break the sugar down, they produce gases, which enter the bloodstream and travel to the lungs. A breath test measures these gases as a person exhales.

Glucose vs. lactulose breath testing

Some doctors perform glucose breath testing instead of lactulose breath testing. Some scientists have criticized this method, as the body can absorb glucose quickly, which means that it might not reach the area of overgrowth.

However, others argue that this rapid absorption can be an advantage, as it makes it less likely that the sugar will reach the colon, where it would generate a false positive result by feeding a large number of bacteria there.

Small bowel aspirate and culture

This is the gold standard for SIBO testing, but it is a more invasive test. Small bowel aspirate tests involve a doctor performing an endoscopy, which means inserting a small, thin camera through the mouth and down into the stomach.

When the device reaches the duodenum, which is where the stomach joins up with the small intestine, doctors use the endoscope to take a tissue sample. They then send the sample to a laboratory, which analyzes the bacteria present.

It is worth noting that with small bowel aspirate testing, as well as breath testing, there is no universally accepted threshold for what constitutes a positive SIBO result. This makes diagnosis more difficult for those who have less conclusive test results.

Other tests

The existing tests for SIBO are not always precise, so a doctor may recommend other tests to get a better picture of someone’s digestive health. These could include:

• blood tests to detect markers of autoimmunity or inflammation
• a mobility test to determine whether someone has any structural problems in the small intestine
• an intestinal permeability test, which assesses whether the intestinal lining is “leaky“
• stool tests to analyze the gut microbiome

As SIBO can occur for complex reasons, it can be difficult to treat. Various treatment options are available, including antibiotics, fecal microbiota transplants, and dietary changes.

Antibiotics

This is the main treatment for SIBO. Doctors may use one type of antibiotic or a combination to remove the overgrowth.

A popular option is rifaximin (Xifaxan). Previous studies suggest that this antibiotic works best for people with hydrogen-dominant overgrowths. Neomycin, or a combination of rifaximin and neomycin, may be better for those with methane-dominant SIBO. However, research into the best ways of treating SIBO is still ongoing.

Recurrence rates after SIBO treatment are relatively high. For this reason, alongside taking antibiotics, it is essential to address the underlying cause of the SIBO to reduce the risk of the overgrowth coming back.

Depending on the root cause, this may mean taking medications to speed up motility, stopping PPI treatment, or treating other conditions that might be contributing.

Probiotics and fecal microbiota transplants

The role of probiotics in SIBO treatment is controversial. While some studies have shown that specific species can improve motility and reduce hydrogen in the breath, others have shown that probiotics may cause SIBO.

If a person has low motility and takes probiotics, it is possible that they may make an overgrowth more likely or worsen an existing one. The results can vary from person to person.

A fecal microbiota transplant (FMT) is a fairly new treatment that involves a doctor transplanting a donor’s gut flora into a patient via the rectum. Again, research has produced mixed results on using this procedure as a treatment for SIBO. Some case studies have noted that FMT seems to cause SIBO. Currently, the Food and Drug Administration (FDA) has not approved this treatment.

Diets cannot cure SIBO, but they can lessen the symptoms. What works can vary from person to person, but a popular option is the low FODMAP diet.

The low FODMAP diet limits the intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are substances that the human body does not break down, which means that bacteria can feed on them. Limiting high FODMAP foods may reduce gas, bloating, constipation, and diarrhea.

Both the type and amount of foods a person eats are important in the low FODMAP diet. As it is fairly complex and can involve major dietary changes, it is best to work with a dietitian to implement it. A professional can ensure that a person gets all the nutrients they need.

Learn more about the low FODMAP diet.

In cases where SIBO is severe or not well-controlled, a person may have significant diarrhea or constipation. These symptoms can lead to complications, such as:

• nutritional deficiencies
• unintentional weight loss
• dehydration

These complications can affect many aspects of health, including a person’s energy levels, hormones, and mental health. Additionally, living with SIBO can be challenging, which may cause stress, anxiety, and low mood.

