Small intestinal bacterial overgrowth (SIBO) occurs when there is an abnormal increase in the overall bacterial population in the small intestine — particularly types of bacteria not commonly found in that part of the digestive tract. This condition is sometimes called blind loop syndrome.
Bloating is a common symptom in SIBO. Apart from bloating, other common symptoms of SIBO include abdominal pain, nutrient insufficiency (e.g. B12 or iron), aching joints, excessive gas, belching, diarrhoea or constipation.
To treat SIBO, you need to get your gut bacteria back in balance. That should ease your symptoms and help your body absorb more nutrients from your food. The treatment might depend on the results of your breath test. If your sample had a lot of hydrogen in it, the main treatment is the antibiotic rifaximin (Xifaxan).
Fat: With SIBO, the bile acids responsible for the breakdown and absorption of fat are deficient. Fat malabsorption produces visible signs, including oily, smelly, and floating stools.
Symptoms of SIBO are nonspecific and include bloating, abdominal distension, abdominal pain or discomfort, diarrhea, fatigue, and weakness. The frequency and severity of symptoms likely reflect both the degree of bacterial overgrowth along with the extent of mucosal inflammation.
During a SIBO flare-up, a wide range of gut health symptoms can increase or appear. This can involve an increase in symptoms such as bloating, an increase in gas and abdominal pain. It's also common for bowel patterns to alter.
When patients suffer from excessive belching, they can belch acid from the stomach into the gullet, causing symptoms that mimic reflux-like heartburn. Flatulence/wind – again some wind is normal, after all everybody farts! Patients with SIBO are often very windy and the wind can be very smelly.
Allowed sugars: glucose, sucrose, aspartame (Nutra sweet), saccharin. AVOID: Lactose dairy, milk) fructose concentrate, lactulose, Splenda (sucralose), mannitol sorbitol (sugar free gum/mints), oligosaccharides (soy milk), corn syrup (regular sodas many others sweetened foods).
For most people, the initial way to treat bacterial overgrowth is with antibiotics. Doctors may start this treatment if your symptoms and medical history strongly suggest this is the cause, even when test results are inconclusive or without any testing at all.
Left untreated, SIBO can lead to serious complications including nutrient deficiencies, dehydration and malnutrition. The condition is treatable, but it can also recur. If you suspect you have SIBO, it's important to work with an experienced physician.
small intestinal bacterial overgrowth (SIBO) commonly results when a circumstance — such as surgery or disease — slows the passage of food and waste products in the digestive tract, creating a breeding ground for bacteria. The excess bacteria often cause diarrhea and may cause weight loss and malnutrition.
The hydrogen breath test is a fast, easy, and non-invasive method for testing for SIBO. By measuring the gases in the small intestine, a hydrogen breath test can determine if a patient is suffering from excess bacteria, and if so, to what extent. The process is so simple it can even be performed at home!
Slower transit time
Methane-producing SIBO has been shown to cause constipation and may cause a slower transit time, which means that food stays in the digestive tract longer than it should2. This slower transit time can lead to various symptoms such as nausea, abdominal pain and weight gain.
Lifestyle Changes for SIBO
Drink plenty of fresh water throughout the day to stay properly hydrated. It's also important to manage stress during healing. Yoga, barre, tai chi, regular exercise and acupuncture can help reduce stress levels and keep you motivated to stay on track with the SIBO diet.
Low FODMAP Diet (LFD): The most widely discussed option in conjunction with IBS and SIBO, this diet removes various types of sugars, including legumes, dairy, wheat, high fructose fruits and sweeteners (including honey and agave), artificial sweeteners, and many vegetables.
SIBO and Coffee Wrap Up
While some people may react adversely to coffee, that doesn't mean a bad reaction will happen to everyone. If you feel like coffee may be causing you issues, try removing it from your diet for a little while then slowly reintroduce it to see if that's really what's causing the issue.
Many with SIBO have low stomach acid. Increasing stomach acid helps normalize the pH throughout the digestive system and prevent overgrowth. Some ways to increase stomach acid include taking apple cider vinegar or digestive bitters before meals or supplementing with HCl during meals.
Hydrogen Sulfide Dominant SIBO
This type of SIBO occurs when bacteria in the small intestine consume the hydrogen gas made by other bacteria to produce hydrogen sulfide, the gas that smells like rotten eggs. Hydrogen Sulfide SIBO may correlate with diarrhea.
On account of the build-up of gas, someone with SIBO usually feels bloated, experiences excessive flatulence, burps, and has bad breath. The pressure in the stomach resulting from gas can also cause nausea, heartburn, and spastic abdominal pain primarily located near the navel and right lower abdomen.
Of all the symptoms of SIBO, fatigue is often the most debilitating and frustrating. There's plenty of anecdotal evidence to suggest that fatigue is common for SIBO patients — I observe this in the clinic all the time.
You experience bloating that worsens throughout the day and is alleviated first thing in the morning. Gas and bloating are hallmark symptoms of SIBO. This is mainly due to the fermentation of carbohydrates from the overgrown bacteria, producing large amounts of gas (typically hydrogen).
Examination of the tissue of the GI tract itself with an upper endoscopy or colonoscopy may be obtained. Some of the material from the jejunum, the middle part of the small intestine, may be obtained to analyze. The number of bacteria present in this sample can determine if there is overgrowth.
It would take six weeks of antimicrobial medicines and another six months of a restricted diet for her digestion to feel normal again, and for the bloat to finally go away. Lapine, a food and health writer and chef, chronicled her SIBO journey and shared SIBO-appropriate recipes on her blog and podcast in early 2018.