After subtotal colectomy, 40% of patients report abdominal pain, gas and diarrhea, and poor quality of life; whose etiology is unknown. The investigators determined whether small intestinal bacterial (SIBO or fungal overgrowth SIFO) could cause these sympotoms (> 1 year).

Inclusion Criteria:

patients who were referred to a specialist motility center over 4 year period with:

• Unexplained gastrointestinal symptoms such as gas, bloating, belching, diarrhea, and abdominal discomfort
• history of colectomy
• patients with no history of colectomy
• patients included who had normal: upper endoscopy, colonoscopy, computerized abdominal tomography scan, and normal hematology, biochemical profiles, tissue transglutaminase antibody, thyroid stimulating hormone, and normal right upper quadrant ultrasound scan.
• patients with glucose breath test and/or duodenal aspirate

Exclusion Criteria:

• patients with upper gut or small bowel surgery
• Patients who were hospitalized or with serious cardiac or pulmonary or neurologic comorbidities
• Patients with intestinal strictures or known intestinal motility disorders such as scleroderma or pseudo-obstruction syndrome

All adult patients of the Digestive Health Center over a 4 year period who have been seen by the motility specialists for unexplained gastrointestinal symptoms.