Learn more about chronic illness and depression.

It is not always possible to prevent SIBO, but people can take steps to look after their gut health. These include:

• Eating a nutritious and varied diet: Eating a wide variety of foods can help increase gut flora diversity, which may reduce the chances of dysbiosis. Fruits, vegetables, and whole grains are especially beneficial.
• Stopping smoking: Cigarettes and other products that contain nicotine can change the composition of a person’s gut flora. This may play a role in dysbiosis.
• Taking prokinetics: Prokinetics are a type of drug that speeds up digestive motility. They may reduce the risk of SIBO in people with an increased risk of developing it, such as those who have underlying conditions or take PPIs. A 2018 study found that people who took prokinetics and PPIs together were less likely to receive a SIBO diagnosis that those who took PPIs alone.
• Treating hypochlorhydria: If a person has low stomach acid, addressing this issue may reduce the risk of SIBO, although there is a need for more studies to confirm this link. How a doctor treats hypochlorhydria will depend on the cause.
• Managing other conditions: If a person has conditions that are associated with SIBO, such as hypothyroidism or diabetes, then effectively managing these conditions may reduce the impact they have on the digestive system.

Here are some answers to questions people often ask about SIBO.

What is SIBO poop like?

Stools may be watery, fatty, and foul-smelling. Fatty stools tend to float on water.

How do you fix SIBO?

Treatment is usually with antibiotics. Around 45% of people find SIBO returns after a full course of treatment. If this happens within 3 months, the doctor will prescribe a second course of antibiotics. If it returns at a later date, they may give antibiotics or they may look for other possible causes.

What are the symptoms of SIBO?

Symptoms typically include abdominal discomfort, bloating and flatulence, watery diarrhea, and fatty stools. Over time, weight loss and vitamin deficiencies can result.

What happens if you do not treat SIBO?

Complications of SIBO include weight loss and nutritional deficiencies. Eventually, it can lead to intestinal failure, where the gut no longer functions effectively.

Where is SIBO pain located?

SIBO causes pain in the abdomen.

SIBO occurs when bacteria from the large intestine migrate into the small intestine. It can cause symptoms such as bloating, diarrhea, and constipation. Doctors can diagnose SIBO by carrying out a lactulose breath test or a small bowel aspirate and culture test.

The treatment for SIBO usually involves taking one or more antibiotics to remove the overgrowth of bacteria. The effectiveness of other treatments, such as probiotics, is less clear. Newer options, such as FMT, are not fully understood and may carry risks.

People should speak with a gastroenterologist who knows about SIBO and related digestive disorders if they are experiencing persistent symptoms.

Symptoms, causes, treatment, and diet

Small intestinal bacterial overgrowth (SIBO) occurs when large numbers of bacteria colonize the small intestine. It can cause bloating, diarrhea, or constipation. Treatment options include antibiotics, fecal transplant, and dietary changes.

Bacteria are essential to the digestive system, in the form of the gut microbiome. This is mostly present in the large intestine, but the small intestine does not contain many bacteria.

Gastric secretions and the forward movement of food through the digestive system prevent too many bacteria from growing in the small intestine. However, if these functions do not work effectively, bacteria can multiply.

The small intestine is not able to handle high numbers of bacteria. When a person eats, these bacteria begin to ferment the food. In some people, this causes symptoms.

SIBO appears to be related to irritable bowel syndrome (IBS). People with IBS are more likely to have SIBO than the rest of the population. However, not everyone with an IBS diagnosis tests positive for SIBO.

In this article, we discuss the symptoms, risk factors, and complications of SIBO. We also look at the best diets to relieve the symptoms.

The symptoms of SIBO can vary from person to person, depending on how mild or severe the overgrowth of bacteria is and whether someone has any coexisting conditions.

However, the symptoms may include:

• bloating
• diarrhea
• constipation
• unexplained vitamin deficiencies, especially a vitamin B12 deficiency

The type of microbe that is overgrowing may also determine the symptoms. Research suggests that hydrogen-producing bacteria are more associated with diarrhea, while methane-producing species are more associated with constipation.

