Which of the following is a nutritional impact of SBBO?

• A. Deconjugation of bile salts and impaired micelle formation
• B. Increased SCFA production that decreases luminal pH and increases osmotic load
• C. Decreased SCFA production
• D. No effect on digestion

Answer: (A)

Bile salt deconjugation by intestinal bacteria disrupts micelle formation. When bile salts are deconjugated, their ability to solubilize fats into mixed micelles diminishes, so fat digestion and absorption in the small intestine are impaired. This fat malabsorption is the primary nutritional consequence of SBBO and can lead to fat-soluble vitamin deficiencies. While overgrowth can increase bacterial fermentation and lower luminal pH, it does not consistently raise osmotic load, and decreased SCFA production is not expected with overgrowth. No effect on digestion is not accurate given the impact on lipid absorption.