REVIEW PAPER
IMPORTANCE OF SMALL INTESTINAL BACTERIAL OVERGROWTH (SIBO)
IN THE ETIOPATHOGENESIS OF CHRONIC DISEASES
1
Chair and Department of Environmental Medicine and Epidemiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
Submission date: 2025-06-06
Final revision date: 2025-08-22
Acceptance date: 2025-09-11
Publication date: 2025-10-02
TOPICS
ABSTRACT
Small intestinal bacterial overgrowth (SIBO) is a condition characterized by the abnormal proliferation of commensal or pathogenic microorganisms within the small intestine. There is increasing evidence that SIBO plays a significant role in the development of various chronic diseases, including systemic autoimmune disorders, metabolic syndromes and neurodegenerative conditions. Dysbiosis in the small intestine can disrupt the integrity of the mucosal barrier, induce chronic low-grade inflammation, alter intestinal motility and modulate immune responses. This can contribute to systemic pathologies. Furthermore, SIBO may exacerbate nutrient malabsorption, leading to deficiencies that can accelerate disease progression. Understanding the mechanistic links between SIBO and chronic diseases is essential for developing targeted therapeutic strategies, including antibiotic treatment and dietary interventions. This review critically examines the role of SIBO in the pathophysiological continuum of chronic diseases, emphasizing the need for greater clinical awareness and more robust diagnostic and therapeutic protocols.
REFERENCES (50)
1.
Roszkowska P, Klimczak E, Ostrycharz E, Rączka A, Wojciechowska-Koszko I, Dybus A, et al. Small intestinal bacterial overgrowth (SIBO) and twelve groups of related diseases—current state of knowledge. Biomedicines. 2024; 12(5): 1030. https://doi.org/10.3390/biomed....
2.
Banaszak M, Górna I, Woźniak D, Przysławski J, Drzymała-Czyż S. Association between gut dysbiosis and the occurrence of SIBO, LIBO, SIFO and IMO. Microorganisms. 2023; 11(3): 573. https://doi.org/10.3390/microo....
3.
Suárez Terán J, Guarner Aguilar F. Small intestinal bacterial overgrowth (SIBO), a clinically overdiagnosed entity?. Gastroenterología y Hepatología (English Edition). 2024; 47(9): 502190. https://doi.org/10.1016/j.gast....
4.
Crnčević N, Hukić M, Deumić S, Selimagić A, Dozić A, Gavrankapetanović I, et al. Gastrointestinal tract microbiome effect and role in disease development. Diseases. 2022; 10(3): 45. https://doi.org/10.3390/diseas....
5.
Jensen BAH, Heyndrickx M, Jonkers D, Mackie A, Millet S, Naghibi M, et al. Small intestine vs. colon ecology and physiology: why it matters in probiotic administration. Cell Reports Medicine. 2023; 4(9): 101190. https://doi.org/10.1016/j.xcrm....
6.
Sroka N, Rydzewska-Rosołowska A, Kakareko K, Rosołowski M, Głowińska I, Hryszko T. Show me what you have inside—the complex interplay between sibo and multiple medical conditions—a systematic review. Nutrients. 2022; 15(1): 90. https://doi.org/10.3390/nu1501....
7.
Maeda Y, Murakami T. Diagnosis by microbial culture, breath tests and urinary excretion tests, and treatments of small intestinal bacterial overgrowth. Antibiotics. 2023; 12(2): 263. https://doi.org/10.3390/antibi....
8.
Beltrán-Velasco AI, Clemente-Suárez VJ. Harnessing gut microbiota for biomimetic innovations in health and biotechnology. Biomimetics. 2025; 10(2): 73. https://doi.org/10.3390/biomim....
9.
Paul JK, Azmal M, Haque ASNB, Meem M, Talukder OF, Ghosh A. Unlocking the secrets of the human gut microbiota: Comprehensive review on its role in different diseases. World J Gastroenterol. 2025; 31(5). https://doi.org/10.3748/wjg.v3....
10.
Khalil M, Di Ciaula A, Mahdi L, Jaber N, Di Palo DM, Graziani A, et al. Unraveling the role of the human gut microbiome in health and diseases. Microorganisms. 2024; 12(11): 2333. https://doi.org/10.3390/microo....
11.
Park S. Special Issue: “Gut Microbiota and Nutrition in Human Health”. 2024; 25(21): 11589. https://doi.org/10.3390/ijms25....
12.
Chao J, Coleman RA, Keating DJ, Martin AM. Gut microbiome regulation of gut hormone secretion. Endocrinology. 2025; 166(4). https://doi.org/10.1210/endocr....
13.
Ross FC, Patangia D, Grimaud G, Lavelle A, Dempsey EM, Ross RP, et al. The interplay between diet and the gut microbiome: implications for health and disease. Nat Rev Microbiol. 2024; 22(11): 671-686. https://doi.org/10.1038/s41579....
14.
Knez E, Kadac-Czapska K, Grembecka M. The importance of food quality, gut motility, and microbiome in SIBO development and treatment. Nutrition. 2024; 124: 112464. https://doi.org/10.1016/j.nut.....
