Gastrointestinal dysfunction, including SIBO and irritable bowel syndrome (IBS), is very common in women and people with endometriosis.
Many of the symptoms of endometriosis present as irritable bowel syndrome and SIBO, namely distension, abdominal pain, painful bowel movements, bloating, constipation and diarrhea. In fact many women with endometriosis are initially misdiagnosed with irritable bowel syndrome (IBS).
In some cases endometriosis can infiltrate the bowel altering the anatomical position of the intestines and digestive organs, which can contribute to pain and symptoms of IBS. However it is important to note that digestive symptoms can occur regardless of where the endometrial lesions are located. So, lesions do not need to necessarily be on or near the bowel to cause digestive dysfunction.
What is SIBO?
SIBO stands for Small Intestine Bacterial Overgrowth and as the name suggests, it is a bacterial overgrowth in the small intestine. Most bacteria in the gastrointestinal tract is found in the large intestine. So, SIBO occurs when too much of this bacteria relocates and then proliferates in small intestine.
The bacteria produce gases hydrogen and methane and cause IBS symptoms. Additionally, these gases cause damage to the intestinal wall and if left untreated may lead to multiple nutrient deficiencies.
What are the symptoms?
SIBO is often misdiagnosed as IBS as they have a similar symptom presentation.
Symptoms include:
- Diarrhoea
- Constipation
- Alternating constipation and diarrhoea
- Abdominal cramping
- Bloating and/or wind
- Burping and Acid Reflux/GORD
- Food sensitivities
- Joint pain
- Skin rashes
- Respiratory symptoms such as asthma
What causes SIBO?
SIBO occurs when there is damage to the migrating motor complex. Factors that can contribute to it’s development include:
- Tissue scarring and adhesions as a result of surgical interventions
- A case of gastroenteritis which can cause nerve damage and slow down clearance of the small intestine
- Medications such as those used to treat GORD and reflux, also opioid pain medications
- Diets high in simple carbohydrates
- Stress leading to hypochloridria (low stomach acid) or changes in the motility of the small intestines
Why the link between endometriosis and SIBO?
After surgery or trauma, scar tissue can form very easily inside the abdominal cavity. Abdominal adhesions are bands of scar-like tissue that form between two or more organs or between organs and the abdominal wall.
Endometriosis is a condition that also causes adhesions. Further, surgery that remove endometrial lesions can also cause scar tissue to form. These adhesions can act like a ‘kink in a garden hose’ so to speak, interfering with the migrating motor complex and stopping bacteria from being cleared from the small intestine. Over time this can contribute to the development of SIBO.
Want to learn more about SIBO?
What next?
If you have endometriosis and would like help managing irritable bowel symptoms or suspect you have SIBO, why not get in touch to see if I can help.
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