How is SIBO diagnosed?

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    Last Updated: October 25, 2023

    SIBO often occurs with other GI diseases that have overlapping symptoms, which can complicate diagnosing either accurately.[1]

    SIBO can be diagnosed with breath tests or a duodenal aspirate culture (a lab test done on a small fluid sample from the small intestine), but the lack of standardization makes accurate diagnosis challenging. Breath tests are an indirect way to measure bacteria in the small intestine, but their ease and low invasiveness make them a more common diagnostic tool than the fluid test.[2][3]

    Clinicians have yet to reach a consensus on diagnostic criteria for a positive result of either test, but it’s generally accepted that SIBO is present when there is a concentration of 103 to 105 colony forming units per milliliter (CFU/mL) in a fluid sample. [2][3]

    References

    1. ^George B Saffouri, Robin R Shields-Cutler, Jun Chen, Yi Yang, Heather R Lekatz, Vanessa L Hale, Janice M Cho, Eric J Battaglioli, Yogesh Bhattarai, Kevin J Thompson, Krishna K Kalari, Gaurav Behera, Jonathan C Berry, Stephanie A Peters, Robin Patel, Audrey N Schuetz, Jeremiah J Faith, Michael Camilleri, Justin L Sonnenburg, Gianrico Farrugia, Jonathan R Swann, Madhusudan Grover, Dan Knights, Purna C KashyapSmall intestinal microbial dysbiosis underlies symptoms associated with functional gastrointestinal disordersNat Commun.(2019 May 1)
    2. ^Ali Rezaie, Michelle Buresi, Anthony Lembo, Henry Lin, Richard McCallum, Satish Rao, Max Schmulson, Miguel Valdovinos, Salam Zakko, Mark PimentelHydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American ConsensusAm J Gastroenterol.(2017 May)
    3. ^Giuseppe Losurdo, Gioacchino Leandro, Enzo Ierardi, Francesco Perri, Michele Barone, Mariabeatrice Principi, Alfredo Di LeoBreath Tests for the Non-invasive Diagnosis of Small Intestinal Bacterial Overgrowth: A Systematic Review With Meta-analysisJ Neurogastroenterol Motil.(2020 Jan 30)