Small intestinal bacterial overgrowth (SIBO) is defined as the presence of more than 100,000 colony forming units/ml of small intestine aspirate (material). The term small intestinal bacterial overgrowth syndrome is used when the presence of bacteria in excess in the small bowel is responsible for the onset of clinical symptoms or signs including bloating, abdominal distention, abdominal pain or discomfort, diarrhoea and fatigue. Its occurrence often relates to alterations in intestinal anatomy, motility and gastric acid secretion.
In a recent study, researchers from the University of Genoa, Italy, assessed the presence of SIBO in patients with rosacea and the clinical effectiveness of its eradication (Parodi, Paolino, Greco, Drago, Mansi, Rebora, Parodi & Savarino, 2008). In this study it was reported that patients with rosacea reported a high incidence of gastrointestinal complaints including dyspepsia, bloating, flatulence, abdominal pain and a reduction in gut transit time. Moreover, eradication of SIBO resulted in a complete regression of skin lesions, which was maintained for a period of 9 months following rifaximin therapy (1200 mg/day for 10 days). Adverse side effects of rifaximin therapy can include elevated liver enzymes, diarrhoa with fever and watery or bloody diarrhoea. For this reason, oregano oil (Preuss, Echard, Enig, Brook & Elliot, 2005), probiotics (Whitehead, 2009) and an alkalising diet (Whitehead, 2009) can be utilised as an effective alternative.
Parodi, A., Paolino, S., Greco, A., Drago, F., Mansi, C., Rebora, A., Parodi, A. & Savarino, V. 2008. Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication. Clinical Gastroenterology Hepatology, 7, 759-764.
Preuss, HG., Echard, B., Enig, M., Brook, I. & Elliot, T.B. 2005. Minimum inhibitory concentrations of herbal essential oils and monolaurin for gram positive and gram negative bacteria. Molecular Cellular Biochemistry, 1, 2, 29-34.
Whitehead, J. 2009. Intestinal alkaline phosphatase: the molecular link between rosacea and gastrointestinal disease? Medical Hypotheses, 73, 6, 1019-1022.