Updated: Mar 30
Bloating, digestive discomfort and abdominal pain are some of the biggest complaints I hear from my patients. Most are feeling deflated, hopeless and have accepted a life of food anxiety and wearing clothes to hide their '6 month pregnant' bloat.
The most frustrating thing is that despite their obvious symptoms all investigations to this point have come back 'normal', and have been left with the label of Irritable Bowel Syndrome.
This is until I mention a game changing condition called Small Intestinal Bacterial Overgrowth (SIBO). Like the name suggests, SIBO is a bacterial overgrowth in your small intestine. Your small intestine is a major area for nutrient absorption, so it is part of the digestive system that doesn't like having lots of bugs (1).
What does this overgrowth mean?
Bacteria have many roles in our health and are vital for keeping us alive and healthy. One thing that they can produce is gas, as a by product of fermenting the food we eat (looking at you garlic, legumes and apples) (3).
In SIBO we can measure methane and hydrogen, two gases these bugs can produce, through a breath test. By capturing these gases we can establish the presence and overgrowth of these bugs. If methane is detected, this suggests a bug called Methanobrevibacter smithii is present (4, 5) and when hydrogen is seen, hydrogen producing species present (6).
It is these gases that are being produced too much and in the wrong place that can cause your bloating, burping, farting, distention and a change in bowel movement. It's important to understand that these bacteria are naturally occurring and generally aren't an issue. It's just for those with SIBO, they have migrated up to your small intestine are are really enjoying their new home (6).
The farty-party in your small intestine may also provide the perfect place for fungus and yeast to overpopulate as well, so in addition to SIBO we also may be looking at Small Intestinal Fungal Overgrowth (SIFO) (7). Interestingly SIFO will not be seen on a breath test, so a trained practitioner in SIBO/SIFO is vital in understanding your gut.
Why you get SIBO/SIFO?
It's a complex condition with several risk factors that need to be identified for each person. Some of these include medications like proton pump inhibitors (7) and antibiotics, surgeries, various health conditions such a diabetes, chronic alcoholics and old age (8).
Two of the biggest protective mechanisms you have against SIBO is healthy strong stomach acid and a thorough cleaning motion in your intestines. Other defence mechanisms to prevent SIBO include intact valves (to keep things moving in the right direction), healthy secretions from your liver and gallbladder, and a functioning immune system within your gut (6). It can be assumed if that if you have SIBO that may need to be addressed too.
How to treat SIBO?
It's a complex condition and when addressed can dramatically change your health. Whilst finding the right health professional trained in SIBO/SIFO you need to help you address this issue, here are my top three tips to get you started.