Should Small Intestine Bacterial Overgrowth be Ruled out as a Cause of Non-Responsive Celiac Disease?: A Case Report

Non-responsive celiac disease is defined as the persistency of symptoms, signs or laboratory abnormalities typical of CD despite 6-12 months of dietary gluten avoidance. Small intestine bacterial overgrowth has been classically considered a potential cause for non-responsive celiac disease. Nevertheless, the evidence regarding its prevalence among non-responsive celiac patients is conflicting, as well as the evidence showing a benefit in small intestine bacterial overgrowth treatment in this clinical setting. We report the case of a 34 year-old woman diagnosed with non-responsive celiac disease in spite of adequate gluten-free diet, that had complete resolution of symptoms after treatment with antibiotics for small intestine bacterial overgrowth.