SIBO is an acronym for Small Intestinal Bacterial Overgrowth, and many people with IBS, Crohn’s, and Ulcerative colitis will experience SIBO at some time during their diagnosis. In fact, a recent study found that as many as 78% of those with IBS also have SIBO. In addition, an eleven-study database showed an odds ratio of SIBO and IBD at almost 95%. As the name implies, this is a condition caused by too much of certain bacteria buildup in the small intestine. Often, the symptoms of IBS/IBD overlap with SIBO, making it hard to diagnose. SIBO can occur for many different reasons, but the root cause needs to be identified to treat and heal the intestine.
This significant overgrowth of harmful bacteria causes many symptoms including; bloating, brain fog, fatigue, diarrhea, joint pain, and mood disorders. These symptoms can overlap not only with IBS/IBD but also things like celiac disease, liver cirrhosis, pancreatitis, hypothyroidism, and use of chemotherapy/ immunotherapy medications. Other major influencing factors for SIBO can include; food intolerances, extreme stress, toxins, poor diet, genetics, the immune system’s health, brain-gut connection, and the health of your gut’s nervous system. With all these things in play, you can see why many people get misdiagnosed or not diagnosed at all.
Now that we have a basic understanding of what SIBO is, you may be wondering how it’s diagnosed. While there are a few ways SIBO can be diagnosed the most popular is with a breath test. Your doctor can choose to do either a lactose or hydrogen breath test. These tests consist of drinking a special sugary drink and then measuring the output of gases through the exhale of the breath. These tests however, do not have the best reliability, so many physicians will treat based on symptoms alone. A direct sample can be taken from the small intestinal fluid, but this is usually reserved for special cases. While the testing is not the most accurate, it’s important to educate yourself on possible complications with IBD so you can bring any concerns or symptoms up to your specialist to discuss further.
SIBO can be treated a few different ways depending on your healthcare provider. Traditional SIBO treatment includes antibiotics as well as similar mobility agent medications. Some doctors may prescribe a low sugar diet as well, and in severe cases a liquid diet is recommended to ‘starve’ the bad bacteria. If you see an integrative doctor, you have many more treatment options and some may even be used in conjunction together. Some of these treatment options include; probiotics, vitamins, elimination diets, digestive enzymes, and herbal antibiotics. There are also several diets approved for SIBO and all of them aim to reduce harmful sugars the bad bacteria are thriving on. Some of these diets include SCD, Paleo, Low FOODMAP, GAPS, and Candida. Incorporating one of these diets long term often helps symptoms of IBS/IBD and helps prevent SIBO from recurring.
While those of us with IBS/IBD are at much higher risk of SIBO, there are things we can do to combat buildup of bad bacteria in our intestines. Taking a good probiotic, limiting or eliminating the consumption of alcohol and refined sugars, adopting one of the diets listed above, and managing our stress through exercise and meditation are all excellent ways to keep your gut bacteria in check. If you’re still experiencing symptoms of your IBS/IBD and having a hard time keeping them at bay, SIBO could be contributing. If you suspect you have SIBO be sure to make an appointment with your gastroenterologist to discuss testing and a treatment plan that is best for you. Together we can take control of our small intestinal gut bacteria!
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