SIBO
Small Intestinal Bacterial Overgrowth
Assessment and management of excessive bacteria in the small intestine, a frequent contributor to bloating, pain, and erratic bowel habits in children.
Small intestinal bacterial overgrowth, or SIBO, occurs when bacteria that normally live in the colon migrate upward into the small intestine, or when the small intestine's natural cleansing mechanisms are impaired. In children, this can cause daily bloating, abdominal discomfort, and unpredictable diarrhea or constipation.
SIBO is often seen alongside conditions that slow gut motility, such as gastroparesis, or after surgeries that alter intestinal anatomy. Dr. Mendez evaluates symptoms in context, coordinates hydrogen breath testing when appropriate, and creates treatment plans that address both the overgrowth and the underlying risk factors.
Signs and symptoms
- Persistent bloating, especially after meals
- Abdominal pain or cramping that improves after a bowel movement
- Diarrhea, constipation, or alternating patterns
- Excessive gas and flatulence
- Nausea or early fullness when eating
- Nutrient deficiencies or poor weight gain in chronic cases
How we treat it
- Symptom review and risk factor assessment, including prior surgeries and motility history.
- Lactulose or glucose hydrogen breath testing to measure bacterial fermentation patterns.
- Targeted antimicrobial therapy, selected carefully for pediatric safety and efficacy.
- Prokinetic support and dietary strategies to reduce recurrence.
- Follow-up breath testing to confirm eradication and monitor for relapse.
When to call a pediatric GI
- Your child has daily bloating and abdominal pain that does not respond to diet changes alone.
- You suspect SIBO after a prior intestinal surgery or in the setting of motility issues.
- A breath test was positive elsewhere and you need a pediatric GI to interpret results and plan treatment.
- Symptoms keep returning after treatment and you need a strategy for prevention.
- Your child has both constipation and bloating and you want to rule out underlying bacterial overgrowth.
Frequently asked
Is breath testing accurate in children?
Hydrogen breath testing is useful in children when performed with proper preparation and interpreted by a clinician experienced in pediatric gut physiology. We ensure the test is conducted under conditions that maximize accuracy.
Can SIBO be cured permanently?
SIBO can be effectively treated, but recurrence is common if the underlying predisposing factors are not addressed. We focus on both eradication and long-term prevention through motility support, dietary guidance, and careful follow-up.
Ready to talk it through?
Concierge access means we have the time to listen, evaluate carefully, and stay with your family through every step.