SIBO

Small Intestinal Bacterial Overgrowth

Small Intestinal Bacterial Overgrowth

If you suffer from IBS you may have come across a condition called SIBO.

SIBO stands for Small Intestinal Bacterial Overgrowth and occurs when an elevated number of bacteria are found in the small intestine.

Since the small intestine is meant to contain a low number of bacteria, an overgrowth of organisms can lead to symptoms of IBS.

These are symptoms such as:

  • bloating
  • cramping
  • altered bowel patterns (constipation or diarrhoea)
  • heartburn
  • unpredictable food reactions

It has been estimated by some that up to 80% of those with IBS have SIBO.

Clues it may be SIBO

In addition to the symptoms of bloating, cramping, abdominal pain and constipation or diarrhea there are additional indicators that SIBO may be present.

  • You feel worse with prebiotics or probiotics.
  • Your bloating starts within 1 hour of eating.
  • Your symptoms started following a case of food poisoning or travellers diarrhoea.
  • The symptoms improved temporarily while on antibiotics for an unrelated problem.
  • Fibre worsens bowel movements.
  • You’re Coeliac yet continue to have symptoms whilst on a gluten-free diet.

Additional symptoms and conditions associated with SIBO

An increasing amount of food sensitivities

Impaired vitamin absorption

Maldigestion of fats

Histamine intolerance

Brain fog

Restless leg syndrome

Acne rosacea

Fibromyalgia

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Underlying Causes of SIBO

Impaired Digestion

Microbiome dysfunction, chronic stress, sIgA deficiency, poor bile flow, low stomach acid.

Altered Motility

Hypothyroidism, diabetes, chronic infection, MMC damage, scleroderma, traumatic brain injury.

Medications

Opiates, proton pump inhibitors, tricyclic antidepressants.

Impaired Flow Through the Intestines

Ileocecal valve dysfunction, endometriosis, abdominal surgeries/adhesions, EDS.

Road to resolution

Once we have established the likelihood of an overgrowth of bacteria in the small intestine the approach is 3 fold:

Lower the bacterial load in the small intestine

Support the healing of the gut lining

Address the underlying cause of the overgrowth

Testing for SIBO

The small intestine is a particularly tricky place to get to.  However, one test we can use is the SIBO breath test.

  • The test is performed by drinking a sugar solution which acts as a food source for the bacteria in the digestive system.  When the bacteria come into contact with this sugar solution, fermentation takes place.
  • The gases produced during the fermentation process are then absorbed into general circulation, transferred into the lungs, and then exhaled.
  • Elevated levels of these gases found in breath samples can indicate the presence of SIBO which can then help guide your protocol.
  • These tests can be carried out in your own home with results typically back from the lab within 10 working days.

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Frequently Asked SIBO Questions

Are there different types of SIBO?

The SIBO tests measure 2 types of gas, hydrogen, and methane.  If there are elevations in 1 of these gases, we can name that Hydrogen or Methane SIBO.  It’s also possible to have elevations in both gases.

The type of gas that is elevated helps to guide supplement protocols to target the specific organisms that produce that type of gas.

A third type of gas, hydrogen sulfide, can also be produced by the gut bacteria. However, it is not currently possible to test for this gas.

Are supplements needed to address SIBO?

Generally speaking, there are 3 components to a supplement protocol to address the elevated bacteria in SIBO.  These can include a combination of probiotics, prebiotics, and antimicrobial herbs.

Depending on the underlying issue (eg. the reasons why the bacteria are there in the first place) additional supplements may be suggested.

Can SIBO be cured?

SIBO is a bacterial overgrowth in the small intestine with several underlying causes.  The majority of those with SIBO can have the small intestine rebalance, however, there are also some who either have treatment-resistant or chronic SIBO.

This largely depends on the underlying cause.  Particularly, if parts of the small intestine have been damaged, this may lead to reoccurring SIBO.

Is the SIBO breath test available on the NHS?

This SIBO test may be offered through the NHS, however, it’s not uncommon for the waiting time for this test to be several months.

By ordering directly from the laboratory, we are able to have the test sent to your home within 3-5 days. The results will be back 7-10 days after the laboratory has received the samples.

What tests are available for SIBO?

