{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:03:06Z","timestamp":1790856186677,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Small intestinal bacterial overgrowth (SIBO) has recently gained increasing attention as a potential cause of postoperative gastrointestinal symptoms following gastrointestinal cancer surgery. Surgical procedures can disrupt normal gastrointestinal physiology through anatomical reconstruction, impaired motility, reduced gastric acid secretion, vagal nerve injury, and alterations in the gut microbiota, thereby predisposing patients to bacterial overgrowth. Although positive breath tests for SIBO have frequently been reported after esophageal, gastric, and colorectal cancer surgery, the reported positivity rates vary widely because of differences in patient selection, surgical procedures, and diagnostic methods. Importantly, several studies evaluated selected symptomatic or referred patients; therefore, these rates should not necessarily be interpreted as the true prevalence of SIBO in the overall postoperative population. Breath testing is widely used because of its simplicity and non\u2010invasive nature; however, altered gastrointestinal anatomy and accelerated postoperative transit may affect test specificity and potentially produce false\u2010positive results. Evidence regarding treatment specifically in patients after gastrointestinal cancer surgery remains limited, and most data regarding rifaximin and other therapeutic approaches are extrapolated from general SIBO populations. This review summarizes the current evidence regarding the epidemiology, pathophysiology, diagnosis, and treatment of SIBO following gastrointestinal cancer surgery. We discuss future perspectives, including standardization of diagnostic criteria, optimization of breath testing, microbiome\u2010based approaches, refinement of rifaximin therapy, and strategies for recurrence prevention. A better understanding of SIBO may improve the recognition and management of postoperative gastrointestinal symptoms and nutritional abnormalities; however, whether SIBO\u2010directed management improves body composition, treatment tolerance, postoperative recovery, or long\u2010term outcomes remains to be established.<\/jats:p>","DOI":"10.1002\/ags3.70291","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T11:12:47Z","timestamp":1790853167000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Small Intestinal Bacterial Overgrowth Following Gastrointestinal Cancer Surgery: Current Evidence and Future Perspectives"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6803-3800","authenticated-orcid":false,"given":"Toru","family":"Aoyama","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery Yokohama City University  Yokohama Japan"},{"name":"Department of Gastric Surgery Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhiko","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Gastric Surgery Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaki","family":"Yoshikawa","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery Yokohama City University  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"e_1_2_14_2_1","first-page":"229","article-title":"Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"74","author":"Bray F.","year":"2024","journal-title":"CA: A Cancer Journal for Clinicians"},{"key":"e_1_2_14_3_1","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1038\/s41574-020-0357-5","article-title":"International Consensus on the Diagnosis and Management of Dumping Syndrome","volume":"16","author":"Scarpellini E.","year":"2020","journal-title":"Nature Reviews. 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