If you’ve been diagnosed with irritable bowel syndrome (IBS), you may want to consider a little known condition called Small Intestinal Bacterial Overgrowth as a possible cause for your symptoms. Small Intestinal Bacterial Overgrowth otherwise known as SIBO is now understood to be the leading cause of IBS and unfortunately is commonly undiagnosed. Read on to find out more about SIBO symptoms and treatment options.
What is SIBO?
As the name suggests, SIBO is a bacterial overgrowth in the 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 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
Long term effects
If left undiagnosed, the gases produced in the small intestine can cause damage to the gut wall. SIBO can also lead to leaky gut whereby the damaged junctions in the gut wall allow larger partials to pass into the bloodstream, causing an immune response.
Nutrient deficiencies are also common, in particular B12 and folic acid, iron, magnesium, calcium and fat soluble vitamins A, E and D.
How do I know if I have SIBO?
Fortunately testing is easy to access. In Australia, patients can access testing via sibotest.com
If you already have a practitioner they can also refer you for a test.
What causes SIBO?
- One of the most common causes is 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
- Tissue scarring and adhesions as a result of surgical interventions or conditions such endometriosis.
Conventional treatment options
A doctor may prescribe antibiotics to treat the bacterial overgrowth. Unfortunately this wont repair the damage that has occurred to the mucosal lining of the small intestine. Research has also suggested that the recurrence rate with antibiotic treatment is higher.
Naturopathic treatment on the other hand aims to not only reduce bacterial numbers but also repair damage to the intestinal mucosa and treat the underly root cause of SIBO.
Naturopathic treatment is individualised
The exact naturopathic treatment will depend on a variety of factors such as:
- The underlying cause of SIBO, such as history of food poisoning or inadequate levels of stomach acid
- Symptoms – not all cases experience the same symptoms. Symptomatic treatment is tailored to the individual to provide relief while work is done on reducing bacterial load
- Which gas is most dominant– while there are some similarities, treatment will differ depending on whether you test higher for hydrogen or methane.
SIBO diet
I use the SIBO Bi-Phasic diet developed by SIBO Doctor to treat patients. It is similar to the low FODMAP diet, however it also removes that can cause fermentation that are still included on the low FODMAP diet.
It is important to note that SIBO or Low FODMAP diets shouldn’t be used as a long term solution. Because they eliminate important food groups, if used long term they can negatively impact the microbiome. The aim is to use the diet as a relatively short term treatment and the re-introduce food once the patient is ready.
What next?
If you would like help managing irritable bowel syndrome or suspect you have SIBO, why not get in touch to see if I can help.