Doctors are not always sure what causes SIBO. So far, researchers have identified the following factors that may contribute to SIBO:

• Low motility: Usually, the intestines push food and bacteria through the digestive tract, which prevents too much bacteria from accumulating in the small intestine. However, if someone has low motility, this mechanism slows down, allowing food to ferment in the small intestine.
• Dysbiosis: Dysbiosis is when a person’s microbiome becomes imbalanced, containing too many harmful species of microbes or not enough beneficial species. Research into how different species of microorganisms influence digestion is still ongoing, but previous studies suggest that people with IBS often have less diversity, fewer beneficial species, and higher amounts of methane-producing species in their microbiome, which can slow motility.
• Hypochlorhydria: This term describes low levels of stomach acid. When someone does not have sufficient stomach acid, it may be possible for bacteria to migrate further up the digestive tract than usual, as the environment is not acidic enough to kill them. Researchers believe that people who take proton pump inhibitors (PPIs), have autoimmune gastritis, or have undergone a gastrectomy have an increased risk of hypochlorhydria and SIBO. However, there is a lack of conclusive evidence on this, and low motility may be a more important risk factor.
• Structural differences: Sometimes, SIBO occurs because a person has structural differences in the digestive tract. Examples include small bowel diverticulosis, fistulas, and a shortened colon. According to a 2018 study, people who have undergone a colectomy are more at risk of developing SIBO.
• Alcohol abuse: Excessive alcohol consumption can damage the microbiome, leading to dysbiosis, damage to the intestinal walls, and inflammation.

People with certain underlying conditions are more likely than other people to get SIBO. These people include those with:

• hypothyroidism
• diabetes
• Parkinson’s disease
• short bowel syndrome
• amyloidosis
• systemic sclerosis
• chronic kidney failure

SIBO is also more common in older adults, possibly due to slower digestive motility. There is a higher prevalence among females, too, but the reasons for this are unclear.

A small 2017 study found that people with obesity were 11 times more likely to have SIBO than those without obesity. It is unclear why this was the case, as the risk was higher in participants who had healthy digestive motility and pH levels. More research is necessary to understand the link.

A doctor will diagnose SIBO by asking about a person’s symptoms and medical history. They may feel the abdomen for signs of excess gas or bloating. If they suspect SIBO, they will recommend testing.

Breath testing

A lactulose breath test measures the concentration of hydrogen and methane in a person’s breath. The results of this test can confirm a SIBO diagnosis and reveal the extent of the overgrowth. They also show whether the overgrowth consists mainly of hydrogen- or methane-producing microbes.

A person has to fast for 24 hours before the test. They then drink a sugary solution containing lactulose, which is a sugar that only gut bacteria can break down.

When bacteria break the sugar down, they produce gases, which enter the bloodstream and travel to the lungs. A breath test measures these gases as a person exhales.

Glucose vs. lactulose breath testing

Some doctors perform glucose breath testing instead of lactulose breath testing. Some scientists have criticized this method, as the body can absorb glucose quickly, which means that it might not reach the area of overgrowth.

However, others argue that this rapid absorption can be an advantage, as it makes it less likely that the sugar will reach the colon, where it would generate a false positive result by feeding a large number of bacteria there.

Small bowel aspirate and culture

This is the gold standard for SIBO testing, but it is a more invasive test. Small bowel aspirate tests involve a doctor performing an endoscopy, which means inserting a small, thin camera through the mouth and down into the stomach.

When the device reaches the duodenum, which is where the stomach joins up with the small intestine, doctors use the endoscope to take a tissue sample. They then send the sample to a laboratory, which analyzes the bacteria present.

It is worth noting that with small bowel aspirate testing, as well as breath testing, there is no universally accepted threshold for what constitutes a positive SIBO result. This makes diagnosis more difficult for those who have less conclusive test results.

