Talk:Small intestinal bacterial overgrowth

Merge from Leaky gut syndrome

Take a look at Leaky gut syndrome because it seems to be the same issue, albeit in a much smaller, not as well referenced article. Arthurrh 10:37, 12 August 2007 (UTC)

I'm not sure... leaky gut syndrome appears to lie more in the realm of alternative medicine, as opposed to bacterial overgrowth, which is well described in conventional gastroenterology. -- Samir 04:49, 14 August 2007 (UTC)

I think that the article makes it appear that way, but from the way the doc described it, they're pieces of the same picture. That's why I think they should be merged, because the leaky gut article is extremely POV. Arthurrh 05:31, 14 August 2007 (UTC)

As I understand, leaky gut syndrome is not an entity that exists in conventional gastroenterology (I'm just not that familiar with the alternative medicine literature, unfortunately). A PubMed search on "leaky gut syndrome" reveals nothing in conventional gastroenterology journals; the only descriptors of "leaky gut" in conventional GI reference bacterial translocation through "leaky" cell junctions, rather than overgrowth within the lumen. Some have hypothesized this for cirrhotics, and others for intestinal permeability in Crohn's (PMID 11383597, PMID 9111522) and other transmural diseases of the bowel. I think it would be best to keep bacterial overgrowth in its own article as a conventional syndrome, and keep "leaky gut syndrome" as an alternative medicine syndrome with its own article. -- Samir 05:54, 14 August 2007 (UTC)

Also, your link on bacterial overgrowth and IBS is excellent. There is increasing evidence for antibiotic use in IBS with SBBO-like pathogenesis thought to play a role in symptoms. We should add this to the article proper also. -- Samir 05:58, 14 August 2007 (UTC)

InquiringMind42 00:07, 30 April 2009 (UTC)

This article should not be combined with leaky gut. Chemically induced leaky gut is not the same thing as microbe induced leaky gut. Leaky gut due to chemical exposure is fairly well established because most kinds of NSAID cause leaky gut. Chemically induced leaky gut can be treated with steroids. That is very different from bacterial infection. You cannot treat microbe induced leaky gut with steroids because that would make an infection worse. Research from outside the United States indicates intestinal bacteria interact with the nervous system with Chronic Fatigue Syndrome, and the only way that can happen is if intestines are leaky. That means the intellectual territory of leaky gut spans two independent knowledge zones that are unrelated. One article to cover both knowledge zones is impossible without either ignoring one of the knowledge zones or confusing the reader. Nanoatzin (talk) 05:58, 20 February 2011 (UTC)

Definately SIBO is a totally seperate topic from leaky gut... SIBO is the more medically recognized, but there are dozens of references to leaky gut in PubMed, however i agree it has a lot less evidence and is by no means mainstream medicine.Tepi (talk) 17:29, 17 August 2012 (UTC)

• No, because one is about permeability, and the other is about bacteria. Two seperate issues; two separate articles. Softlavender (talk) 03:53, 5 March 2013 (UTC)

Suggestion: Change page title to "Small Intestinal Bacterial Overgrown (SIBO)"

The page title currently being used (Small bowel bacterial overgrowth syndrome)is not the phrase most commonly used in medical literature to discribe the condition being discussed, and its acronym (SBBOS) is rarely seen. Searching Google Scholar with the term "intestinal" coupled with "SBBOS" produces two hits. Substituting the acronym SIBO (Small Intestinal Bacterial Overgrown) for SBBOS in the same search returns 641 articles.

In addition, although the acronym SIBO is mentioned in the article, a search of Wikipedia for that term displays a page about a town in Sweden.

It is plausible that a significant number of potential users interested in this topic would know of it, or at least think/verbalize it, in terms of its acronym. Changing the article title should increase its usefulness by allowing it to be displayed higher in Google search results, and to be found in Wikipedia searches.

