Should We Treat SIBO Patients? Impact on Quality of Life and Response to Comprehensive Treatment: A Real-World Clinical Practice Study

Nutrients. 2025 Apr 3;17(7):1251. doi: 10.3390/nu17071251.

Abstract

Background: Small intestinal bacterial overgrowth (SIBO) is a dysbiosis marked by an excessive proliferation of bacteria in the small intestine, resulting in abdominal symptoms that significantly affect patients' quality of life. Objectives: This study aims to evaluate the impact of a comprehensive therapeutic approach in improving the quality of life of patients with SIBO. Methods: For this purpose, standardized questionnaires were used at baseline, 30 days and 90 days, including the IBS-QOL (Irritable Bowel Syndrome Quality of Life Questionnaire), the GSRS (Gastrointestinal Symptom Rating Scale), the EuroQOL-5D, and the Bristol Scale. Results: The results show that a comprehensive approach, combining pharmacological treatment, appropriate dietary intervention, and strategies aimed at improving gut microbiota and intestinal permeability, produces a sustained improvement in the quality of life of a significant proportion of patients who participated in the study. Furthermore, the results suggest that, although gas normalization is a relevant indicator, clinical improvement and quality of life depend considerably on patients' subjective perception of their health. Conclusions: This finding underscores the importance of recognizing SIBO as a prevalent condition that requires accurate diagnoses and individualized treatments to improve patients' well-being.

Keywords: FODMAP diet; Small Intestine Bacterial Overgrowth (SIBO); antibiotics; gut microbiota; herbal therapies; probiotics; quality of life.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Blind Loop Syndrome* / microbiology
  • Blind Loop Syndrome* / psychology
  • Blind Loop Syndrome* / therapy
  • Female
  • Gastrointestinal Microbiome
  • Humans
  • Intestine, Small* / microbiology
  • Irritable Bowel Syndrome
  • Male
  • Middle Aged
  • Quality of Life*
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents

Grants and funding

This research received no external funding.