Is SIBO causing your IBS symptoms?
SIBO is a topic dear to my heart as I experienced debilitating SIBO symptoms for almost 15 years. It wasn’t until I was studying for my Natural Medicine Degree that I learnt about SIBO, and it suddenly dawned on me that it could be the cause of my ongoing IBS (irritable bowel syndrome) symptoms. I then made it my mission to research SIBO extensively and undergo treatment which was the best thing that I ever did to turn around my health. I wish I had known about it sooner!
SIBO is a buzz word in the medicine world recently, but it’s been extensively researched and known about since the early 2000’s. It’s short for Small Intestinal Bacterial Overgrowth and is caused by an overgrowth of bacteria in the small intestine due to a breakdown of the migrating motor complex (MMC). The MMC is known as the gastrointestinal tract’s “housekeeper” and is responsible for pushing potentially harmful pathogens, food and matter through your stomach and small intestine to keep you regular and to prevent gut infections.
When the MMC isn’t working properly, bad bacteria and pathogens can colonise the small intestine, where they feed on carbohydrates creating hydrogen or methane gas causing flatulence, bloating, constipation or diarrhea. The hydrogen and methane gases irritate and stimulate the muscle cells of the intestinal walls causing faster or slower gut motility causing diarrhea or constipation.
‘Research shows that SIBO is the cause of approximately 80% of IBS cases.’
80% of IBS cases is a lot! So, what are the symptoms of SIBO, and do you recognise any of these?
SIBO symptoms
Excessive bloating within 5-60 minutes after eating
Chronic diarrhea or constipation, or alternating diarrhea and constipation
Flatulence, burping, or reflux after eating
Rotten egg smelling gas (common with SIBO hydrogen-sulphide)
Abdominal cramps and pain
Or secondary symptoms such as
Food sensitivities
Acne
Skin rashes
Weight gain
Iron or B12 deficiency
Asthma
Hayfever or sinus problems
Irritability or low mood
Joint pain
Headaches & migraines
Restless legs at night
Difficulty falling and staying asleep
Feeling worse when eating high fibre foods or taking Metamucil
p.s. this can be a big clue!
Types of SIBO
SIBO-D (diarrhea)
SIBO-D causes chronic diarrhea and is the most common form of SIBO. It is also the simplest to treat. It is caused by hydrogen gas producing bacteria that have colonised the small intestine in high numbers. The hydrogen producing bacteria feed on carbohydrates in the small intestine, and in the process produce hydrogen gas causing bloating, flatulence and faster gut motility causing diarrhea.
SIBO-C/IMO (constipation)
SIBO-C causes chronic constipation and has recently been renamed IMO (Intestinal Methanogen Overgrowth). Methanogens are a type of microscopic organism called archaea which aren’t technically a type of bacteria and has therefore been renamed IMO as a more suitable medical name. IMO is caused by methane gas producing archaea that have colonised the small intestine in large quantities. The archaea feed off hydrogen gas produced by hydrogen producing bacteria during the fermentation of carbohydrates in the small intestine. Methane gas is then produced as a by-product causing the intestinal muscles to contract less causing slower gut motility and constipation. In turn constipation allows more methanogens to grow, making IMO and constipation worse.
IMO is more difficult to treat than SIBO-D as archaea are more resistant to antibiotics or herbal antimicrobials and have the ability to survive for a while without their food source hydrogen gas. However, having experienced SIBO-C myself, I can personally vouch that treatment can be successful with persistence and determination, and careful professional guidance.
SIBO - Hydrogen Sulphide (rotten egg smelling gas)
SIBO hydrogen sulphide is less common but very distinctive with its ‘rotten egg’ smelling gas. This is caused by sulphate-reducing bacteria in the small intestine, which produce smelly hydrogen-sulphide gas and diarrhea. Sulphate-reducing bacteria compete with methanogens to feed off hydrogen gas and may therefore keep each other in check. Therefore, killing off one type of bacteria can sometimes cause the other type to proliferate, causing the need to treat this as well.
SIBO Testing
If you suspect that you or a family member may have SIBO then there is a simple SIBO breath test that you can do at home. The breath test is then sent to the lab for analysis. The SIBO test is designed to measure the levels of hydrogen or methane gases to indicate if you have SIBO. It is important to test for SIBO as it is a very complex, and targeted treatment that requires professional and careful guidance. Please contact me if you would like to find out more or to book a test.