Bacterial overgrowth syndrome occurs when the normally low numbers of bacteria inhabiting the small intestine becomes overtaken by bacteria or pathogens. The prevalence of bacteria in the upper GI tract depends on gastric acidity, peristaltic activity, damage to the mucosa or atrophy, the redox potential, pH, diet and much more. The workup for this condition includes a CDSA, various breath tests that involve hydrogen, bile acids, and xylose, and at times endoscopy.
Treatment with antibiotics is often tried empirically with one of many antibiotics such as tetracycline, augmentin, rifaximin, cleocin, flagyl, and many others. A single 7-10 day course may solve the problem in as many as 90%. Serial antibiotic courses are often necessary to relieve symptoms.
