Curbside Consultation of the Colon: 49 Clinical Questions

Brooks D. Cash, MD, FACP, CDR, MC, USN

Question 24: What Is The Evidence For Antibiotics As A Therapy For Irritable Bowel Syndrome? (continued)

Brian Mulhall, MD

The concept of augmenting the management of irritable bowel syndrome (IBS) with antibiotics is evolving, and many questions remain regarding this therapy relative to known and hypothesized IBS pathophysiology. The clinical evidence of small intestinal bacterial overgrowth (SIBO) as an important etiology of IBS continues to accumulate. Clinical symptoms of bacterial overgrowth and IBS are similar; however, a definitive cause-and-effect relationship remains unproven. It is unclear whether motility dysfunction causes bacterial overgrowth, or gas products of enteric bacteria affect intestinal…