The SIBO breath test can be sent straight to your home.  With results back from the lab within 7-10 days, this is a quick and valuable insight into your gut health.

Learn more about testing.

Can I speak with you before booking a consultation?

I always like to speak with people before booking a consultation.  This can help me understand your symptoms and to make sure this is the right approach for you.

Book a free call.

IBS and SIBO

IBS is an overarching umbrella term that describes someone’s symptoms.  Within this, there are 3 subtypes of IBS.  IBS with diarrhoea, IBS with constipation and IBS with a mix between the 2.

Even though these subtypes give a clearer indication of someone’s symptoms, they go no further to inform us what the underlying issue is.

The SIBO tests measure 2 types of gas, hydrogen, and methane.  If there are elevations in 1 of these gases, we can name that Hydrogen or Methane SIBO.  It’s also possible to have elevations in both gases.

The type of gas that is elevated helps to guide supplement protocols to target the specific organisms that produce that type of gas.

A third type of gas, hydrogen sulfide, can also be produced by the gut bacteria. However, it is not currently possible to test for this gas.

Generally speaking, there are 3 components to a supplement protocol to address the elevated bacteria in SIBO.  These can include a combination of probiotics, prebiotics, and antimicrobial herbs.

Depending on the underlying issue (eg. the reasons why the bacteria are there in the first place) additional supplements may be suggested.

SIBO is a bacterial overgrowth in the small intestine with several underlying causes.  The majority of those with SIBO can have the small intestine rebalance, however, there are also some who either have treatment-resistant or chronic SIBO.

This largely depends on the underlying cause.  Particularly, if parts of the small intestine have been damaged, this may lead to reoccurring SIBO.

This SIBO test may be offered through the NHS, however, it’s not uncommon for the waiting time for this test to be several months.

By ordering directly from the laboratory, we are able to have the test sent to your home within 3-5 days. The results will be back 7-10 days after the laboratory has received the samples.

Supplements

From your first consultation, you will receive a supplement protocol.  I like to describe supplements as a form of scaffolding.  If a building is in need of support, we erect scaffolding.  The digestive system is no different.

The aim is not to be taking lots of supplements forever but to use them in the short term to support, repair and rebalance.

The duration of a supplement protocol will vary on your symptoms, the underlying imbalance and any additional factors that may be contributing to your digestive issues.

Generally speaking, 8 weeks is an average time to be on a specific supplement protocol.  Following this, a maintenance protocol may be recommended.

The supplements I recommend vary depending on your specific situation and set of symptoms.  Common recommendations include probiotics, specific herbal extracts to help rebalance and modify the gut bacteria as well as beneficial, gut-friendly prebiotics.

Following your consultations, you will receive a link to an online ‘shopping basket’ with the products I recommend.  These are generally delivered within 24-48 hours.

Qualifications

I am not a doctor and can therefore not officially diagnose your condition.

However, as with the diagnosis of IBS, labels may not always be helpful.  By digging deeper and identify underlying imbalances we can often bring symptoms under control.

It is also important that your GP is kept up to date with any findings.  If appropriate, and with your approval, I may write to your GP to request further investigations or assessments.

I am a fully insured registered Nutritional Therapist with membership through BANT and CNHC, the main governing bodies within the UK.

I am also continuously engaged in current research as well as additional educational courses as a form of continuing professional development (CPD).

Consultations

The initial consultation is 90 minutes long.  Here we talk about your symptoms in depth, how and when they started, other contributing factors as well as your current diet.

From this consultation, you will receive your protocol.  This will include detailed dietary suggestions, a supplement protocol, recommendations for further testing as well as appropriate lifestyle recommendations.

From this point, it’s beneficial to speak every 3-4 weeks to assess progress and make any adjustments to your protocol.

To make sure this is the right approach for you, please book a free 15-minute consultation with me here.

Without knowing more about your specific symptoms this is a hard question to answer.

However, generally speaking, the majority of those that I work with typically feel 3 consultations, over a 2-month period is all that is required.

I appreciate that it can be frustrating when you’re looking for a quick resolution of symptoms.  As with many other health conditions, healing is not always a straightforward path.

There are several dietary templates that often offer symptom relief over a matter of days.  While these are not long-term approaches, they can be a way to help ease symptoms and help you feel more comfortable as the underlying issues are identified and addressed.