Could it be SIBO?

Could my symptoms be caused by small intestinal bacterial overgrowth (SIBO)?

It’s normal to grow bacteria in your large intestine, in fact it’s healthy to grow bacteria in your large intestine.

But what about when that good bacteria moves along into the small intestine and starts to grow?

The results are less than optimal and often uncomfortable.

When this happens, when bacteria from the large intestine moves into and grows in the small intestine, SIBO can create the following symptoms (Madormo):

  • Bloating
  • Flatulence
  • Diarrhea
  • Constipation

Frustratingly, these same symptoms might also indicative of other bowel disorders like, Irritable Bowel Syndrome (IBS), for instance. In fact, research shows that SIBO could be an underlying cause of IBS – and often times goes undiagnosed because of the similarities. (Ghoshal).

With persistent IBS, it might be time to take a look at the root cause – SIBO should be considered.

“SIBO sufferers are usually divided into one of three different categories: diarrhoea-dominant (D), constipation-dominant (C) or alternating variations of both.” (Lindemann)

Although there are several ways to determine if SIBO is at work in your gut, breath tests are the main form of diagnosis. Kits can be ordered through our office to measure hydrogen, methane, and hydrogen-sulfide gases – the gases produced in the small intestine that cause such discomfort.

If SIBO is present, treatment options are available. A general naturopathic approach might include the following:

  1. Anti-Microbial Combinations – including some form of: “Candibactin AR” and Candibactin BR” from Metagenics; Neem; “Biocidin and FC Cidal” from Biotics Research; and “Allimax Pro” by Allimax.  (Please consult your naturopathic or medical physician before starting an anti-microbial regimen).
  2. Dietary Changes – Limiting foods that promote fermentation in the lower gut is advisable. Generally, a low FODMAP diet, monitored by a physician, is recommended.
  3. Intestinal Repair – Once symptoms improve, repairing the intestines so that motility normalizes, hopefully decreases the likelihood of recurrence in the future.  

SIBO has a 40% chance of recurrence (Grace) complicated by fungal growth. Therefore, broad spectrum anti-microbial botanicals could provide benefits antibiotics do not. For this reason it always helpful to look at your symptoms from a whole health perspective.

Worried about whether or not you will ever feel relief from your intestinal discomfort? I would be happy to help you determine what underlying factors may be contributing to your symptoms.

If you live in the Guilford/ Branford/ New Haven/ Madison/ Clinton area and would like to learn more about SIBO and whether or not it’s affecting your overall health, Dr. Fisel is here to help. Call (203) 453-0122 or CLICK HERE to schedule a consultation.

REFERENCES

Bella Lindemann. “SIBO Series Part 1: Is Sibo the Hidden Cause of Your Ibs?” Bella Lindemann, Bella Lindemann, 30 Mar. 2021, https://bellalindemann.com/blog/sibo-series-part-1-hidden-cause-ibs.

Ghoshal, Uday C et al. “Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy.” Gut and liver vol. 11,2 (2017): 196-208. doi:10.5009/gnl16126

Grace E, Shaw C, Whelan K, Andreyev H. Review article: small intestinal bacterial overgrowth – prevalence, clinical features, current and developing diagnostic tests, and treatment. Alimentary Pharmacology & Therapeutics. 2013;38(7):674-688. doi:10.1111/apt.12456.

Madormo, Carrie. “SIBO: Symptoms, Treatment, Diet, and More.” Healthline, Healthline Media, 14 Sept. 2021, https://www.healthline.com/health/sibo.

Veloso, Hazel Galon. “FODMAP Diet: What You Need to Know.” Johns Hopkins Medicine, https://www.hopkinsmedicine.org/health/wellness-and-prevention/fodmap-diet-what-you-need-to-know.

IBS? It May Be Something Else . . .

SIBOPeople often come to my office saying they’ve been diagnosed with IBS. They may complain of intestinal pain, constipation, diarrhea, or all of the above, yet all of their test results come back “normal”, so they are prescribed anti-spasmodic medications to manage their symptoms, and sent on their way. In my experience, IBS is merely a symptom of other underlying causes, rather than  a definitive diagnosis. Whether it’s food intolerances, poor eating habits, or restoring optimal production of stomach acid and digestive enzymes, naturopathic medicine has a lot to offer when it comes to identifying and treating the underlying cause of IBS. [Read more…]

Is It Really IBS?

Irritable bowel syndrome (IBS) affects one in five adult Americans, and is responsible for up to 40% of referrals to gastroenterologists. While there are legitimate criteria used to diagnose IBS (alternating constipation and diarrhea, bloating, abdominal pain), the term is generally used to label patients who don’t have Crohn’s disease, ulcerative colitis, or other underlying “organic” diseases. Once patients have been labeled with having IBS, they are often given one or more medications to treat the symptoms, usually with little to no relief.

Fortunately for IBS sufferers, a multitude of underlying factors may be the real cause of digestive symptoms, making the likelihood of recovery much more promising. One condition in particular that’s often overlooked is small intestinal bacterial overgrowth (SIBO). This is an abnormal colonization of bacteria within the small intestine by bacteria that are normally found in the colon, mouth, or pharynx. When left untreated, SIBO is not only mistaken with IBS, but has been linked to fibromyalgia and chronic fatigue syndrome as well. The cause of SIBO isn’t always clear, but patients who are at higher risk include those with chronic constipation, achlorhydria, diabetes, scleroderma, diverticulosis, and adhesions from prior surgeries.

Up to 78% of patients who are diagnosed with IBS may in fact be experiencing SIBO. Testing for this condition is performed by blowing into a tube that measures gases given off by the excessive amount of bacteria that are present in the small intestine. While these tests are typically offered by gastroenterologists, there are several commercial laboratories that offer test kits for home use, which are then mailed back to the laboratory for analysis. If diagnosed, SIBO can be treated initially with specialized antibiotics. Once the offending bacteria are successfully eradicated, measures should then be taken to improve the intestinal environment (probiotics, digestive enzymes, etc.), which should help to prevent recurrence.

A diagnosis of IBS does not mean all hope is lost. Explore the possibility of SIBO, and seek out a naturopath or other alternative practitioner who can focus on how the digestive tract functions, rather than just looking for a disease.

Small Intestinal Bowel Overgrowth and IBS

I’m posting a link here that explains in detail the symptoms of Small Intestinal Bowel Overgrowth (SIBO), and how it is often an underlying cause of IBS. In my clinic, I’ve diagnosed this several times, even after people have already consulted with their gastroenterologist, which indicates that SIBO is not “mainstream” enough for most doctors to pursue the appropriate testing. All that is required is a simple breath test-Once diagnosed, this condition is easily treatable, so talk to your doctor about performing the test if you’re experiencing recurring digestive symptoms, or have been diagnosed with IBS. 

http://www.medicinenet.com/small_intestinal_bacterial_overgrowth/article.htm