Is your IBS really Small Intestinal Bacterial Overgrowth (SIBO)?

A recent study (Pimentel et al, 2000) showed that 78% of the patient cohort were found to have SIBO when breath tested. This strongly suggests that for many people their IBS is being caused by SIBO either wholly or in part. It therefore is very sensible to get tested for SIBO if you have been diagnosed with IBS via your GP and if the remedial treatments provided have not achieved relief for you.

SIBO is a name given to describe a condition where the bacteria in your upper gut (or small intestine) overgrows. This is an issue as the small intestine is not designed to handle such a high volume of bacteria in the way that the large intestine (or colon) is. As a result the bacteria interfere with normal digestion and nutrient absorption and can damage the intestinal lining to cause “Leaky Gut Syndrome”. Additionally the bacteria compete with us for our food leading to deficiencies (iron and B12 are typical). Huge volumes of gases are produced and these affect the motility of the gut and sufferers can experience either diarrhea or constipation or both. 

Symptoms associated with IBS include: bloating, constipation, diarrhea, burping, or flatulence. You may also find that symptoms are worse after eating certain foods like onions & garlic, broccoli, soft fruits, ice-cream or milk. This is because these foods contain highly fermentable carbohydrates which can feed SIBO growth giving rise to symptoms.

It is possible to test for SIBO using a hydrogen breath test. This test involves ingestion of a Lactulose (or sometimes glucose) solution following a special diet the day before and fasting overnight. Breath samples are taken at the beginning of the test then every 20 minutes thereafter following consumption of the Lactulose. Diagnosis of SIBO is dependant on a rise in hydrogen and/or methane levels (20ppm over baseline) within the first 2 hours of the test.

SIBO is addressed by using reduced carbohydrate diets and the taking of conventional or herbal antibiotics. Nutritionists generally work with herbal antibiotics which are extremely effective. 

Dietary changes need to be maintained for several months or even a year after successful clearance of SIBO to prevent re-occurrence. 

SIBO is a challenging and perplexing condition to resolve and needs patience and diligence on behalf of both the patient and practitioner however it is possible to permanently resolve it.