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  • Scott Adams
    Scott Adams

    Bacterial Overgrowth of Small Intestine Common in Treated Celiac Disease

    Reviewed and edited by a celiac disease expert.

    Dig Liver Dis. 2002 Dec;34(12):846-50.

    Celiac.com 07/12/2004 – In a study designed to determine the causes of continued gastrointestinal problems in celiacs who are on a gluten-free diet, Italian researchers looked at 15 celiac patients who continued to experience symptoms even after 6-8 months on a gluten-free diet. Histology improved in all patients after this time so refractory celiac disease was excluded as the cause. The scientists performed AGA and EMA tests, stool examination, EGD with histological examination of small bowel mucosa, and sorbitol-, lactose-, and lactulose H2-breath tests to determine a possible cause of the patients persistent symptoms.

    The researchers found that one patient who had Marsh II lesions was fully compliant with his diet but had mistakenly taken an antibiotic that contained gluten. Two of the patients had lactose malabsorption, one had Giardia lamblia, and one had Ascaris lumbricoides infestation. Ten patients were found to have small intestinal bacterial overgrowth (SIBO) by lactulose H2-BT. The doctors prescribed a diet without milk or fresh milk-derived foods to the patients with lactose malabsorption; and treated the patients with parasite infestation with mebendazole 500 mg/day for three days for two consecutive weeks. The SIBO patients were treated with rifaximin 800 mg/day for one week. All of the patients were re-evaluated one month after treatment, and all were symptom-free.

    The researchers conclude that SIBO affects most celiacs who have persistent gastrointestinal symptoms after going gluten-free.


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    It has been 3 years since I was diagnosed with celiac. Since then, I have been diagnosed with gastroparesis, collagenous colitis cdiff, which took 3 months to cure. I am on a ENSURE (9 a day) and I am still having problems in the bowel. My gastroenterologist says YOU HAVE TO LEARN TO LIVE WITH IT. I can't be getting any gluten.

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    I'd find another gastroenterologist. Sounds like yours has given up on you. If you live near a medical school, call their G.I. dept. and ask if any of the clinical staff specializes in SIBO and adult celiac. Nobody should have to "learn to live with it." A chronic disease is always annoying, but it shouldn't be crippling!

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  • About Me

    Celiac.com's Founder and CEO, Scott was diagnosed with celiac disease  in 1994, and, due to the nearly total lack of information available at that time, was forced to become an expert on the disease in order to recover. Scott launched the site that later became Celiac.com in 1995 "To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives."  In 1998 he founded The Gluten-Free Mall which he sold in 2014. He is co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

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