InquiringMind42 00:04, 30 April 2009 (UTC) —Preceding unsigned comment added by InquiringMind42 (talk • contribs)

100% agree, this is the first thing i thought when i read the article. SIBO is the more notable term by which this topic is known. I will request page moveTepi (talk) 17:30, 17 August 2012 (UTC)

ICD Codes

ICD-10: K63 and ICD-9: 579.8 do not correspond. The ICD-9 relates to "Other specified intestinal malabsorption" and the ICD-10 code relates to "Other diseases of intestine". ICD-9: 579.8 corresponds to ICD-10 K90.4 "Malabsorption due to intolerance, not elsewhere classified (excluding gluten and lactose intolerance". Changed ICD-10 to K90.4 as malabsorption appears to be more specific than other disease apers0n (talk) 17:49, 17 March 2012 (UTC)

From where do these code suggestions come? I'm not finding anything.--205.175.128.5 (talk) 17:12, 7 April 2017 (UTC)

Only Apers0n can answer where the K90.4 came from 5 years ago. Today, although it didn't back in 2012, ICD9data.com does list K90.4 as one of two suggested equivalent ICD-10-CM codes for 579.8 today; the other being K90.89 (the 5th character is not available in the base classification). K90.8 appears to be more appropriate, to me at least, given that the malabsorbtion is not due to an intolerance; but the increased bacterial load. Also, the WP article suggests that whilst ISBO causes a cluster of symptoms, not every symptom is present in every patient; so it would only be appropriate to code K90.8 if malabsorbtion had actually manifested. If only small intestinal bacterial overgrowth was stated (i.e. there were no symptoms available to the coder), then using K63.8 would be entirely appropriate unless there was further guidance available (e.g. clinician input, national coding guidelines etc). tl;dr: K90.4 is the wrong code. K90.8 is more appropriate if malabsorption is a presenting symptom. However; the actual code(s) assigned will depend on the symptoms presenting in each ISBO patient. Little pob (talk) 09:29, 19 April 2017 (UTC)

• I have boldly changed the code back to K63.8, and given K90.8, among others, to cover the symptoms. However, it might be wise to remove the K90.8, K59.0, R10, R11, and R14 symptom codes, as their presence may cause confusion; both for a novice/entry level coder, as well as anyone looking for codes to run a data dump. Little pob (talk) 10:39, 19 April 2017 (UTC)

typo

change: significanly lower serum albumin concentration. to significantly — Preceding unsigned comment added by Blabber92887 (talk • contribs) 05:27, 31 May 2012 (UTC)

Possible revision of Treatment section.

The first paragraph of this section states "the best evidence is for the use of norfloxacin and amoxicillin-clavulanate.[41]" However, both Scarpellini (http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2007.03259.x/full) and Pimentel, in more recent studies, claim Rifaximin as the best antibiotic treatment choice. Does anyone better qualified than I have an opinion on this? — Preceding unsigned comment added by Beachdayak (talk • contribs) 06:57, 15 July 2013 (UTC) .Probably there will eventually be consideration of mastic gum as a treatment. The gum has been proven to reduce Helicobacter pylori (H. pylori), a type of bacteria that sometimes grows in the lining of the stomach and causes ulcers.

Probiotics

This article currently describes the state of probiotics research in quite positive terms (e.g. "Probiotics taken in uncomplicated cases of SIBO can usually result in the individual becoming symptom free") but this seems to conflict with the information in the probiotic article, which states "scientific evidence as of 2012 has not confirmed any anti-disease claims or health benefits." One of these articles is apparently overstated. My own nonexpert examination of the literature seems to support the "promising but not confirmed" position; but things may have changed. It would be nice if somebody with medical research credentials could evaluate this situation and indicate the generally-agreed state of the science. When commercial products and strongly-held personal beliefs enter the forum, it is harder to maintain scientific detachment. — Preceding unsigned comment added by 71.53.79.192 (talk) 15:36, 9 July 2016 (UTC)

Merge from Blind loop syndrome proposal

The following discussion is closed. Please do not modify it. Subsequent comments should be made in a new section. A summary of the conclusions reached follows.

