Irritable bowel syndrome and small intestinal bacterial overgrowth

So you’ve been told you have irritable bowel syndrome, or as you now know it, IBS. You’ve been experiencing gas, bloating, abdominal pain, nausea, and diarrhea or constipation all your life. Perhaps you’ve even gone as far as having a colonoscopy, endoscopy, biopsies, and testing to rule out Celiac disease, and all of these have come back “normal.” So what are you to do?

Small intestinal bacterial overgrowth (SIBO) may be the cause of your symptoms. As the name says, SIBO implies an overgrowth of bacteria in your small intestine. SIBO may exist in up to 80% of individuals with IBS.  The small intestine, large intestine and all surfaces of your body are host to millions, even trillions of microbes. However, overgrowth of certain strains of microbes can be the cause of different disease conditions. SIBO is one such condition. The overabundant bacteria in the small intestine produce gas and can cause focal contractions of the intestinal tract, leading to IBS symptoms.

Unfortunately, this condition also leads to the malabsorption of foods. So despite the good food choices you make, you won’t reap the full nutrient benefits and may experience anemia, malnourishment, fatigue and mood swings, all related to your gut symptoms!

Different forms of testing exist for the diagnosis of SIBO, but the most commonly used test is called the lactulose breath test. This test has been shown to agree well with the findings from small intestinal biopsies, and is far less invasive. Performing this test requires some dietary restrictions for 24 to 36 hours before the test, consumption of a lactulose solution (provided) the morning of the test and the collection of breath samples at regular intervals over the following three hours. The test kit is then sent off to be analyzed for the amount of hydrogen and methane — gases the problematic bacteria produce — present in the sample.

A variety of treatment options exist for SIBO, including prescription antibiotics, herbal antibiotics, dietary changes or a specific “food” solution called an elemental diet. Long-term recovery also often involves dietary changes to eliminate offending foods which cause overgrowth to happen. The dietary changes necessary for treatment and prevention of reoccurrence vary from person to person, but most often involve minimization of carbohydrates, which are commonly malabsorbed and lead to symptoms. An agent called a prokinetic, which promotes small intestine motility, may also be employed to prevent reoccurrence of the condition. Most people who experience long-term recovery have employed a variety of these solution options; however, it is best to work with a physician to determine the next best step along the way.

In closing, it is important to note that our gastrointestinal tract doesn’t operate independently of our brain and other parts of our body, such as the thyroid, circulatory system and adrenal glands. Proper management of gastrointestinal symptoms also includes assessment and regulation of these organs as well. The best cure for a symptom involves fixing the cause, which is often multi-factorial in nature.