Other tests

The existing tests for SIBO are not always precise, so a doctor may recommend other tests to get a better picture of someone’s digestive health. These could include:

• blood tests to detect markers of autoimmunity or inflammation
• a mobility test to determine whether someone has any structural problems in the small intestine
• an intestinal permeability test, which assesses whether the intestinal lining is “leaky“
• stool tests to analyze the gut microbiome

As SIBO can occur for complex reasons, it can be difficult to treat. Various treatment options are available, including antibiotics, fecal microbiota transplants, and dietary changes.

Antibiotics

This is the main treatment for SIBO. Doctors may use one type of antibiotic or a combination to remove the overgrowth.

A popular option is rifaximin (Xifaxan). Previous studies suggest that this antibiotic works best for people with hydrogen-dominant overgrowths. Neomycin, or a combination of rifaximin and neomycin, may be better for those with methane-dominant SIBO. However, research into the best ways of treating SIBO is still ongoing.

Recurrence rates after SIBO treatment are relatively high. For this reason, alongside taking antibiotics, it is essential to address the underlying cause of the SIBO to reduce the risk of the overgrowth coming back.

Depending on the root cause, this may mean taking medications to speed up motility, stopping PPI treatment, or treating other conditions that might be contributing.

Probiotics and fecal microbiota transplants

The role of probiotics in SIBO treatment is controversial. While some studies have shown that specific species can improve motility and reduce hydrogen in the breath, others have shown that probiotics may cause SIBO.

If a person has low motility and takes probiotics, it is possible that they may make an overgrowth more likely or worsen an existing one. The results can vary from person to person.

A fecal microbiota transplant (FMT) is a fairly new treatment that involves a doctor transplanting a donor’s gut flora into a patient via the rectum. Again, research has produced mixed results on using this procedure as a treatment for SIBO. Some case studies have noted that FMT seems to cause SIBO. Currently, the Food and Drug Administration (FDA) has not approved this treatment.

Diets cannot cure SIBO, but they can lessen the symptoms. What works can vary from person to person, but a popular option is the low FODMAP diet.

The low FODMAP diet limits the intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are substances that the human body does not break down, which means that bacteria can feed on them. Limiting high FODMAP foods may reduce gas, bloating, constipation, and diarrhea.

Both the type and amount of foods a person eats are important in the low FODMAP diet. As it is fairly complex and can involve major dietary changes, it is best to work with a dietitian to implement it. A professional can ensure that a person gets all the nutrients they need.

Learn more about the low FODMAP diet.

In cases where SIBO is severe or not well-controlled, a person may have significant diarrhea or constipation. These symptoms can lead to complications, such as:

• nutritional deficiencies
• unintentional weight loss
• dehydration

These complications can affect many aspects of health, including a person’s energy levels, hormones, and mental health. Additionally, living with SIBO can be challenging, which may cause stress, anxiety, and low mood.

Learn more about chronic illness and depression.

It is not always possible to prevent SIBO, but people can take steps to look after their gut health. These include:

• Eating a nutritious and varied diet: Eating a wide variety of foods can help increase gut flora diversity, which may reduce the chances of dysbiosis. Fruits, vegetables, and whole grains are especially beneficial.
• Stopping smoking: Cigarettes and other products that contain nicotine can change the composition of a person’s gut flora. This may play a role in dysbiosis.
• Taking prokinetics: Prokinetics are a type of drug that speeds up digestive motility. They may reduce the risk of SIBO in people with an increased risk of developing it, such as those who have underlying conditions or take PPIs. A 2018 study found that people who took prokinetics and PPIs together were less likely to receive a SIBO diagnosis that those who took PPIs alone.
• Treating hypochlorhydria: If a person has low stomach acid, addressing this issue may reduce the risk of SIBO, although there is a need for more studies to confirm this link. How a doctor treats hypochlorhydria will depend on the cause.
• Managing other conditions: If a person has conditions that are associated with SIBO, such as hypothyroidism or diabetes, then effectively managing these conditions may reduce the impact they have on the digestive system.

