ReviewArquivos de gastroenterologia2025
DIAGNOSIS AND TREATMENT OF SMALL INTESTINAL BACTERIAL OVERGROWTH: AN OFFICIAL POSITION PAPER FROM THE BRAZILIAN FEDERATION OF GASTROENTEROLOGY.
Review in Arquivos de gastroenterologia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Relationship between small intestinal bacterial overgrowth and irritable bowel syndrome and the efficacy of rifaximin intervention: a systematic review and meta-analysis.Frontiers in microbiology · 2026Pooled it
- Antibiotic therapy for small intestinal bacterial overgrowth: a systematic review of comparative efficacy, clinical-test discordance, and pediatric evidence gaps.Frontiers in pharmacology · 2026Pooled it
- Constipation with bloating: a clinical approach to evaluation and management.Annals of medicine · 2026Review
- Treatment of Small Intestinal Bacterial Overgrowth (SIBO) in Gastrointestinal, Hepatic, Endocrine, Neurological, and Postoperative Diseases: A Comprehensive Narrative Review.Medical sciences (Basel, Switzerland) · 2026Review
- Exploring effectiveness of Metronidazole, Bismuth, and Rifaximin in treating small intestinal bacterial overgrowth and irritable bowel syndrome: A systematic review.World journal of methodology · 2026Article
- Association of small intestinal bacterial overgrowth with portal hypertension in HCV-related cirrhosis: a cross-sectional study.Clinical and experimental medicine · 2026Article
- Difficulties in diagnosing a pediatric patient with small intestinal bacterial overgrowth.Einstein (Sao Paulo, Brazil) · 2026Article
- Prevalence and Impact on Quality of Life of Small Intestinal Bacterial Overgrowth (SIBO)-Related Symptoms in Patients with Upper Gastrointestinal Cancer.Diseases (Basel, Switzerland) · 2025Article
- The Duration of Proton Pump Inhibitor Therapy and the Risk of Small Intestinal Bacterial Overgrowth: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- The alleviating effects and mechanisms ofFrontiers in veterinary science · 2025Article
- Comparative efficacy of diverse therapeutic regimens for small intestinal bacterial overgrowth: a systematic network meta-analysis.Therapeutic advances in gastroenterology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSmall intestinal bacterial overgrowth (SIBO) is a condition characterized by an abnormal increase in bacterial population in the small intestine, leading to symptoms such as bloating, abdominal pain, distension, diarrhea, and eventually malabsorption. The diagnosis and management of SIBO remain challenging due to overlapping symptoms with other gastrointestinal disorders such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and coeliac disease.
objectiveThis article aims to review current evidence on the diagnosis and treatment of SIBO, with a focus on strategies suitable for the Brazilian healthcare system.
methodsA comprehensive literature review was performed, focusing on clinical guidelines, randomized controlled trials, and cohort studies concerning SIBO. Diagnostic methods, including breath tests and direct aspiration techniques, were critically analyzed. Treatment approaches, including antibiotics, dietary modifications, and probiotics, were reviewed. The recommendations were formulated based on a panel of gastroenterologists, members of the Brazilian Federation of Gastroenterology (FBG), with approval from the majority of the members.
resultsBreath tests using glucose and lactulose remain the most commonly used non-invasive diagnostic tools, though they are subject to limitations such as false positives and false negatives. Treatment with rifaximin is effective in most cases of SIBO, while systemic antibiotics like metronidazole and ciprofloxacin are alternatives. Probiotics and dietary interventions, particularly low FODMAP diets, can complement antibiotic therapy. Long-term follow-up is essential due to the recurrence rate, which is common in SIBO patients.
conclusionStandardizing SIBO diagnosis and treatment in Brazil is essential to reduce diagnostic delays and optimize care, especially given the disparities and heterogeneity in clinical practice across the country. This article provides evidence-based recommendations to guide clinical practice. Further research is needed to refine diagnostic methods, explore novel treatment strategies, and better understand the specific characteristics of the Brazilian population.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.