Is SIBO Common In Multiple Sclerosis?

Is SIBO Common In Multiple Sclerosis?

Is SIBO Common In Multiple Sclerosis?

Before we start, other blogs that you might be interested in, include:

In my blog entitled The Gut Microbiome In Multiple Sclerosis we discussed how there are many ways that the microbiome may contribute to Multiple Sclerosis:

  • The Gut-Brain Axis
  • Microbial metabolites
  • Modulation of the immune system
  • Maintaining a healthy gut barrier (preventing leaky gut)

Today we focus in on a new point – small intestine bacterial overgrowth.

The Gut In Multiple Sclerosis

An example of the connection between imbalances in the gut and multiple sclerosis is the known association between multiple sclerosis and IBD.

It has been suggested this is because of common epidemiological, immunological and genetic patterns. IBD patients have an increased risk for cerebrovascular disease, peripheral neuropathy and demyelinating disease.

Also, in patients with multiple sclerosis, markers of coeliac disease are more frequent than in healthy controls (1).

SIBO In Multiple Sclerosis

SIBO is highly prevalent in Chinese patients with MS. Further analytical work is required to establish a causal association between SIBO and MS risk and progression.

In addition, 102 out of the 118 patients (86.4%) presented at least one GI symptom. Constipation (78.0%), Bloating (46.6%), and fecal incontinence (44.1%) were common.

In a different study looking at systemic sclerosis, 88 patients (30 male and 59 female) underwent the glucose hydrogen and methane breath test. The mean age was 54. Twelve participants were positive for the breath test, yielding a SIBO prevalence of 13.5% among patients.

Duration of disease >5 years was significantly associated with SIBO

The authors concluded that the prevalence of SIBO, using the glucose breath test, is not common among Thai patients. However, a positive result was associated with longer duration of disease. (2)



Conclusions: Is SIBO Common In Multiple Sclerosis

Compared to research looking in to the gut microbiome (often in the large intestine, not the small intestine), the integrity of the gut lining (i.e leaky gut) and microbiome metabolites (such as butyrate), there is very little published research looking directly at SIBO and multiple sclerosis.

However, with quotes like this in the research:

“The modification of gut microbiota by either dietary (e.g., probiotic supplementation) or medicinal approaches (e.g., antibiotic administration) may serve as additional therapeutic strategies for MS prophylaxis.”

It is clear that considering the gut is essential when it comes to neurological condones such as M.S.


  1. Prevalence of Small Intestinal Bacterial Overgrowth in Multiple Sclerosis: a Case-Control Study from China (click here)
  2. Prevalence and associated factors of small intestinal bacterial overgrowth among systemic sclerosis patients (click here)
  3. The intestinal barrier in multiple sclerosis: implications for pathophysiology and therapeutics (click here)
  4. The Gut-Brain Axis in Multiple Sclerosis. Is Its Dysfunction a Pathological Trigger or a Consequence of the Disease? (click here)
  5. Increased intestinal permeability in primary Sjögren’s syndrome and multiple sclerosis (click here)
  6. Undigested Food and Gut Microbiota May Cooperate in the Pathogenesis of Neuroinflammatory Diseases: A Matter of Barriers and a Proposal on the Origin of Organ Specificity (click here)
  7. Microbiome in Multiple Sclerosis: Where Are We, What We Know and Do Not Know (click here)
  8. The Gut Microbiome and Multiple Sclerosis (click here)
  9. Multiple sclerosis, the microbiome, TLR2, and the hygiene hypothesis (click here)
  10. Gut microbiome in multiple sclerosis: The players involved and the roles they play (click here)
  11. The gut microbiome in neurological disorders (click here)
  12. Gut microbiome and multiple sclerosis: New insights and perspective (click here)
  13. Alterations of the human gut microbiome in multiple sclerosis (click here)
  14. A probiotic modulates the microbiome and immunity in multiple sclerosis (click here)
  15. Multiple sclerosis and faecal microbiome transplantation: are you going to eat that? (click here)
  16. The Gut-CNS Axis in Multiple Sclerosis (click here)
  17. The intestinal barrier in multiple sclerosis: implications for pathophysiology and therapeutics (click here)
  18. Focus on the gut-brain axis: Multiple sclerosis, the intestinal barrier and the microbiome (click here)
  19. Diet, Gut Microbiota, and Vitamins D + A in Multiple Sclerosis (click here)
  20. The “Gut Feeling”: Breaking Down the Role of Gut Microbiome in Multiple Sclerosis (click here)
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