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Bacterial Overgrowth Treatment


Updated May 23, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.


During treatment, it is necessary to limit intake of sweet and starchy foods. People usually experience a noticeable decline in bloating, gas, indigestion, diarrhea, and other digestive symptoms.

A popular diet for bacterial overgrowth is the specific carbohydrate diet by Elaine Gottschall. This diet limits grains, starchy vegetables, and some legumes, and was created to address digestive disorders such as bacterial overgrowth, Crohn's disease, and ulcerative colitis.

Medium Chain Triglycerides - Unlike regular oils, which a person with bacterial overgrowth may not be able to assimilate, medium chain triglycerides are absorbed directly without the need for digestive enzymes. Medium chain triglycerides are often recommended for people with bacterial overgrowth or any type of malabsorption. Coconut oil is a medium chain triglyceride.

Digestive enzymes - Digestive enzyme supplements can support the body's digestive enzymes until function is restored. They should be taken before meals. A typical dose is one capsule before each meal. More on digestive enzymes.

Vitamins and minerals that may be deficient in people with bacterial overgrowth include vitamin B12, magnesium, calcium, iron, zinc, copper, vitamin A, D, E, K.

Probiotics - needed to replace healthy bacteria in the intestines. Lactobacillus plantarum and lactobactillus GG are some types that have been used for bacterial overgrowth.

Getting a Diagnosis

The "gold standard" test is to take bacterial cultures of small intestine fluid.

Lactulose hydrogen breath test - The most common test is the lactulose hydrogen breath test because it is less invasive. Lactulose is a non-absorbable sugar that's fermented if there is intestinal bacteria, resulting in hydrogen production. If there is bacterial overgrowth, fasting hydrogen levels will be high. In addition, after ingesting glucose, there will be a significant rise in hydrogen. More about the breath test.

Other tests are the schilling test (for b12 deficiency). A small bowel follow through may be done to look for structural problems.

One of the underlying causes of bacterial overgrowth is insufficient stomach acid, called hypochlorhydria. Stomach acid naturally declines with age. Take the hypochlorhydria screening test.

What Conditions Can Bacterial Overgrowth Lead to?

  • leaky gut syndrome
  • vitamin and mineral deficiency
  • non-alcoholic steatohepatitis (NASH)
  • chronic fatigue syndrome


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    Pimentel, Mark, Chow, Evelyn J. & Lin, Henry C. Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome. American Journal of Gastroenterology 2000, 95 (12), 3503-3506.

    Lichtman SN, Keku J, Schwab JH, Sartor RB. Hepatic injury associated with small bowel bacterial overgrowth in rats is prevented by metronidazole and tetracycline. Gastroenterology. 1991 Feb;100(2):513-9.

    Shindo K, Machida M, Miyakawa K, Fukumura M. A syndrome of cirrhosis, achlorhydria, small intestinal bacterial overgrowth, and fat malabsorption. Am J Gastroenterol. 1993 Dec;88(12):2084-91.

    Teo, Marcus, Chung, Stephen, Chitti, Lauri, Tran, Cuong, Kritas, Stamatiki, Butler, Ross, Cummins, Adrian. Small bowel bacterial overgrowth is a common cause of chronic diarrhea. Journal of Gastroenterology and Hepatology 2004; 19 (8), 904-909.

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    Jeffery S. Meyers, MD, Eli D. Ehrenpreis, MD, and Robert M. Craig, MD Small Intestinal Bacterial Overgrowth Syndrome. Current Treatment Options in Gastroenterology 2001, 4:7-14
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