Gut Instincts: A Clinician's Handbook of Digestive and Liver Diseases

Eric Esrailian, MD, MPH

Chapter 22: Small Intestinal Bacterial Overgrowth (continued)

Mark Pimentel, MD, FRCP(C); Gillian M. Barlow, PhD

The digestive tract is host to a large diversity of bacterial flora. Each area has its own unique type and number of flora. Having the slowest transit time, the colon is the largest reservoir of bacteria in the human body. There is an estimated 1011 bacteria for every milliliter of colon contents. The human small bowel has a series of principles that prevent the accumulation of bacteria in this location. When any of these mechanisms fail, the small intestine can readily accumulate bacteria from the colon, and this leads to small intestinal bacterial overgrowth (SIBO). In this chapter, the…