To not merge, given that no consensus over more than a year and the discussion is stale; a key argument was that Blind loop syndrome may be a distinctly notable cause of Small intestinal bacterial overgrowth. Klbrain (talk) 22:23, 25 August 2019 (UTC)

---

I propose that Blind loop syndrome (a start-class article that hasn't been updated since 2007) be merged into this article. The proposed article opens by stating:

Blind loop syndrome (BLS), commonly referred to in the literature as small intestinal bacterial overgrowth (SIBO)...

Amcedwards (talk) 00:48, 19 May 2018 (UTC)

Support (see reply to Doc James below)Oppose The quoted statement in the BLS article is tagged as needed citation. The SIBO article, Mayo Clinic[1] and Patient.info[2] all say BLS is a cause of bacterial overgrowth; but not the exclusive reason for developing SIBO. I am, however, mindful that I'm not a clinician; so will notify WP:MED. Little pob (talk) 17:41, 19 May 2018 (UTC)

Support Patient.info lists SIBO as a synonyms of blind loop syndrome.[3]

SIBO is typically due to "blind loop syndrome" but it may also have other causes.[4]

"blind loop syndrome" always includes SIBO so SIBO is a wider term than BLS.[5] IMO as the two are so closely related it is reasonable to have BLS redirect to SIBO and cover BLS within the SIBO article along with the few other rare cases. Doc James (talk · contribs · email) 23:57, 19 May 2018 (UTC)

Happy to defer to clinical expertise. Even though their BLS article discusses SIBO in some detail, my takeaway from Patient.info was: "This may lead to ... small intestinal bacterial overgrowth (SIBO) syndrome." (Emphasis mine.)

Though still in beta, ICD-11 groups SIBO and BLS into Bacterial Overgrowth Syndrome.[6]

Original opposition struck. Little pob (talk) 10:16, 20 May 2018 (UTC)

So maybe merge both into Bacterial overgrowth syndrome User:Little pob? Doc James (talk · contribs · email) 05:01, 23 May 2018 (UTC)

User:Doc James I'm not sure; even though it is WHO/ICD, it's still just one source. (WHO's weight vs ICD-11's beta status would also need to be considered.)

That said, assuming this merge proposal passes, I think you're right in alluding to getting the WP:COMMONNAME sorted at the same time. Do other MEDRS tend towards SIBO, BLS, or BOS? Little pob (talk) 10:38, 23 May 2018 (UTC)

It is a rare condition. In my experience all three of the terms are often used interchangably. Even though as Literaturegeek mentions below they technically have slightly variable meanings. Doc James (talk · contribs · email) 16:20, 23 May 2018 (UTC)

Don't get me wrong, I'm happy for the ICD-11 term to be used as the article name; but as a coder I might be biased... Little pob (talk) 18:56, 23 May 2018 (UTC)

• Weak oppose I am leaning oppose, because there are 520 published papers listed on PubMed describing "blind loop syndrome" as a syndrome as a result of a surgical complication. Blind loop syndrome causes small intestinal bacteria overgrowth, but blind loop syndrome is not SIBO in and of itself. It definitely needs to be included in the cause section of our SIBO article, but for professionals and non-professionals searching for blind loop syndrome, they will be looking for a standalone article describing it.--Literaturegeek | T@1k? 15:56, 20 May 2018 (UTC)

Oppose- I would prefer that the blind loop syndrome Wikipedia page remain as a stand-alone. As a medical diagnosis, blind loop syndrome has more traditional underpinnings in the literature (ie Polter, Boyle, Miller and Finegold, 1968; Gorbach and Tabaqchali, 1969) and, in my humble opinion, lends itself to a more deductive approach than do irritable bowel syndrome and small intestine bacterial overgrowth. DidacticApproach (talk) 21:46, 26 February 2019 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.