Small intestinal bacterial overgrowth (SIBO), also termed bacterial overgrowth, or small bowel bacterial overgrowth syndrome (SBBOS), is a disorder of excessive bacterial growth in the small intestine. Unlike the colon (or large bowel), which is rich with bacteria, the small bowel usually has fewer than 100,000 organisms per millilitre. Patients with bacterial overgrowth typically develop symptoms which may include nausea, bloating, vomiting, diarrhea, malnutrition, weight loss and malabsorption, which is caused by a number of mechanisms. The diagnosis of bacterial overgrowth is made by a number of techniques, with the gold standard being an aspirate from the jejunum that grows in excess of 105 bacteria per millilitre. Risk factors for the development of bacterial overgrowth include dysmotility; anatomical disturbances in the bowel, including fistulae, diverticula and blind loops created after surgery, and resection of the ileo-cecal valve; gastroenteritis-induced alterations to the small intestine; and the use of certain medications, including proton pump inhibitors. Small bowel bacterial overgrowth syndrome is treated with an elemental diet or antibiotics, which may be given in a cyclic fashion to prevent tolerance to the antibiotics, sometimes followed by prokinetic drugs to prevent recurrence if dysmotility is a suspected cause. Definition
SIBO may be defined as an increased number of bacteria measured via exhaled hydrogen and/or methane gas following the ingestion of glucose, or via analysis of small bowel aspirate fluid.
Oslers nodes are painful, red, raised lesions found on the hands and feet. They are associated with a number of conditions, including infective endocarditis, and are caused by immune complex deposition. Their presence is one definition of Oslers sign. Causes
Oslers nodes result from the deposition of immune complexes. The resulting inflammatory response leads to swelling, redness, and pain that characterize these lesions. The nodes are commonly indicative of subacute bacterial endocarditis. 10–25% of endocarditis patients will have Oslers nodes. Other signs of endocarditis include Roths spots and Janeway lesions. The latter, which also occur on the palms and soles, can be differentiated from Oslers nodes because they are non-tender.Oslers nodes can also be seen in

Systemic lupus erythematosus
Marantic endocarditis
Disseminated gonococcal infection
Distal to infected arterial catheter

Etymology
Oslers nodes are named after Sir William Osler who described them in the early twentieth century. He described them as "ephemeral spots of a painful nodular erythema, chiefly in the skin of the hands and feet." == References ==