Small Intestinal Bacterial Overgrowth (SIBO)

If you suffer from IBS you may have come across a condition called SIBO. SIBO stands for Small Intestinal Bacterial Overgrowth and occurs when elevated number of bacteria are found in the small intestine. Since the small intestine is meant to contain a low number of bacteria an elevation in these bacteria can lead to symptoms of IBS. These are symptoms such as bloating, constipation and diarrhoea.

IBS impacts 11.3% of the globe and it’s been estimated by some that between 60-80% of these cases are due to SIBO.

Other symptoms often associated with Small Intestinal Bacterial Overgrowth

• Food sensitivities, especially garlic, onions and beans / lentils.
• Damage to the gut which can impair vitamin absorption
• Microvilli damage (leaky Gut and food allergies, histamine intolerance)
• Fat malabsorption (fat soluble vitamins can’t be absorbed: A, E, D)

Other conditions often associated with Small Intestinal Bacterial Overgrowth

While there is a growing list of conditions associated with SIBO the 4 with the strongest scientific backing are:

• Fibromyalgia
• Interstitial cystitis
• Acne rosacea
• Restless leg syndrome

Clues it may be SIBO

• You feel worse with prebiotics or probiotics.
• Your symptoms appear after a case of food poisoning.
• The symptoms improved while on antibiotics for an unrelated problem.
• Fibre worsens constipation.
• Your symptoms worsen with xylitol and other sugar alcohols.
• If you’re Coeliac yet continue to have symptoms whilst on a gluten free diet.

Road to Resolution

Once we have established the likelihood of an overgrowth of bacteria in the small intestine the approach is 3 fold.

• Rebalancing the bacteria in the small intestine.
• To heal the gut.
• Identify and address the underlying cause.

Testing the small intestine

Stool testing provides information on the bacteria in the large intestine. However it is not particularly helpful when investigating the small intestine.

The bacteria in the small intestine can be assess by a breath test. The test in performed by drinking a liquid which the bacteria in the gut will ferment. The gases produced are then absorbed into circulation, transferred into the lungs and exhaled. Elevated levels of these bacteria can indicate an elevation in bacteria in the small intestine.