Here are some answers to questions people often ask about SIBO.

What is SIBO poop like?

Stools may be watery, fatty, and foul-smelling. Fatty stools tend to float on water.

How do you fix SIBO?

Treatment is usually with antibiotics. Around 45% of people find SIBO returns after a full course of treatment. If this happens within 3 months, the doctor will prescribe a second course of antibiotics. If it returns at a later date, they may give antibiotics or they may look for other possible causes.

What are the symptoms of SIBO?

Symptoms typically include abdominal discomfort, bloating and flatulence, watery diarrhea, and fatty stools. Over time, weight loss and vitamin deficiencies can result.

What happens if you do not treat SIBO?

Complications of SIBO include weight loss and nutritional deficiencies. Eventually, it can lead to intestinal failure, where the gut no longer functions effectively.

Where is SIBO pain located?

SIBO causes pain in the abdomen.

SIBO occurs when bacteria from the large intestine migrate into the small intestine. It can cause symptoms such as bloating, diarrhea, and constipation. Doctors can diagnose SIBO by carrying out a lactulose breath test or a small bowel aspirate and culture test.

The treatment for SIBO usually involves taking one or more antibiotics to remove the overgrowth of bacteria. The effectiveness of other treatments, such as probiotics, is less clear. Newer options, such as FMT, are not fully understood and may carry risks.

People should speak with a gastroenterologist who knows about SIBO and related digestive disorders if they are experiencing persistent symptoms.

ABC-medicine

In eubiosis (that is, normal), the intestinal microflora is the optimal ratio of various bacteria – Escherichia coli, lactobacilli, enterococci, etc., in total more than 500 species. Dysbacteriosis is an imbalance of microbes that lasts for a long time. This is a very common condition, occurring in about 90% of adults and 95% of children.

With proper correction, which can only be prescribed by a doctor, intestinal dysbacteriosis resolves, but if left untreated, it usually passes into a more severe, progressive form. This bacteriological condition is usually considered as a manifestation or complication of a disease, most often of the gastrointestinal tract.

Causes of dysbacteriosis

The death of beneficial bacteria that inhabit the intestinal microflora may be associated with factors such as: pathogenic microbes;

the presence of parasites or pathogenic microbes in the intestines, whose waste products kill beneficial microorganisms – this is usually associated with dysentery, salmonellosis, viral diseases, etc . ;

Factors that increase the risk of developing intestinal dysbacteriosis include constant stress and unfavorable ecology, from which residents of modern megacities suffer.

General symptoms

Symptoms of intestinal dysbacteriosis differ in localization of dysbiotic changes and their severity. The severity of clinical manifestations is influenced by age, lifestyle, the state of the immune system, and the stage of development of the pathology.

stage 1

At this stage, the imbalance of bacteria is mild: the patient may be disturbed by minor intestinal disorders. Typically, this condition is associated with a short-term effect on the microflora, for example, with a change in the usual food and drinks. After the end of exposure to provoking factors or getting used to new conditions, the balance of microflora is restored.

Stage 2

The intestine stops producing the necessary amount of enzymes that ensure normal digestion. As a result, a fermentation process occurs, which is manifested by pain and bloating, bitterness in the mouth, flatulence, constipation, or, conversely, diarrhea. These can be symptoms of both progressive dysbacteriosis and the development of diseases of the gastrointestinal tract.

Stage 3

At this stage, when a large amount of pathogenic flora is exposed to the intestinal wall, an inflammatory process develops. Such dysbacteriosis already requires medical intervention. To severe symptoms are added nausea, vomiting, undigested food fragments in the stool, severe abdominal pain. In some cases, an increase in body temperature.

Stage 4

This is a condition of the intestine, in which the normal microflora is almost completely replaced by pathogens, which leads to impaired absorption of nutrients, the development of beriberi and even anemia. The resulting toxins enter the bloodstream and provoke severe allergic reactions. Clinical manifestations include rash, eczema, urticaria, asthma, insomnia, and chronic fatigue. The patient may complain of trouble concentrating. In the absence of timely treatment, there is a threat of the development of severe intestinal infections.

