Small Intestinal Bacterial Overgrowth
If your IBS symptoms include a lot of gas production, especially if this happens soon after eating, alongside constipation or diarrhoea, then it is possible that SIBO may be playing a role.
Small Intestinal bacterial overgrowth is an increase in the number of bacteria in the small bowel. When these bacteria come into contact with fermentable carbohydrates (e.g onions, bread, apples) they produce lots of gas which may cause abdominal distension. The increase in bacteria can also negatively impact on functions of the small bowel such as digestion and absorption of nutrients which can lead to nutrient deficiencies.
There are a number of different causes of SIBO and often it happens because of poor gut motility, which means that the gut is not so efficient at sweeping the bacteria down into the large intestine. This can happen after a bout of food poisoning which becomes post infectious and damages this mechanism. Other causes include hypochloridria (low stomach acid), use of antibiotics or ant acids, abdominal surgery. There is a strong link between SIBO and other conditions such as endometriosis, fibromyalgia, hypothyroidism, Crohn’s disease.
Some studies suggest that as many as 80% of people with IBS have SIBO.
However, it is largely under-diagnosed as it is poorly understood by conventional medicine.
The most common symptoms of SIBO are:
Bloating (sometimes even just with water)
Abdominal pain / discomfort
Belching and reflux
Frequent food poisoning
At IBS holistic I use hydrogen and methane breath testing to assess for small intestinal bacterial overgrowth.