How is SIBO different from SIFO?

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    Last Updated: October 13, 2024

    Small intestinal fungal overgrowth (SIFO) is characterized by a high quantity of fungi (such as yeast) in the small intestine, while SIBO is caused by elevated numbers of bacteria. Despite the conditions sounding similar, their risk factors, symptoms, and treatments differ.

    Prescription antacids and altered gut motility may increase the risk of developing SIBO, but they aren’t associated with SIFO.[1]

    Studies have foundthat the rates of unexplained GI symptoms are similar in participants regardless of fungal colonization, which contrasts with the relationship between bacterial overgrowth and GI distress.

    Also, while SIBO is conventionally treated with antibiotics, SIFO requires antifungal medications.[2] Probiotics may prevent or suppress intestinal overgrowth of Candida (a type of yeast), but they don’t prevent SIBO.[3][4]

    However, in both cases, emerging research suggests that the composition of the fungi or bacteria — not simply a higher number of either — has a greater impact on whether the overgrowth might lead to symptoms.[5][6]

    References

    1. ^C Jacobs, E Coss Adame, A Attaluri, J Valestin, S S C RaoDysmotility and proton pump inhibitor use are independent risk factors for small intestinal bacterial and/or fungal overgrowthAliment Pharmacol Ther.(2013 Jun)
    2. ^Wolfgang Knitsch, Jean-Louis Vincent, Stefan Utzolino, Bruno François, Tamás Dinya, George Dimopoulos, İlhan Özgüneş, Juan Carlos Valía, Philippe Eggimann, Cristóbal León, Philippe Montravers, Stephen Phillips, Lorraine Tweddle, Andreas Karas, Malcolm Brown, Oliver A CornelyA randomized, placebo-controlled trial of preemptive antifungal therapy for the prevention of invasive candidiasis following gastrointestinal surgery for intra-abdominal infectionsClin Infect Dis.(2015 Dec 1)
    3. ^Hua-Jian Hu, Guo-Qiang Zhang, Qiao Zhang, Shristi Shakya, Zhong-Yue LiProbiotics Prevent Candida Colonization and Invasive Fungal Sepsis in Preterm Neonates: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsPediatr Neonatol.(2017 Apr)
    4. ^Changqing Zhong, Changmin Qu, Baoyan Wang, Shuwen Liang, Bolun ZengProbiotics for Preventing and Treating Small Intestinal Bacterial Overgrowth: A Meta-Analysis and Systematic Review of Current EvidenceJ Clin Gastroenterol.(2017 Apr)
    5. ^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)
    6. ^Gaichao Hong, Ying Li, Min Yang, Gangping Li, Wei Qian, Hanhua Xiong, Tao Bai, Jun Song, Lei Zhang, Xiaohua HouGut fungal dysbiosis and altered bacterial-fungal interaction in patients with diarrhea-predominant irritable bowel syndrome: An explorative studyNeurogastroenterol Motil.(2020 Nov)