Gastroenterology · UKMLA & AKT
Small intestinal bacterial overgrowth (SIBO)
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Bacteria deconjugate bile acids → fat malabsorption, steatorrhoea, fat-soluble vitamin deficiency (A, D, E, K)
- Bacterial fermentation of carbohydrates in small bowel → bloating, flatulence, osmotic diarrhoea
- Bacteria consume B12 but synthesise folate → low B12 + elevated folate (hallmark biochemical pattern)
Low B12 with elevated folate = SIBO. In coeliac disease, both B12 and folate tend to be low - a key exam discriminator.
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