Ernährung bei bakterieller Fehlbesiedlung des Dünndarms

Bacterial overgrowth of the small intestine (SIBO) is an increasingly recognized clinical problem that can occur secondary to multiple underlying diseases and primarily as part of irritable bowel syndrome.

Summary of current knowledge on the pathophysiology, diagnosis, and treatment of SIBO with particular emphasis on the role of nutrition and the microbiome.

Summary and discussion of existing studies, reviews, and guidelines.

The definition and diagnosis of SIBO is imprecise. Molecular genetic studies of the small intestinal microbiome suggest that SIBO is defined by a small intestinal dysbiosis rather than a general overgrowth. Therapy is based on optimal treatment of the underlying disease, compensation for nutrient deficiencies, and administration of antibiotics. In addition, probiotics and dietary therapies such as a low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet should be considered, although the evidence for these therapies is low.

Further studies are needed to (i) develop a diagnostic gold standard, (ii) investigate the nutritional factors that influence the small intestinal microbiome and the development of SIBO, and (iii) better understand the effectiveness of various nutritional interventions for the treatment of SIBO.