Tummy Troubles: 8 Signs you may have Small Intestine Bacterial Overgrowth (SIBO)

Have you ever eaten something and within a few hours your stomach is so bloated that you need to unbutton your pants? Or maybe you wake with a flat belly each day only to have it be so distended by evening that you look six months pregnant?

Even if you haven’t experienced such extreme abdominal swelling, any amount of increased bloating, gas, or abdominal pain is not normal. In fact, it may point to a condition known as Small Intestine Bacterial Overgrowth, or SIBO (pronounced “see-bow”).

What is SIBO?

SIBO is a chronic bacterial infection of the small intestine. These bacteria normally live in the gastrointestinal tract, but have abnormally overgrown in a location not meant for so many bacteria. They interfere with our normal digestion and absorption of food, damage the lining of the small intestine and feed on our food to create excess gas.

What causes the bacterial overgrowth?

Our gut relies on nerves, muscles, enzymes and neurotransmitters to properly digest food. In particular, the nerves, muscles and neurotransmitters help stimulate a sweeping action that moves the food through our digestive tract, from stomach to colon. With SIBO, this sweeping action is damaged and the bacteria get stuck in the small intestine and continue to multiply.

The most common inciting factor for this damage is your average stomach flu (gastroenteritis) or food poisoning. In an attempt to fight the offending organism, the body produces antibodies. However, these antibodies also end up attacking and damaging the cells responsible for the sweeping action.  Without an effective “broom,” the bacteria just sit like a pile of dirt that continues to grow.

The 8 signs of SIBO

While there can be other signs and symptoms associated with SIBO, the most commonly cited are:

  1. Bloating/abdominal gas
  2. Flatulence, belching
  3. Abdominal pain, discomfort or cramps
  4. Constipation, diarrhea, or a mixture of both
  5. Heartburn
  6. Nausea
  7. Malabsorption: fatty stools, anemia, low iron and/or B12 levels without other cause
  8. Systemic symptoms: headache, joint/muscle pain, fatigue

Some other diseases and conditions commonly associated with SIBO include: acne rosacea, low thyroid function (hypothyroidism), lactose intolerance, restless leg syndrome, fibromyalgia, interstitial cystitis (chronic painful bladder), celiac disease and Crohn’s disease.

Is IBS the same as SIBO?

For many people who experience the eight signs of SIBO, they will be diagnosed with Irritable Bowel Syndrome (IBS). However, it has been argued that SIBO may be the underlying cause of IBS. Research studies suggest 50-85 per cent of people diagnosed with IBS will test positive for SIBO and that treatment of diagnosed cases of SIBO may reduce IBS symptoms by up to 75 per cent.

How do you test for SIBO?

The best currently available method is hydrogen/methane breath testing. When the bacteria ferment the food we eat, they produce excess gas; most commonly hydrogen and methane. We can measure these gases via breath samples to see if they are elevated. If either of the gases, or both, are elevated beyond a certain threshold it confirms presence of SIBO and subsequent treatment can be undertaken.

If you recognize yourself in any of the eight signs of SIBO or have been diagnosed with IBS, yet still struggle with your digestive health, then it could be time to seek a qualified naturopathic doctor who can test you for SIBO and help you tame your tummy troubles.

QuinnHandHeadShotDR.QUINN HAND, ND, is a naturopathic doctor and natural health educator with clinical interest in women’s health, hormonal balance, fertility and sports medicine. qwellness.ca


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