ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth

• Published in: The American journal of gastroenterology Vol. 115; no. 2; pp. 165 - 178
• Main Authors: Pimentel, Mark, Saad, Richard J., Long, Millie D., Rao, Satish S. C.
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer 01.02.2020; Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
• Subjects: Abdomen; Anti-Bacterial Agents - therapeutic use; Bacteria; Blind Loop Syndrome - diagnosis; Blind Loop Syndrome - therapy; Breath Tests; Carbohydrates; Confidence; Culture Techniques; Diarrhea; Diet Therapy; Disease; Fecal Microbiota Transplantation; Fermentation; Gases; Gastroenterology; Humans; Hydrogen; Hydrogen - analysis; Inflammation; Intestine, Small; Irritable bowel syndrome; Laboratories; Methane - analysis; Pain; Patients; Probiotics - therapeutic use; Small intestine; Suction
• ISSN: 0002-9270; 1572-0241; 1572-0241
• DOI: 10.14309/ajg.0000000000000501

Small intestinal bacterial overgrowth is defined as the presence of excessive numbers of bacteria in the small bowel, causing gastrointestinal symptoms. This guideline statement evaluates criteria for diagnosis, defines the optimal methods for diagnostic testing, and summarizes treatment options for small intestinal bacterial overgrowth. This guideline provides an evidence-based evaluation of the literature through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process. In instances where the available evidence was not appropriate for a formal GRADE recommendation, key concepts were developed using expert consensus.