Consultant of internal diseases, digestive system and liver, Dr. Wafa’a Al-Hashash, revealed that about 30 percent of diabetics in the country suffer from Small intestinal bacterial overgrowth (SIBO), indicating that this number is equivalent to about 340,000 diabetics in the country.

Al-Hashash told Al-Rai daily that the elderly are more at risk of contracting the disease due to a change in the level of stomach acid, and most of them receive medications that increase the risk of contracting the disease.

She added that SIBO occurs when there is an abnormal increase in the total number of bacteria in the small intestine, explaining that if SIBO is present, food becomes stagnant in the small intestine, and becomes a fertile soil for bacteria to multiply, producing toxins and affecting the absorption of nutrients and then the symptoms occur, the most important of which are gas, bloating, and diarrhea.

Al-Hashash added that among the most important symptoms of SIBO are abdominal pain, nausea, gas, bloating, a feeling of fullness even after eating a small amount of food, diarrhea and weight loss, indicating that one of the most important factors for SIBO is also performing abdominal surgeries such as sleeve gastrectomy, gastric bypass surgery, peptic ulcer surgery, adhesions in the small intestine, or diverticulosis in the intestine, as well as infection in some pathological conditions such as Crohn’s, Celiac disease, diabetes, radiation enteritis, or any conditions that can slow down bowel movement.

And she continued: “SIBO” is diagnosed by a hydrogen and methane breath test, and the accuracy of the examination reaches 83 percent, as the device measures the amount of hydrogen and methane that a person exhales during exhalation, after eating the reagent, and indicates a rapid rise in hydrogen and methane in exhalation. To an overgrowth of bacteria in the small intestine. A laboratory blood test is also performed to look for vitamin deficiencies, and stool examination to test for malabsorption of fats, in addition to performing a stomach and colonoscopy to rule out other causes of symptoms.

Al-Hashash said that it is sometimes possible to request x-rays, CT scans, or MRI scans to look for abnormalities in the structure of the small intestine.

Al-Hashash indicated that one of the complications of SIBO is poor absorption of fats, carbohydrates, and proteins, in addition to a lack of essential vitamins and minerals for the body. It also leads to osteoporosis and the formation of kidney stones due to poor absorption of calcium.

Al-Hashash explained that the underlying cause of SIBO must be treated, and the treatment is done by using antibiotics to reduce the number of harmful bacteria, but it is a short-term treatment, because the bacteria may return after stopping the antibiotic, so the treatment must be long-term.

The attending physician changes the antibiotic to prevent bacterial resistance, referring to nutritional support therapy, which is compensating for nutritional deficiency is the most important step, by compensating for the lack of vitamins and compensating for weight loss, in addition to the use of nutritional supplements and a lactose-free diet.

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