Lupine Publishers-Journal of Hepatology









Small intestinal bacterial overgrowth (SIBO) is often secondary to intestinal dysmotility and several other predisposing conditions. Treatment of SIBO typically includes antibiotics and treatment of underlying etiology. Identification and treatment of the underlying modifiable causes is critical for management of refractory and recurrent SIBO. We report here a case of scleroderma with small bowel dysmotility and bacterial overgrowth, on different occasions the patient failed to respond to Rifaximin. We showed that restoring small bowel motility is critical in maintaining the effectiveness of Rifaximin in the treatment of SIBO. Rifaximin resistance may also develop following prolonged use of antibiotics. Rotation of antibiotic regimen is important to prevent drug resistance.




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