Small intestinal bacterial overgrowth (SIBO) is a serious condition affecting the small intestine. It occurs when bacteria that normally grow in other parts of the gut start growing in the small intestine where they don’t belong. What this migration of bacteria occurs, you can experience abdominal pain that may be severe and diarrhea. Commonly, it can also lead to malnutrition as the bacteria start to use up the body’s nutrients. Many patients frequently check their gut health to ensure they have the right balance of good and bad bacteria.

What symptoms would I have with SIBO?

SIBO symptoms mainly affect the gut. As a result, you may feel symptoms related to the gastrointestinal tract. These symptoms may include but are not limited to: 

  • pain in the stomach, especially after eating
  • bloating
  • cramps
  • diarrhea
  • constipation
  • indigestion
  • regular feeling of fullness
  • gas
  • You may also experience weight loss.

Causes of SIBO

SIBO is not yet well understood. In reality, SIBO can affect anyone patient, of any age, with any medical history.  It can occur when:

  • your small bowel has anatomic abnormalities
  • the pH changes in your small bowel
  • your immune system isn't working properly
  • the muscular activity of the small intestine malfunctions, which means that food and bacteria aren’t removed from the organ

SIBO is associated with various conditions, such as:

  • Gastroenteritis, or a stomach bug
  • Celiac Disease
  • Crohn’s Disease
  • hypochlorhydria, or low stomach acid levels
  • Gastroparesis
  • Nerve damage
  • Liver disease
  • portal hypertension
  • Certain gastric bypass procedures
  • Surgeries that cause strictures or adhesions
  • Connective tissue disorders
  • Autoimmune disorders

How Is SIBO Diagnosed?

Since SIBO often mimics other conditions that affect gut health, it may not be the first condition your doctor thinks to test for. However, SIBO can really impact your quality of life and cause a whole host of symptoms.

Testing for SIBO

There are two main ways to diagnose SIBO: a breath test and a bacterial culture. A breath test is the simplest, least invasive, and most commonly used test for SIBO. There are multiple types of breath tests used, but the two most common are the glucose hydrogen and the lactulose test. These tests measure the gases produced by bacteria in the intestines from your breath.

If you are going to take a breath test for SIBO here is what to expect. You will be asked to fast overnight and avoid eating unfermented carbohydrates such as whole grain bread or pasta. Smokers are advised not to smoke for a couple of hours before the test. During the test day, you will first drink infused with either glucose  or lactulose. With DiagnoseAtHome, you complete a home collection. Our doctors can then determine whether you have SIBO by measuring the level of hydrogen gas produced in the breath samples, which is produced by bacteria.

The lactulose breath test is more often found to be positive in individuals with GI symptoms than the glucose breath test.

Both tests may miss SIBO if a species that does not metabolize carbohydrates to hydrogen gas (as most bacteria do) is responsible. You may be mistakenly diagnosed with SIBO if you have hydrogen-producing bacteria present in the mouth.

How Is SIBO Treated?

The first-line approach by most traditional doctors for SIBO is antibiotics. This can augment the microbiota in your gut by killing the bacteria that are overgrowing.  Augmentin and Xifaxan are two of the most commonly prescribed antibiotics, usually for a course of one to two weeks. However, some people will experience a relapse of symptoms after the course of antibiotics is finished, and have to repeat the treatment. Hence, antibiotics may not be the best solution for SIBO.

Antibiotics have side effects that range from mild to severe. Yeast infections are a common side effect of taking antibiotics; since antibiotics indiscriminately kill bacteria and other microbes, they tend to kill off the good bacteria that keep Candida yeast in check under normal conditions. On a bigger scale, the regular use of antibiotics by people — as well as in food animals — is resulting in many antibiotic-resistant strains of bacteria, which is a major health concern worldwide.There are natural approaches to SIBO and other gastrointestinal issues that can work together with traditional medicine or independently to try to optimize health.

Probiotics for SIBO

A supplement containing both probiotics and prebiotics are beneficial for SIBO because they support gut health, keep harmful organisms in check, and soothe irritation and redness. Consuming probiotic-rich foods or probiotic supplements can also help restore gut health. Probiotics can relieve abdominal discomfort and are an effective approach for SIBO. 

All in all do I have to worry?

In general SIBO is not life threatening but can result in serious gastrointestinal symptoms that can result in a reduction in your quality of life, time of work, more stress/anxiety and other related medical symptoms. Getting tested can be the first step to getting to the bottom of your gastrointestinal symptoms. Being able to do this discreetly from home can save you time, money and embarrassment. Test yourself quietly and privately from the comfort of your own home with the DiagnoseAtHome SIBO test. Your healthcare team is standing by.