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. 2025 Apr 3;17(7):1251.
doi: 10.3390/nu17071251.

Should We Treat SIBO Patients? Impact on Quality of Life and Response to Comprehensive Treatment: A Real-World Clinical Practice Study

Ana Reyes Liébana-Castillo  1 , Lucía Redondo-Cuevas  1 , Ángela Nicolás  1 , Vanessa Martín-Carbonell  1   2 , Laura Sanchis  1   2 , Aroa Olivares  1 , Francisco Grau  1 , Marina Ynfante  1 , Michel Colmenares  1 , María Leonor Molina  1 , José Ramón Lorente  1 , Héctor Tomás  1 , Nadia Moreno  1 , Ana Garayoa  2 , Mercedes Jaén  1   2 , María Mora  1   2 , José Gonzalvo  2 , José Ramón Molés  1   2 , Samuel Díaz  1 , Noelia Sancho  1 , Eva Sánchez  1   2 , Juan Ortiz  1 , Vicente Gil-Guillén  3 , Ernesto Cortés-Castell  3 , Xavier Cortés-Rizo  1   2
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Should We Treat SIBO Patients? Impact on Quality of Life and Response to Comprehensive Treatment: A Real-World Clinical Practice Study

Ana Reyes Liébana-Castillo et al. Nutrients. .

Abstract

Background: Small intestinal bacterial overgrowth (SIBO) is a dysbiosis marked by an excessive proliferation of bacteria in the small intestine, resulting in abdominal symptoms that significantly affect patients' quality of life. Objectives: This study aims to evaluate the impact of a comprehensive therapeutic approach in improving the quality of life of patients with SIBO. Methods: For this purpose, standardized questionnaires were used at baseline, 30 days and 90 days, including the IBS-QOL (Irritable Bowel Syndrome Quality of Life Questionnaire), the GSRS (Gastrointestinal Symptom Rating Scale), the EuroQOL-5D, and the Bristol Scale. Results: The results show that a comprehensive approach, combining pharmacological treatment, appropriate dietary intervention, and strategies aimed at improving gut microbiota and intestinal permeability, produces a sustained improvement in the quality of life of a significant proportion of patients who participated in the study. Furthermore, the results suggest that, although gas normalization is a relevant indicator, clinical improvement and quality of life depend considerably on patients' subjective perception of their health. Conclusions: This finding underscores the importance of recognizing SIBO as a prevalent condition that requires accurate diagnoses and individualized treatments to improve patients' well-being.

Keywords: FODMAP diet; Small Intestine Bacterial Overgrowth (SIBO); antibiotics; gut microbiota; herbal therapies; probiotics; quality of life.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Diagram of the treatment time course (adapted from Redondo-Cuevas et al. [22]).
Figure 2
Figure 2
Evolution of the percentage of patients with normal stools (Panel A), hard stools (Panel B), or loose stools (Panel C) according to the Bristol Stool Scale. Patients who did not normalize gas levels are represented in blue (NN), while those who achieved normalization are shown in orange (N).
Figure 3
Figure 3
Evolution of the percentage of patients with normal stools (Panel A), hard stools (Panel B), or loose stools (Panel C) according to the Bristol Stool Scale. Patients who did not normalize clinical symptoms are represented in blue (NR), while those who achieved normalization are shown in orange (R).
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