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The Mysteries and Underdiagnosis of SIBO

SIBO is a notoriously underdiagnosed condition, despite research suggesting it may be a chief cause of irritable bowel syndrome (IBS). Approximately 11% of people worldwide suffer from IBS, a “wastebasket diagnosis” many patients with an array of digestive issues are given when doctors can’t pinpoint a more precise cause. Their symptoms can be managed through diet and a handful of supplements and medications, but for a long time, a cure was considered to be out of the question. “People were relegated to ‘learn to live with it.’ When SIBO came along, it really offered some cures and solutions,” says Dr. Nirala Jacobi

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Featured

 Natural SIBO Treatment Protocols...

SIBO (Small Intestinal Bacterial Overgrowth) is infamously difficult to kill and even more difficult to keep that way. This is because attacking a small intestinal bacterial overgrowth with anything less than a really comprehensive natural treatment protocol, that is more than just diet or antibiotics, is essential for long-term healing. Natural SIBO treatment protocols that rely on single herbal products just don’t seem to cut it.

 SIBO SERIES PART 1: Is SIBO The Hidden Cause of Your IBS?

This post is personal. As a SIBO sufferer I am pretty passionate about getting the word out about this under-diagnosed IBS condition. It wrecked my life for 2 years, so I’m dedicating a three-part series to it, to give you the most up-to-date science and everything you need to know about what it is, and how to get started with testing and treatment so it doesn’t wreck yours.

 SIBO SERIES PART 2: The Science (and Art) of SIBO Testing

We know that SIBO is hugely underdiagnosed and potentially responsible for up to 85% of IBS cases (1); people who are told that there is nothing identifiably wrong with them. But how can this be? Why is SIBO so commonly missed or overlooked? A big part of the problem has to do with SIBO testing; who to test, when to test, how to test and most importantly how to interpret the SIBO breath test results. This is an area of SIBO research that has changed quite a bit in the last few years and one that many practitioners haven’t kept pace with. For a lot of IBS sufferers, a proper diagnosis is so critical, both psychologically and for informing effective treatment to overcome the horrible symptoms that negatively impact on your overall health… something that can only be achieved with the right testing.

 Small Intestinal Bacterial Overgrowth (SIBO)

The consensus at this conference was to undergo a lactulose breath test to evaluate for SIBO. The test should measure BOTH hydrogen and methane gas. Some GI doctors are not fully on board with this the breath test for diagnosing SIBO as it is not a validated test… but for now…it is the least invasive and most likely test to be used in clinical practice.

Articles of Interest

Rethinking SIBO in the microbiome era

Small intestinal bacterial overgrowth is thought of as very rare, but in an era of booming microbiome research, gastroenterologists and other physicians are starting to become more aware of SIBO in the general population and provide effective treatment.

Aetiology, diagnosis and management of small intestinal bacterial overgrowth

Small intestinal bacterial overgrowth can arise as a consequence of disorders in small intestinal motility, gastric acid and pancreaticobiliary secretion, local immunity and alterations in the anatomy of the gastrointestinal tract.

Do I Have Small Intestinal Bacterial Overgrowth (SIBO)?

Over the past few years, the number of people being diagnosed with SIBO seems to be on the rise. This may be due to our modern lifestyle, or it could be that more people are learning about the condition and asking their doctors to test them for it. Despite this, I still find that many people suffer with SIBO without knowing they have it, and many doctors fail to diagnose it.

Rifaximin for small intestinal bacterial overgrowth in patients without irritable bowel syndrome

Rifaximin is a minimally absorbed antibiotic with high luminal activity, used to treat various gastrointestinal diseases. Although rifaximin has been proposed as first line treatment for small intestinal bacterial overgrowth (SIBO), few data are available regarding its efficacy in non-IBS subjects.

SIBO: What the Science Says

An integrative approach to SIBO treatment should involve identifying any underlying causes, treating the bacterial overgrowth, correcting nutrient deficiencies, and preventing recurrence.

Small Intestinal Bacterial Overgrowth

Small intestinal bacterial overgrowth (SIBO), defined as excessive bacteria in the small intestine, remains a poorly understood disease. Initially thought to occur in only a small number of patients, it is now apparent that this disorder is more prevalent than previously thought. Patients with SIBO vary in presentation, from being only mildly symptomatic to suffering from chronic diarrhea, weight loss, and malabsorption.

Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome – An Update

Small intestinal bacterial overgrowth (SIBO) is one manifestation of gut microbiome dysbiosis and is highly prevalent in IBS (Irritable Bowel Syndrome). SIBO can be diagnosed either by a small bowel aspirate culture showing ≥103 colony-forming units (CFU) per mL of aspirate, or a positive hydrogen lactulose or glucose breath test.

Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy

The pathogenesis of irritable bowel syndrome (IBS), once thought to be largely psychogenic in origin, is now understood to be multifactorial. One of the reasons for this paradigm shift is the realization that gut dysbiosis, including small intestinal bacterial overgrowth (SIBO), causes IBS symptoms.

Small Intestinal Bacterial Overgrowth: Comprehensive Review of Diagnosis, Prevention, and Treatment Methods

Despite its prevalence, it remains underdiagnosed due to the invasive nature of diagnostic testing. Symptoms observed in SIBO, including abdominal distension, bloating, diarrhea, and gas formation, are nonspecific and can overlap with other gastrointestinal disorders.

What is SIBO? A Guide to This Under-The-Radar Gut Health Condition

Bloating, flatulence, abdominal pain? It could be small intestinal bacterial overgrowth (SIBO), an increasingly common condition caused by too much bacteria in the wrong part of your GI tract.

What Is SIBO–and Could It Be Causing Your Digestive Issues?

Having bacteria in your gut is a good thing–as long as it's the right bacteria in the right place. But people with a condition called small intestinal bacterial overgrowth (SIBO) have bacteria that are supposed to live in the colon (aka the large intestine) trapped in the small intestine.

Resources

SIBO - Small Intestinal Bacterial Overgrowth

The place for all things SIBO.