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Wilmslow, Cheshire & Central Manchester


Small Intestinal Bacterial Overgrowth (SIBO)

If you suffer from IBS you may have come across a condition called SIBO.  SIBO stands for Small Intestinal Bacteria Overgrowth and occurs when elevated number of bacteria are found in the small intestine.  The small intestine is meant to contain a low number of bacteria so it is when this elevated number of bacteria ferment starches and fibre that gas is produced which can then damage the small intestine and lead to symptoms.

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 associated with SIBO

  • Damage to the gut which can impaired vitamin absorption
  • Microvilli damage (leaky Gut and food allergies, histamine intolerance)
  • Fat malabsorption (fat soluble vitamins can’t be absorbed: A, E, D, K)
  • Impaired migrating motor complex (reduced movement through the small intestine causing bacteria to stay in the small intestine)

Other condition associated with SIBO

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 gastroenteritis
  • The symptoms transiently 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.

  • To re-balance the gut
  • To heal the gut
  • To identify and address the underlying cause.

Underlying causes fall into 4 categories.

  • Slow gut movement
  • Impaired digestion
  • Impaired flow through the intestines
  • Medications


As stool testing is not helpful to assess to the presence of bacteria in the small intestine breath testing is used.  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.

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