Is it IBS, or SIBO?

IBS is on the rise, and more than 5 million Canadians have a diagnosis of IBS. Symptoms often include:

Gas, bloating, cramps, abdominal pain related to bowel movements
Irregular bowel patterns
Diarrhea or constipation or alternating between both
Mucus present around or within the stools
Heartburn, nausea

Most patients are advised to manage their symptoms with a combination of diet and lifestyle changes. These often include elimination diets (such as the FODMAP diet), stress management and occasionally medication. But, new research suggests that many people diagnosed with IBS may actually have a condition called Small Intestinal Bacterial Overgrowth (SIBO).

What is SIBO?

SIBO is an infection of the small intestine with bacteria that normally only live in the lower digestive tract. This is problematic as these bacteria can interfere with normal digestion and absorption. The bacteria ferment the food we eat which produces gas in our upper intestine. The gas then causes bloating, abdominal pain, belching, flatulence, constipation, diarrhea or both (the symptoms of IBS). Deficiencies of B12 and iron are common in people with SIBO. In fact, I've seen many chronic cases of iron deficiency anemia resolve once the SIBO has been treated.

What Causes SIBO and How is it Diagnosed?

There are a number of things that can contribute to SIBO including acid-suppressing drugs, antibiotics, and gastrointestinal infections. Essentially, SIBO can occur anytime normal digestion is impaired, allowing the bacteria to overpopulated. SIBO can be diagnosed by culturing secretions from the small intestine (not easy to do!) or by breath testing. Breath tests can determine the presence hydrogen and methane producing bacteria, confirming a diagnosis of SIBO.

SIBO Treatment

Treatment depends on the type of gas present (hydrogen or methane) but typically involves the use of antimicrobials (herbal or pharmaceutical) to reduce the bacterial population. Diet changes may also be recommended during the treatment period, which can last up to 12 weeks. Interested in learning more about SIBO and IBS?

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