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SIBO and Rosacea


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  • Root Admin


SIBO refers to "Small bowel bacterial overgrowth syndrome (SBBOS), or small intestinal bacterial overgrowth (SIBO), also termed bacterial overgrowth; is a disorder of excessive bacterial growth in the small intestine." [1]

It has also been called Dysbiosis (sometimes called dysbacteriosis).

The presence of small intestinal bacterial overgrowth (SIBO) in patients with rosacea has been investigated and the results of this study says, "We found an increased prevalence of SIBO in patients with rosacea compared to controls (40/60 vs 3/60, respectively, p<0.001). Oro-cecal transit time resulted significantly delayed in patients with SIBO than in controls (p<0.01). After SIBO eradication we obtained a complete recovery of cutaneous lesions in 17/20 (85%) and a relevant improvement in 2/20 (10%) patients, while those treated with placebo remained unchanged (14/16) or even worsened (2/16), (p<0,001). These latter patients were subsequently switched to rifaximin therapy with complete resolution of rosacea in 14/16 and significant improvement in the remaining 2 cases.

CONCLUSION: Our study shows the high prevalence of SIBO in patients with rosacea and emphasizes the clinical effectiveness of its eradication in inducing almost complete remission of cutaneous lesions." [2]

Another report shows similar results. [3]

You might notice that the article [Clin Gastroenterol Hepatol] says that "Patients positive for SIBO were randomized to receive rifaximin 1200 mg/day for 10 days or placebo...These latter patients were subsequently switched to rifaximin therapy with complete resolution of rosacea in 14/16 and significant improvement in the remaining 2 cases."[2]

Wikipedia says that Rifaximin is "a semisynthetic, rifamycin-based non-systemic antibiotic, meaning that the drug will not pass the gastrointestinal wall into the circulation as is common for other types of orally administered antibiotics....It is currently sold in the U.S. under the brand name Xifaxan by Salix Pharmaceuticals. It's also sold in Europe under the name Spiraxin and Zaxine.."

Another source says "Rifaximin is effective in treatment of SIBO in IBS and controlled trials are warranted."

There is also evidence that SIBO occurs "in patients suffering from scleroderma" as well. [4]

An EIR Report on SIBO says that according "to Dr. Leo Galland, a specialist in dysbiosis related illness, the best diet to aid in the treatment of SIBO is very similar to that used to treat yeast overgrowth. This being a diet free of simple sugars and grains/cereals and low in fruit and starchy vegetables depending on individual tolerance. This diet restricts the nutrition available for bacteria in the upper GI tract to proliferate and reduces the excess alcohols and organic acids that are produced as a result of bacterial fermentation." [5] This is similar to the Rosacea Diet, reducing sugar/carbohydrate

A report in 2013 concluded: "This study demonstrated that rosacea patients have a significantly higher SIBO prevalence than controls. Moreover, eradication of SIBO induced an almost complete regression of their cutaneous lesions and maintained this excellent result for at least 9 months. [6]

"For example, rosacea has an association with SIBO (small intestine bacteria overgrowth). In one study, there was a higher number of patients with rosacea who tested positive for SIBO than the group without the skin disease. The researchers randomly assigned the patients with a positive SIBO breath test to either take a placebo or rifaximin (an antibiotic) therapy at 1200 mg/day for 10 days to clear the SIBO. Some patients also underwent the therapy despite having a negative breath test. Upon treating the SIBO, 20 of 28 patients had a clearance of cutaneous lesions, while there was either no change or worsening of the lesions in those who were on the placebo. The researchers then switched the patients taking the placebo to the antibiotic treatment, resulting in 17 of the 20 experiencing an eradication of SIBO. Out of that group, 15 also saw a complete resolution of their rosacea. The improvement of rosacea lasted for at least 9 months. There was no change in rosacea in 13 of the 16 patients who tested negative for SIBO. This study demonstrates that not only is there a strong association between SIBO and rosacea, but that treating the SIBO improved rosacea." [7]

Certain foods common in diets of US adults with inflammatory bowel disease

You may want to consider the Rosacea Diet.

Anecdotal Rifaximin Treatment Reports



IBS and Rosacea

IBD and Rosacea

HLA-DRA Locus and Rosacea

Gastrointestinal Rosacea [GR], aka, Gut Rosacea

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End Notes

[1] Image courtesy of Wikimedia Commons, 


United European Gastroenterology Week
Clin Gastroenterol Hepatol. 2008 Jul;6(7):759-64. Epub 2008 May 5
Parodi A, Paolino S, Greco A, Drago F, Mansi C, Rebora A, Parodi AU, Savarino V

[3] Journal of the American Academy of Dermatology
Volume 68, Issue 5, Pages 875–876, May 2013
Rosacea and small intestinal bacterial overgrowth: Prevalence and response to rifaximin
Leonard B. Weinstock, MD, Martin Steinhoff, MD, PhD

[4] Small intestinal bacterial overgrowth in patients suffering from scleroderma: clinical effectiveness of its eradication.
Parodi A, Sessarego M, Greco A, Bazzica M, Filaci G, Setti M, Savarino E, Indiveri F, Savarino V, Ghio M.
Am J Gastroenterol. 2008 May;103(5):1257-62. Epub 2008 Apr 16.

[5] Antibacterial Treatment, For The Treatment Of Bacterial Dysbiosis, Small Intestinal Bacterial Overgrowth (SIBO), Bacterial Overgrowth, Environmental Illness Report

[6] Clin Gastroenterol Hepatol.
Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication
By A. Parodi A et al. • ProHealth.com • April 12, 2013

[7] The Gut-Skin Axis: The Importance of Gut Health for Radiant Skin, Deanna Minich, Ph.D., Contributor, Huff Post

Image courtesy of Wikimedia Commons

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  • 3 months later...
  • Root Admin

"Patients with rosacea also have a higher incidence of hyperglycemia, which means increased risk of SIBO due to gut hypomotility. Again, the flushing and erythrosis seen in many rosacea patients could be due to the release of angiogenic and vasoactive agents including nitric oxide or TNF-α. The fact is that papulopustular rosacea and erythrotic rosacea could be due to different causes."

Rosacea and Small Intestinal Bacterial Overgrowth (SIBO), By Liji Thomas, MD, News Medical

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