Bloating, cramping, gas, diarrhoea. Sounds like classic IBS. 

…or could it be something more?

Nearly one in three people put up with the symptoms of Irritable Bowel Syndrome (IBS) every day. IBS is one of the most common digestive disorders in the world and accounts for nearly half of all visits to gastroenterologists. 

But recent research suggests that what many people think of as “just IBS” may, in fact, be SIBO: small intestine bacterial overgrowth. Recent research has shown that SIBO is much more common than previously thought. 

Here’s why identifying SIBO can make all the difference to your recovery. 

SIBO vs IBS: What’s the difference?

First things first: Irritable bowel syndrome isn’t actually a condition in itself. It’s an umbrella term for a range of gastrointestinal symptoms, such as: 

  • Abdominal pain, cramps, and spasms
  • Bowel motility issues (diarrhoea, constipation, or both)
  • Bloating, gas
  • General digestive discomfort

While symptoms may be a result of many different factors, it’s now known that the main cause is often SIBO. Studies suggest that up to 78% of patients with IBS have SIBO

What is SIBO?

Small intestinal bacterial overgrowth is exactly as it sounds: an excess of bacteria in your small intestine. 

Now, your whole gastrointestinal tract is home to varying amounts of bacteria, but your small bowel is meant to contain much less: only around 10,000 bacteria per millilitre of fluid. Your large bowel, on the other hand, contains at least 1,000,000,000 bacteria per millilitre of fluid. Patients with SIBO are shown to have an increase in bacteria equal to or greater than 100,000 per mL of fluid. These bacteria are also often the types that would normally be in the colon.

The symptoms of SIBO are generally the same as IBS, which is partly why it is so often missed. Other symptoms can include bloating and abdominal distension after eating, food intolerances and sensitivities, nutrient deficiencies (usually vitamin B12 and iron), weight loss, fatigue, brain fog, and even fibromyalgia.

Why is SIBO a problem?

Small intestinal bacterial overgrowth can damage the cells lining your small bowel. Over time, this damage can lead to increased intestinal permeability (known as Leaky Gut Syndrome) which then allows large protein molecules to pass through the gut lining into your bloodstream. This is a major causative factor in immune reactions linked to food allergies or sensitivities, autoimmune diseases, and chronic inflammation. It also impairs your body’s ability to digest food and absorb nutrients.

Identifying and treating SIBO should be a priority. If untreated, it can lead to chronic malabsorption, diarrhoea, unintentional weight loss, nutritional deficiencies, and osteoporosis. 

How is SIBO treated?

Unfortunately, most doctors usually still prescribe antibiotics to treat SIBO – even though there’s plenty of evidence to show that antibiotics kill off both healthy AND unhealthy bacteria. This can severely hinder your body’s ability to recover. In fact, recurrence rates of SIBO are around 43.7% in the nine months after antibiotics!

The key in treating SIBO is to address the cause of the excess bacteria in your small intestines, not just the symptoms you are experiencing. Treatment involves a comprehensive consultation in which I examine every aspect of your health history, diet, and lifestyle.

There can be many reasons your intestinal bacteria have grown out of control. Certain foods, medications, alcohol intake, environmental influences, lifestyle factors (stress, lack of exercise) can all contribute to poor gut microbiome. Everyone is different, and it’s only through identifying the unique factors that have caused your SIBO that we can begin to make healthy changes. 

What is the SIBO diet?

Dietary protocols for treating SIBO generally involve avoiding foods that ‘feed’ the bacterial overgrowth in your small intestine. Instead, the aim is to eat foods that are easier for your body to digest and absorb. 

Depending on your needs, your SIBO treatment plan may include the Low-FODMAP diet, the Specific Carbohydrate diet (SCD), the Gut and Psychology Syndrome (GAPS) diet, and Low Starch diet. 

What about SIBO probiotics?

Given that SIBO antibiotics have been shown to do more harm than good, treatment for SIBO is now more focused on restoring the microbial balance of the small intestine. Recent studies have shown that certain strains of probiotics can help to do this. 

Of course, not just any old probiotic off the shelf will do! I use only practitioner-grade probiotic brands that contain the strains most effective in treating gut dysbiosis. 

Where necessary, my treatment protocol may also include a specific SIBO herbal treatment to help eliminate pathogenic bacteria and yeast overgrowth in the gut. 

How to test for SIBO

Diagnosis is best done with a SIBO breath test, which I organise through my clinic. This simple breath sample determines the presence of methanogenic or hydrogenic bacteria, which then allows me to design your personalised treatment plan. If you think SIBO may be the cause of your IBS or other digestive issues, don’t put up with it! Contact me here