SIBO and intestinal health: clinical implications of an altered microbiota

Small intestinal bacterial overgrowth (SIBO) was described as a condition characterised by an abnormal increase of bacteria in the small intestine, frequently associated with non-specific gastrointestinal symptoms. Over the years, its study has been deepened thanks to advances in diagnostic techniques and in the knowledge of its pathophysiology. Predisposing factors such as hypochlorhydria and anatomical or motility alterations were identified. In diagnosis, although jejunal aspirate culture remained the reference method, breath tests were widely used because of their accessibility, despite their limitations. The interpretation of these results was complex and the need to standardise criteria to avoid diagnostic errors and unnecessary treatments was emphasised. Continuous medical training and a comprehensive clinical approach were fundamental for the adequate management of SIBO.