15.
Labetoulle M, Baudouin C, Benitez del Castillo JM, Rolando M, Rescigno M, Messmer EM, et al. How gut microbiota may impact ocular surface homeostasis and related disorders. Progress in Retinal and Eye Research. 2024; 100: 101250. https://doi.org/10.1016/j.pret....
16.
Nikola L, Iva L. Gut microbiota as a modulator of type 1 diabetes: a molecular perspective. Life Sciences. 2024; 359: 123187. https://doi.org/10.1016/j.lfs.....
17.
Yan K, Sun X, Fan C, Wang X, Yu H. Unveiling the role of gut microbiota and metabolites in autoimmune thyroid diseases: emerging perspectives. IJMS. 2024; 25(20): 10918. https://doi.org/10.3390/ijms25....
18.
Dalamaga M, Tsigalou C. Diet patterns, gut microbiota and metabolic disorders: perspectives and challenges. Metabolism Open. 2024; 23: 100310. https://doi.org/10.1016/j.meto....
19.
Wielgosz-Grochowska JP, Domanski N, Drywień ME. Identification of SIBO subtypes along with nutritional status and diet as key elements of SIBO therapy. IJMS. 2024; 25(13): 7341. https://doi.org/10.3390/ijms25....
20.
Alcedo González J, Estremera-Arévalo F, Cobián Malaver J, Santos Vicente J, Alcalá-González LG, Naves J, et al. Common questions and rationale answers about the intestinal bacterial overgrowth syndrome (SIBO). Gastroenterología y Hepatología (English Edition). 2025; 48(2): 502216. https://doi.org/10.1016/j.gast....
21.
Skrzydło-Radomańska B, Cukrowska B. How to recognize and treat small intestinal bacterial overgrowth?. JCM. 2022; 11(20): 6017. https://doi.org/10.3390/jcm112....
22.
Souza C, Rocha R, Cotrim HP. Diet and intestinal bacterial overgrowth: is there evidence?. WJCC. 2022; 10(15): 4713-4716. https://doi.org/10.12998/wjcc.....
23.
Martyniak A, Wójcicka M, Rogatko I, Piskorz T, Tomasik PJ. A comprehensive review of the usefulness of prebiotics, probiotics, and postbiotics in the diagnosis and treatment of small intestine bacterial overgrowth. Microorganisms. 2025; 13(1): 57. https://doi.org/10.3390/microo....
24.
Bamba S, Imai T, Sasaki M, Ohno M, Yoshida S, Nishida A, et al. Altered gut microbiota in patients with small intestinal bacterial overgrowth. J of Gastro and Hepatol. 2022; 38(1): 61-69. http://doi.org/10.1111/jgh.160....
25.
Zafar H, Jimenez B, Schneider A. Small intestinal bacterial overgrowth: current update. Current Opinion in Gastroenterology. 2023; 39(6): 522-528. https://doi.org/10.1097/MOG.00....
26.
Wang Y, Qu Z, Chu J, Han S. Aging gut microbiome in healthy and unhealthy aging. Aging Dis. 2024; 16(2): 980‑1002. https://doi.org/10.14336/AD.20....
27.
Jennings T, Janquart M, Washak C, Duddleston K, Kurtz C. What’s gut got to do with it? The role of the microbiota and inflammation in the development of adiposity and obesity. Immunometabolism. 2023; 5(3): e00029. https://doi.org/10.1097/IN9.00....
28.
Liébana-Castillo AR, Redondo-Cuevas L, Nicolás Á, Martín-Carbonell V, Sanchis L, Olivares A, et al. Should we treat SIBO patients? Impact on quality of life and response to comprehensive treatment: a real-world clinical practice study. Nutrients. 2025; 17(7): 1251. https://doi.org/10.3390/nu1707....
29.
Losurdo G, D’Abramo FS, Indellicati G, Lillo C, Ierardi E, Di Leo A. the influence of small intestinal bacterial overgrowth in digestive and extra-intestinal disorders. IJMS. 2020; 21(10): 3531. https://doi.org/10.3390/ijms21....
30.
Goździewska M, Łyszczarz A, Kaczoruk M, Kolarzyk E. Relationship between SIBO and other bowel diseases and a common eating pattern for them. Part III. Ann Agric Environ Med. 2024; 31(3): 322-328. https://doi.org/10.26444/aaem/....
31.
Angelini G, Russo S, Mingrone G. Incretin hormones, obesity and gut microbiota. Peptides. 2024; 178: 171216. https://doi.org/10.1016/j.pept....
32.
Efremova I, Maslennikov R, Poluektova E, Vasilieva E, Zharikov Y, Suslov A, et al. Epidemiology of small intestinal bacterial overgrowth. World J Gastroenterol. 2023; 29(22): 3400-3421. https://doi.org/10.3748/wjg.v2....
33.
Li Y, Liu X, Sun X, Li H, Wang S, Tian W, et al. Gut dysbiosis impairs intestinal renewal and lipid absorption in Scarb2 deficiency-associated neurodegeneration. Protein & Cell. 2024; 15(11): 818-839. https://doi.org/10.1093/procel....