The extreme degree of dysbacteriosis is the penetration of bacteria of the gastrointestinal tract into the blood (bacteremia), in some cases the development of sepsis.

Diagnostics of dysbacteriosis

The main purpose of diagnostics is to determine the type of microbes inhabiting the intestines and their quantity. As a rule, the following main methods are used:

• bacteriological examination, the quality of the results of which is affected by compliance with the delivery time and preservation of the material, as well as the conditions for cultivating different types of bacteria;
• study of metabolites of microflora, which is based on the determination of volatile fatty acids released by microorganisms. Differs in accuracy of results, simplicity and efficiency of performance.

When conducting diagnostics and making a diagnosis, it is also taken into account that the intestinal microflora is individual for each person. Its composition may depend on age, food intake and season. In this regard, the specialist is based not only on the results of the tests, but also on additional examinations to identify the cause of the development of dysbacteriosis.

Treatment of dysbacteriosis

Treatment of dysbacteriosis in adults depends on the causes and symptoms and is prescribed in a complex manner. The standard scheme usually includes measures aimed at:

• elimination of excess pathogens;
• restoration of normal microflora;
• improvement of the digestion process;
• normalization of intestinal motility;
• stimulation of the reactivity of the whole organism.

Remember that only a specialist can prescribe competent and effective treatment. To get a qualified consultation, make an appointment with the doctor of the AVS-Medicine clinic at +7 (495) 223-38-83 or fill out an application on our website.

Intestinal dysbacteriosis – Health Clinic 365 Yekaterinburg

Alphabetical index

Microbioceosis is a community of microorganisms living in a territorially limited area with homogeneous living conditions. Bacteria of the normal intestinal flora live by attaching to the intestinal wall and forming a film that covers the intestines from the inside. Through this film, all absorption in the intestine occurs. Bacteria of normal intestinal microflora together provide 50-80% of all digestion, and also perform protective functions, neutralize the action of foreign and putrefactive bacteria. Bifidobacteria. These are the main representatives of the normal intestinal microflora, the number of which in the intestine should be 95 – 99%. Bifidobacteria perform the important job of breaking down, digesting and absorbing various food components, such as carbohydrates; they themselves synthesize vitamins, and also contribute to their absorption from food. With the participation of bifidobacteria, iron, calcium and other important trace elements are absorbed in the intestine; neutralize various toxic substances. The analysis form indicates the titer of bifidobacteria, which must be at least 10 ⁷ – 10 ⁸ . A significant decrease in the number of bifidobacteria is a sign of pronounced dysbacteriosis.

Lactobacilli (lactobacilli, lactic acid microbes, lactic streptococci).

The second most representative (5% of the total intestinal microorganisms) and the most important representative of the normal flora. Lactobacilli or lactic acid microbes produce lactic acid – an essential component for normal bowel function. In the results of the study, their number should be at least 10 ⁶ – 10 ⁷ . Deficiency of lactobacilli can lead to the development of allergic diseases, constipation, lactase deficiency.

Escherichia coli with normal enzymatic activity (escherichia).

The third representative of the normal flora. The number of Escherichia coli among other bacteria does not exceed 1%, but its role is very important. Firstly, E. coli is the main competitor of opportunistic flora, preventing colonization of the intestinal wall by alien microbes; secondly, Escherichia coli takes oxygen from the intestinal lumen, which is a poison for bifidobacteria and lactobacilli. A decrease in the total number of E. coli may be a sign of the presence of non-bacterial parasites in the intestines (worms, protozoa, which also need oxygen, depriving them of E. coli). Escherichia coli with reduced enzymatic activity. This is an inferior E. coli, which does not pose any harm, but does not perform its beneficial functions. The presence of this indicator in the analysis is a sign of incipient dysbacteriosis, and as well as a decrease in the total number, it can be an indirect sign of the presence of worms or protozoa in the intestines.

