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Acarbose Even though acarbose has been shown to produce changes in the composition of the microbiota, dysbiosis and intestinal bacterial overgrowth are not the pathophysiologic mechanisms involved in the bloating and diarrhea associated with the administration of the drug.6,7,6064 The acarbose-associated alteration of the microbiota is an increase in the density of the genus Lactobacillus and the genus Bifidobacterium, a composition of the microbiota that is protective for gastrointestinal symptomatology.64,65 Despite the protective modification in the microbiota, acarbose is associated with gastrointestinal adverse effects by producing poor disaccharide, oligosaccharide, and polysaccharide absorption

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