34.
Liang Y, Liu C, Cheng M, Geng L, Li J, Du W, et al. The link between gut microbiome and Alzheimer’s disease: from the perspective of new revised criteria for diagnosis and staging of Alzheimer’s disease. Alzheimer’s & Dementia. 2024; 20(8): 5771-5788. https://doi.org/10.1002/alz.14....
35.
Zhou Q, Yang B, Zhu Y, Wang F, Tai Y, Liu Z, et al. Association of bacterial overgrowth in the small intestine with cortical thickness and functional connectivity in Parkinson’s disease involving mild cognitive impairment. Brain Imaging and Behavior. 2024; 18(6): 1509-1514. https://doi.org/10.1007/s11682....
36.
Leta V, Klingelhoefer L, Longardner K, Campagnolo M, Levent HÇ, Aureli F, et al. Gastrointestinal barriers to levodopa transport and absorption in Parkinson’s disease. Euro J of Neurology. 2023; 30(5): 1465-1480. https://doi.org/10.1111/ene.15....
37.
Chuah KH, Hian WX, Lim SZ, Beh KH, Mahadeva S. Impact of small intestinal bacterial overgrowth on symptoms and quality of life in irritable bowel syndrome. J of Digest Diseases. 2023; 24(3): 194-202. https://doi.org/10.1111/1751-2....
38.
Gong S, Zhang X, Chen X, Wan P, Zhou L, Zhang J. The impact of bariatric surgery on gut microbiota: a bibliometric analysis of research trends and scientific contributions. Front Microbiol. 2025; 16. https://doi.org/10.3389/fmicb.....
39.
Mollar A, Marrachelli VG, Núñez E, Monleon D, Bodí V, Sanchis J, et al. Bacterial metabolites trimethylamine N-oxide and butyrate as surrogates of small intestinal bacterial overgrowth in patients with a recent decompensated heart failure. Sci Rep. 2021; 11(1). https://doi.org/10.1038/s41598....
40.
Öz N, Gezer HH, Karabulut Y, Duruöz MT. Association of nutritional status indices with gastrointestinal symptoms in systemic sclerosis: a cross-sectional study. Rheumatol Int. 2025; 45(1). https://doi.org/10.1007/s00296....
41.
Daniluk A, Iwaniuk K, Wojda M, Świstowska M, Wielgosz A. Gut microbiota and thyroid diseases – summary of current knowledge. Qual Sport. 2024; 16: 52770. https://doi.org/10.12775/QS.20....
42.
Guertler A, Hering P, Pacífico C, Gasche N, Sladek B, Irimi M, et al. Characteristics of gut microbiota in rosacea patients—a cross-sectional, controlled pilot study. Life. 2024; 14(5): 585. https://doi.org/10.3390/life14....
43.
Wei F, Zhou L, Wang Q, Zheng G, Su S. Effect of compound lactic acid bacteria capsules on the small intestinal bacterial overgrowth in patients with depression and diabetes: a blinded randomized controlled clinical trial. Disease Markers. 2022; 2022: 1-6. https://doi.org/10.1155/2022/6....
44.
Bogielski B, Michalczyk K, Głodek P, Tempka B, Gębski W, Stygar D. Association between small intestine bacterial overgrowth and psychiatric disorders. Front Endocrinol. 2024; 15. https://doi.org/10.3389/fendo.....
45.
Sowmiya S, Dhivya LS, Rajendran P, Harikrishnan N, Singh AS. Exploring the potential of probiotics in Alzheimer’s disease and gut dysbiosis. IBRO Neuroscience Reports. 2024; 17: 441-455. https://doi.org/10.1016/j.ibne....
46.
Kossewska J, Bierlit K, Trajkovski V. Personality, anxiety, and stress in patients with small intestine bacterial overgrowth syndrome. The Polish preliminary study. IJERPH. 2022; 20(1): 93. https://doi.org/10.3390/ijerph....
47.
Feng X, Hu J, Zhang X. Prevalence and predictors of small intestinal bacterial overgrowth in inflammatory bowel disease: a meta-analysis. Front Med. 2025; 11. https://doi.org/10.3389/fmed.2....
48.
Wilk K, Witkowska E, Ciechański M, Cholewiński S, Wilk B, Stachura P, et al. Understanding SIBO: a comprehensive review of causes, symptoms, diagnosis and treatment strategies of small intestinal bacterial overgrowth. J Educ Health Sport. 2025; 82: 60508. https://doi.org/10.12775/JEHS.....
49.
Sharabi E, Rezaie A. Small intestinal bacterial overgrowth. Curr Infect Dis Rep. 2024; 26(11): 227-33. https://doi.org/10.1007/s11908....
50.
Nowakowski K, Mularczyk Z, Reclik M, Oleksy P, Tenderenda M. Small intestinal bacterial overgrowth syndrome: new clinical insights for multimorbid and high-risk patients. Qual Sport. 2024; 36: 56729. https://doi.org/10.12775/QS.20....
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