Are you struggling with gas, belching, bloating, abdominal discomfort or irregular stools? Dealing with these symptoms on a daily basis is no way to live. It may be time to consider whether small intestinal bacterial overgrowth (SIBO) is the true culprit! Unfortunately, common SIBO symptoms often mirror those of IBS and other digestive conditions. Some studies have indicated that up to 80% of people with irritable bowel syndrome (IBS) actually have SIBO. So how do you know if your symptoms have been overlooked? Let’s dive into what causes SIBO, and strategies to properly identify and treat it.
The Good and The Bad Bacteria
The bacteria in your gut have a key role in your digestive process! Good bacteria help to break down food, reduce inflammation by creating specific products for us, and can even influence your immune system or help to regulate your mood! The small intestine is supposed to be sparsely populated with bacteria in comparison to the large intestine. SIBO, or Small Intestinal Bacterial Overgrowth, occurs when there is an increase in bacteria within the small intestine. When the small intestine isn’t properly moving food along, this can lead to bacteria buildup. Too much bacteria (especially the wrong bacteria) can overwhelm the healthy, good gut flora, and ultimately lead to problems with your digestive system.
Common SIBO symptoms include diarrhea or constipation (sometimes even alternating between the two), abdominal distention and bloating, gas and belching, abdominal pain, fatigue, indigestion, a loss of appetite, or an uncomfortable fullness after eating. When left untreated, SIBO can lead to significant health challenges including diarrhea, weight loss, weak bones, anemia, an electrolyte imbalance, vitamin and nutrient deficiency, and kidney stones.
Unfortunately, symptoms of SIBO can look like those of many other conditions. Some studies have indicated that up to 80% of people with irritable bowel syndrome (IBS) actually have SIBO. Some mild cases can even be asymptomatic, and SIBO is not often directly tested for. SIBO is not cut and dry, meaning it can be tricky to pick apart and understand because there are several types of SIBO. These types are often delineated by the symptoms you are having, or by identifying the types of gasses being produced by the bacteria or archaea present.
If you’ve been experiencing symptoms that don’t go away, it is important to see a gastroenterologist who will run the proper tests for a diagnosis. Imaging can help to identify blockages or problems in your intestines, blood tests can check for anemia or autoimmune concerns, stool tests can assess for infectious causes of GI concerns or the presence of blood.
Beyond that, visiting a doctor who specializes in holistic gut health can offer additional testing (such as stool testing) to provide a better picture of your inflammation markers and digestive power, and determine what bacteria or yeast is present. At ISAIH Natural Medicine, one of our effective strategies for identifying SIBO is utilizing a lactulose breath test to specifically determine the types of gasses being produced in the small intestine.
Your Gut Motility
There are many factors which can cause SIBO, including low stomach acid, obstructions in the gut (such as scar tissue from previous injury or surgery), or overuse of medications, but gut motility is one of the most significant underlying factors that is often overlooked! Motility refers to the movement of food throughout your GI tract. This movement starts at the mouth and works its way through the throat, esophagus, stomach, small and large intestines, and out the body.
Factors including food poisoning or gastroenteritis, irregular bowel movements, stressful events, poor thyroid function, or taking medications such as PPIs or opioids can all affect your gut motility and set us up for the potential to get SIBO. Addressing the whole picture of your health and thyroid function, as well as identifying and treating the cause of poor motility is imperative in finding long-term improvement and reducing the risk for SIBO relapse.
Your diet is part of the SIBO picture. Bacteria have certain foods they prefer over others, and when they get those foods, they produce more gasses. The top foods that SIBO bacteria love are fermented goods such as cheese, kombucha, and sauerkraut, or foods rich in sugar and fiber. If you feel worse after eating these types of foods, you may have SIBO. Modifying your diet can help to relieve SIBO symptoms, but changing your diet alone will not cure your SIBO. This is where having an expert on your team can make all the difference.
At ISAIH Natural Medicine, we help patients implement diet strategies (such as a low FODMAP diet, Specific Carbohydrate Diet, GAPS diet, or SIBO Bi-Phasic diet) to restore bacterial balance and work towards returning to a comprehensive diet that agrees with their gut. Choosing the right diet for you and employing other strategies along the way (such as antibiotics, supplements, or lifestyle modifications) can help to reduce problematic bacteria, support your gut motility, and achieve a SIBO-free life!
Get tested! The only way to truly know what’s causing your symptoms is to properly evaluate for SIBO. Many patients may begin to treat themselves or work with well-meaning practitioners to treat what they believe is SIBO – without being tested beforehand… This is something that can actually make symptoms worse. Like your symptoms, testing should not be overlooked! There are three major gasses to assess for SIBO, which can all be determined with a reliable lactulose breath test, and each type of SIBO is treated differently. Understanding what we are treating matters.
It is important to choose your health care team wisely. Choose someone who is well-versed and understands the intricacies of SIBO, and choose someone who is able to help navigate any other health concerns you may have in addition to your SIBO. Find a doctor who considers your gut motility, and will help you to navigate treatment strategies that work for your lifestyle. If you’re looking to relieve your SIBO symptoms, consider becoming a patient with us. At ISAIH Natural Medicine, we help patients get back to living a SIBO-free life!