Updated: Mar 30, 2020
Irritable bowel syndrome (IBS) is an incredibly common digestive disorder that affects up 9-23% of the population worldwide(1). It can be a frustrating condition to have because it often seems like there is no detectable cause for the abdominal pain and discomfort, constipation, diarrhoea and bloating you may experience(2).
What is known about IBS is that issues with muscle contractions (motility), dysfunction in muscle and organ signalling systems, irritation of the intestines and psychological stress can contribute to its presence(3).
The majority of IBS sufferers find that their symptoms are triggered by certain foods, which is why a low FODMAP (fermentable fibre) diet is proven to be effective in providing symptom relief. Unfortunately this diet doesn’t address the cause of your issues and only provides conditional symptom reduction(4).
Interestingly, there is another gut condition called Small Intestinal Bacterial Overgrowth (SIBO) for which it’s symptoms (which are similar to IBS) can also improve when high FODMAP foods are avoided(5).
It raises the question, could your unmanaged and unresolved IBS issues actually be caused by SIBO? Absolutely! 60-80% of all cases of IBS can be attributed to SIBO(6).
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So, what is SIBO?
SIBO is a condition characterised by abnormally high levels of bacteria in your small intestine. Its symptoms can be very similar to IBS, which is why it is often overlooked(7). SIBO symptoms are also relieved when you avoid high FODMAP foods because these foods act as food for our gut bacteria. When there is an overgrowth of bacteria in our small intestine, their natural fermentation process produces a large amount of much gas, which you may experience as bloating(5).
SIBO can occur at any age and has many risk factors, some of which are similar to IBS. These include low stomach acid, irregular bowel movements, unhealthy gut wall and changes in your gut flora(8). The use of antibiotics or the oral contraceptive pill, drinking alcohol and stress also increase your risk of SIBO(9).
What this means is that IBS could be a misdiagnosis for SIBO or you have IBS and SIBO is a contributing factor(10).
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"I'm confused. Don’t we need bacteria in our gut?"
Although our digestive system is happiest when our gut is full of bugs from a wide variety of species, our small intestine is one area that needs fewer numbers. This area is important for the digestion and absorption of food so we don’t want our bacteria competing with us for this food(11).
What does this overgrowth mean for my health?
An increased number of bacteria here causes havoc to your gut wall and can lead to: trouble with digestion; poor nutrient absorption; immune dysfunction; and reactions to ‘normal’ and ‘healthy’ foods.
Additionally, SIBO left untreated has been linked to a huge number of conditions including depression, anxiety(12), fibromyalgia (13), hypothyroidism and rosacea (14), so it’s very important to identify and address it as soon as possible.