Some analyzes describe bacteroids whose role is unclear, but known to be non-harmful bacteria, usually their number is of no practical importance. All other indicators of microflora are conditionally pathogenic flora. They become pathogenic (violating the normal functions of the intestine) under certain conditions: an increase in their absolute number or a decrease in the function of the immune system.

Conditionally pathogenic flora is lactose-negative enterobacteria (Klebsiella, Proteus, Citrobacter, Enterobacter, hafnia, serrations), hemolyzing Escherichia coli and various cocci (Enterococci, epidermal or sa profitable staphylococci, Staphylococcus aureus). In addition, opportunistic pathogens include clostridia, which are not sown in all laboratories. Conditionally pathogenic flora is introduced, competing with beneficial bacteria, into the microbial film of the intestine, colonizes the intestinal wall and causes disruption of the entire gastrointestinal tract. Intestinal dysbacteriosis with a high content of opportunistic flora may be accompanied by allergic skin reactions, stool disorders (constipation, diarrhea, greenery and mucus in the feces), abdominal pain, bloating, regurgitation, vomiting.

Coccal forms in the total amount of microbes.

The most harmless representatives of opportunistic flora are enterococci. They are most often found in the intestines of healthy people, their number up to 10 ⁶ – 10 ⁷ does not pose a threat to health. If the amount exceeds 25% (more than 10 ⁷ ), this is most often associated with a decrease in normal flora. Epidermal (or saprophytic) staphylococcus aureus (S. epidermidis, S. saprophyticus). These types of staphylococci can cause disturbances, but their number is up to 10 ⁴ is valid. Staphylococcus aureus (S. aureus). One of the most unpleasant (along with hemolyzing Escherichia coli, Proteus and Klebsiella) representatives of conditionally pathogenic flora. Even small amounts of it can cause pronounced clinical manifestations, especially in children during the first months of life. Therefore, usually in the norms given in the analysis form, it is indicated that it should not be (in fact, quantities not exceeding 10 ³ are acceptable). The pathogenicity of Staphylococcus aureus directly depends on the state of the normal flora: the more bifidobacteria, lactobacilli and normal E. coli, the less harm from staphylococcus. Hemolysing Escherichia coli. It is a representative of lactose-negative enterobacteria, but stands out separately due to its prevalence and significance. Normally, it should be absent. Almost everything said about Staphylococcus aureus applies to this microbe. That is, it can cause allergic and intestinal problems, is very common in the environment (although it is almost never found in breast milk), causes problems in weakened children, and requires immunocorrection. It should be noted that the term “hemolysing” does not mean that there is any effect on the blood. lactose-negative enterobacteria. A large group of opportunistic bacteria of a greater or lesser degree of pathogenicity. Their number should not exceed (in credits: 10 ³ – 10 ⁶ ). The most unpleasant bacteria from this group are Proteus (most often associated with constipation) and Klebsiella (they are direct antagonists (competitors) of lactobacilli, which leads to the development of allergies and constipation, as well as manifestations of lactase deficiency). Often, the analysis form indicates the total number of lactose-negative enterobacteria (the most informative percentage), and then comes the decoding: Klebsiella, Proteus, hafnia, serrations, enterobacteria and citrobacteria. Usually some amount of these bacteria live permanently in the intestines without causing problems. In the norms, numbers from 10 9 can be indicated0093 4 to 10 ⁵ which are valid.

Fungi of the genus Candida.

Up to 10 ³ allowed. An increase in this parameter may be after the use of antibiotics. If the number of fungi is increased, and the amount of normal intestinal flora is sharply reduced, while candidiasis (thrush) of the visible mucous membranes (oral cavity, genitals) is noted – these are manifestations of systemic candidiasis, that is, there is infection with intestinal fungi. If the number of fungi in the analysis for dysbacteriosis is increased, but there is no decrease in the normal intestinal flora, this indicates that the fungi live on the skin around the anus, and not in the intestines, in this case external therapy using antifungal ointments or creams is sufficient.