Could it be SIBO?

Understanding Small Intestinal Bacterial Overgrowth (SIBO)

Small Intestinal Bacterial Overgrowth (SIBO) is a gastrointestinal disorder characterised by an excessive accumulation of bacteria in the small intestine. While the small intestine typically contains a relatively low level of bacteria compared to the colon, in SIBO, this balance is disrupted, leading to various unpleasant symptoms and potential complications. We have many patients asking us: Could it be SIBO?

Symptoms of SIBO:

  • Bloating: Patients often experience significant abdominal bloating, which may worsen after eating.
  • Gas: Excessive gas production is a common complaint, contributing to discomfort and sometimes embarrassment.
  • Diarrhoea or Constipation: SIBO can disrupt normal bowel movements, leading to either diarrhoea or constipation or alternating between the two.
  • Abdominal Pain: Many individuals with SIBO report abdominal pain or discomfort, which can range from mild to severe.
  • Malabsorption: Due to bacterial interference in the small intestine, nutrient absorption may be compromised, leading to malnutrition in severe cases.

Causes of SIBO:

  • Impaired Motility: Conditions that slow down the movement of food through the digestive tract, such as intestinal dysmotility or structural abnormalities, can predispose individuals to SIBO.
  • Anatomical Abnormalities: Certain anatomical factors, such as intestinal strictures or surgical alterations, can contribute to the development of SIBO.
  • Medications: Some medications, particularly those that affect gut motility or stomach acid production, may increase the risk of SIBO.
  • Underlying Conditions: Conditions such as Irritable Bowel Syndrome (IBS), coeliac disease, or diabetes can be associated with SIBO.

Diagnosis and Treatment:

  • Breath Testing: Hydrogen and methane breath tests are commonly used to diagnose SIBO by detecting gases produced by bacteria in the small intestine. We recommend doing a test checking against all three possible sugars, which is a frustrating test to do, but it really removed false negatives AND false positives which narrows our treatment options and helps you recover quicker.
  • Antibiotics: Treatment can involve a course of antibiotics to reduce bacterial overgrowth, with rifaximin being a commonly prescribed option. However, research shows that the impact of this treatment is often short-lived and more additional support is needed.
  • Dietary Changes: Following FODMAP diets is really popular for SIBO, however, we find that there is less need for dietary changes and restrictions in managing SIBO - as new research shows that dietary changes alone do not remove the sibo.
  • Prokinetics: Medications that improve gastrointestinal motility may be prescribed to prevent bacterial regrowth.
  • Probiotics: Certain probiotic strains may help restore a healthy balance of gut bacteria, although their efficacy in SIBO treatment is still being studied.
  • Targeted Herbal Antimicrobials: We are cautious about the herbal medicines we prescribe to treat SIBO - they need to be specific and selective to reduce compromising digestive microbiota even more.

In conclusion, SIBO is a complex gastrointestinal disorder that can significantly impact a person's quality of life. Prompt diagnosis and appropriate management, including antibiotics, dietary adjustments, and other interventions, are essential in effectively managing this condition and alleviating its symptoms. If you suspect you may have SIBO, consult with a healthcare professional for proper evaluation and treatment.

Supporting gut health is the starting point for managing so many conditions, so it’s a special area of interest for us. That’s why our practitioners have gained our certification as Microbiome Analysts and Healthy Gut Practitioners.

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