Small Bowel Bacterial Overgrowth Syndrome - Treatment

Treatment

Bacterial overgrowth is usually treated with a course of antibiotics. A variety of antibiotics, including neomycin, rifaximin, amoxicillin-clavulanate, fluoroquinolone antibiotics and tetracycline have been used; however, the best evidence is for the use of norfloxacin and amoxicillin-clavulanate.

A course of one week of antibiotics is usually sufficient to treat the condition. However, if the condition recurs, antibiotics can be given in a cyclical fashion in order to prevent tolerance. For example, antibiotics may be given for a week, followed by three weeks off antibiotics, followed by another week of treatment. Alternatively, the choice of antibiotic used can be cycled.

The condition that predisposed the patient to bacterial overgrowth should also be treated. For example, if the bacterial overgrowth is caused by chronic pancreatitis, the patient should be treated with coated pancreatic enzyme supplements.

Probiotics are bacterial preparations that alter the bacterial flora in the bowel to cause a beneficial effect. Their role in bacterial overgrowth is somewhat uncertain.

A diet void of certain foods that feed the bacteria can help alleviate the symptoms. For example if the symptoms are caused by bacterial overgrowth on complex carbohydrate rich foods (for example bread), eating light food consisting of fruits and green leafy vegetables may substantially lessen the symptoms.

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