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Excessive bacterial growth in the small intestine - recommended diets for SIBO syndrome

Tim Klein

Tim Klein

2026-03-23
7 min. read
Excessive bacterial growth in the small intestine - recommended diets for SIBO syndrome
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SIBO syndrome, characterized by bacterial overgrowth in the small intestine, affects up to 22% of the adult population. Conventional treatment is based on targeted antibiotics aimed at reducing the number of bacteria colonizing the small intestines. However, this treatment should be supported by an appropriate diet, preferably FODMAP, SCD, GAPS or Dr. Siebecker's protocol. In this article, we will discuss these dietary models and their role in the treatment of SIBO.

Zespół nadmiernego rozrostu bakteryjnego jelita cienkiego (SIBO)

Zespół nadmiernego rozrostu bakteryjnego jelita cienkiego, znany pod skrótem SIBO (od angielskiej nazwy *Small Intestinal Bacterial Overgrowth*), stanowi zaburzenie charakteryzujące się obecnością w świetle jelita cienkiego nieprawidłowych szczepów bakteryjnych, które w warunkach fizjologicznych nie powinny się tam znajdować, bądź też nadmiernym namnożeniem mikroorganizmów, które normalnie występują w tym odcinku przewodu pokarmowego jedynie w śladowych ilościach. Patologiczna kolonizacja bakteryjna prowadzi do wystąpienia u pacjentów szeregu uciążliwych symptomów ze strony układu trawiennego, takich jak nawracające bóle brzuszne, naprzemienne zaparcia i biegunki, uciążliwy refluks żołądkowo-przełykowy, nadmierne gromadzenie się gazów oraz wzdęcia. Ponadto obserwuje się także objawy pozajelitowe, w tym epizody depresyjne, przewlekłe uczucie zmęczenia, dolegliwości stawowe o charakterze zapalnym oraz różnorodne zmiany skórne. Etiologia SIBO jest złożona i wieloczynnikowa – wśród najczęstszych przyczyn wymienia się obniżoną produkcję kwasu solnego w żołądku (achlorhydrię), dysfunkcje w wydzielaniu enzymów trzustkowych, zaburzenia odporności immunologicznej, a także strukturalne nieprawidłowości w obrębie przewodu pokarmowego, takie jak zwężenia, nowotworowe zmiany jelita cienkiego czy obecność uchyłków. Schorzenie to często współwystępuje z innymi jednostkami chorobowymi, w tym z celiakią, chorobą Leśniowskiego-Crohna, przewlekłymi chorobami wątroby oraz neuropatią cukrzycową. Terapia SIBO stanowi wyzwanie kliniczne ze względu na złożoność patomechanizmu oraz tendencję do nawrotów. Standardowe podejście terapeutyczne opiera się przede wszystkim na celowanej antybiotykoterapii, z wykorzystaniem preparatów takich jak metronidazol, doksycyklina oraz rifaksymina, które wykazują skuteczność w redukcji nadmiernej populacji bakteryjnej. Niemniej jednak kluczowym, uzupełniającym elementem leczenia okazuje się być odpowiednio zbilansowana dieta, której zasadniczym celem jest przywrócenie równowagi mikrobiologicznej w jelicie cienkim oraz złagodzenie charakterystycznych dla SIBO objawów klinicznych.

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