Your IBS Might be “SIBO”.  And it Might be Curable!

If you’re often running to the bathroom after meals, you might be convinced you have Irritable Bowel Syndrome. It’s a prevalent  issue in Canada, impacting up to 18 per cent of the population, according to the Canadian Digestive Foundation. But that figure may not be entirely accurate. In fact, up to 80 per cent of IBS cases could potentially be misdiagnosed as something called SIBO, according to SIBO Clinic Canada. 

SIBO: Small Intestinal Bacterial Overgrowth

The two are remarkably similar, especially in the early stages of SIBO. But there is a big difference between the two in terms of diagnostics. IBS is a chronic condition based on symptoms and ruling out other possibilities while SIBO can be tested for, treated, and cured. It’s possible to have both SIBO and IBS at the same time. 

What is SIBO?

SIBO is a condition where bacteria builds up in the small intestine, a part of the digestive tract that is usually low in bacteria, compared to the colon. Your small intestine is essential for breaking down food and absorbing nutrients. But when the passage of food and waste through this area experiences motility issues and the bacterial population shifts, problems can ensue.. 

Additionally, low stomach acid, which commonly becomes a problem with age, can reduce your body’s ability to stop harmful bacteria from setting up camp in your intestines. Your digestive tract becomes unable to properly break down food due to these invaders and food starts to ferment in your small intestine. 

Because you can’t break it down, the bacteria gets dibs on all the vitamins and nutrients from your food, which can lead to severe problems over time including vitamin B-12 deficiencies which can cause issues in the functioning of your nervous system, anemia, osteoporosis, or kidney stones. 

This causes bloating, gas, abdominal cramps, and unpredictable bowel movements. These symptoms also happen to be common in patients diagnosed with IBS. It’s not surprising then, to learn that SIBO is often misdiagnosed as IBS. Let’s compare the symptoms of SIBO and IBS.

SIBO vs IBS

Testing for SIBO

There are multiple tests available, but SIBO may not be at the forefront of your practitioner’s mind. Both the symptoms of and the onset of SIBO typically overlap with other gastrointestinal issues, making it difficult to catch. 

SIBO is often caused by complications of another illness, such as diabetes, celiac disease, diverticulosis, hypothyroidism, etc., as well as certain medications. It can also be caused by motility issues resulting from surgery or structural abnormalities in the digestive tract.

Tests available in Canada:

• Blood tests (for vitamin/nutrient deficiencies.)
• Breath test (lactulose, and/or glucose. Other tests are available outside of Canada.)
• Stool test (for undigested fats/bile.)

Breath testing is the most popular because it is more accurate, minimally invasive and it can be done either with your family doctor or alone at home. They are approximately 80 per cent accurate, so there is room for error. It’s possible your doctor may have you take it a couple times to account for false positives/negatives.

These tests can cost up to $250, and are generally not covered by insurance. If the test is prescribed to you and ordered for you by your doctor, you may be able to claim it under private health insurance, though it is not covered by many plans. Most plans will not reimburse you for it if you purchase a breath test individually.

In order to take the breath test, you will have to follow a prep diet for one or two days to ensure the results are accurate. “During this time, you’ll need to avoid all non-essential medications, supplements, and probiotics — including things like over-the-counter painkillers, allergy meds, and antacids,” according to SIBO Clinic Canada. Do not smoke or drink during this time.

The diet starves the bacteria so the gas they produce isn’t tainted by foods that could alter test results. 

Curing SIBO

It’s actually fairly easy to cure SIBO. The standard treatment is antibiotics to kill off the excess bacteria. In conjunction, you’ll likely be asked to follow a diet to ensure the bacteria is completely gone and to control future bacterial growth. 

Not all antibiotics are effective against the bacteria. Antibiotics that cure SIBO: traditionally tetracyclines, fluoroquinolones, or co-trimoxazole are prescribed for effective treatment. But recently, research has proven rifaximin to be the preferred treatment method.

If the bacterial overgrowth is minimal, you could start feeling better in just a few short weeks; if the growth is severe, it could take a few months before you’re symptom free. 

The SIBO Diet – Promising but Needs More Research

Probiotics will be your best friend during and after treating SIBO. Studies suggest that “probiotics are effective in reducing the bacterial burden in SIBO patients and alleviating their symptoms,” and could even improve the efficacy of antibiotics, though more research is required to corroborate this. 

Cutting out carbs, sugars, and high fibre foods could help control symptoms of SIBO, though again, research on this topic is minimal and therefore it is not conclusive. The University of Virginia suggests following an elimination diet: cut out one type of food at a time, wait at least three days before reintroducing it into your diet and see how it impacts you. 

Ask Your Doctor About the Possibility of SIBO

If your gut is making your life unpredictable, and nothing seems to help, it might be time to dig a little deeper. While IBS is a common diagnosis, it’s not the only one—and it might not even be the right one. Ask your doctor if SIBO could be impacting you. You deserve to feel good and eat well.

~ Read more from The Health Insider ~

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  Your IBS Might be “SIBO”.  And it Might be Curable!
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  The Gut Health Wakeup Call at 40: Are You Paying Attention?
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The information provided on TheHealthInsider.ca is for educational purposes only and does not substitute for professional medical advice. TheHealthInsider.ca advises consulting a medical professional or healthcare provider when seeking medical advice, diagnoses, or treatment.