Gastroenterology · UKMLA & AKT
Small intestinal bacterial overgrowth (SIBO)
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise small intestinal bacterial overgrowth (sibo) — the full SA Note notes add investigations, management, complications and 10 practice questions.
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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