Small Intestinal Bacterial Overgrowth (SIBO): Symptoms, Causes, and Risk Factors
Learn about the symptoms and the causes of SIBO.
CONTACT USUnderstanding SIBO and Gut Health
SIBO (small intestinal bacterial overgrowth) is a condition where a high number of bacteria are found in the small intestine.
Since the small intestine is a section of the gut that is meant to have a lower level of bacteria, this increase in organisms can impact digestive health leading to a wide range of symptoms. Many of these symptoms are what are typically seen in IBS.
Recognising SIBO Symptoms
The typical symptoms of SIBO are very similar to the symptoms of IBS.
These symptoms of SIBO include:
- Bloating and distention
- Abdominal pain
- Food intolerances
- Constipation or diarrhoea
As with IBS, these symptoms can increase and decrease over time, often referred to as flare-ups. While these symptoms of SIBO may not be life-threatening, they do decrease quality of life.
Additional symptoms of SIBO may include:
- Skin issues (roseaca, eczema, acne)
- Anxiety or low mood
- Fatigue
- Brain fog
- Fibromyalgia
SIBO Symptoms
What are the first signs of SIBO?
SIBO can start gradually or quickly. Often the first signs of SIBO include digestive symptoms such as bloating, abdominal pain and food reactions. Many people diagnosed with IBS may actually have SIBO as the underlying cause of their gut symptoms.
What is SIBO poop like?
Depending on the type of bacteria that are overgrown, diarrhoea or constipation may be present. For some, SIBO can lead to very loose stools that contain undigested food. In other cases, mucus may be present. It is also not uncommon for bowel patterns to move back and forth between constipation and diarrhoea.
What colour is poop with SIBO?
In SIBO, the colour of the stool is often a normal shade of brown. If diarrhoea is present it may be a lighter shade and with constipation, it may be a darker shade. For some, the stool may be yellow, pale or oily which may be related to malabsorption caused by SIBO.
What are the causes of SIBO?
Understanding the cause of SIBO is an important factor for successful SIBO treatment. The causes of SIBO include:
Impaired Motility
Factors such as chronic infections, low grade inflammation, food poisoning, hypothyroidism and traumatic brain injuries can impact bowel contractions, leading to the accumulation of bacteria in the small intestine.
Impaired Digestion
Changes in enzyme release can alter the environment in the small intestine making it most hospitable to bacteria. Causes include: microbiome dysfunction, chronic stress, low stomach acid, poor bile flow and pancreatic insufficiency.
Further Causes of SIBO
Further causes of SIBO include:
Reduced Flow
Reduced flow of food and stool through the intestines can lead to impaired microbiome function and bacterial overgrowth. This is often structural in nature and includes causes such as: Ileocecal valve dysfunction, endometriosis, abdominal surgery and c-section delivery.
Medications
Medications may alter bowel motility or enzyme release. The result of this is a change in the small intestinal environment, making it more hospitable to bacteria which allows an overgrowth to develop. These medications include: Proton pump inhibitors (eg omeprazole), tricyclic antidepressants and opiates.
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Identifying SIBO Risk Factors
As with IBS, there is not a single cause of SIBO. However, a range of risk factors can be considered that may increase the risk of developing SIBO.
One of the most common causes of SIBO is a case of food poisoning, gastroenteritis or travellers’ diarrhoea. Events such as these can trigger a low-grade inflammatory response which can then lead to SIBO developing. This risk of developing gut symptoms after one of these events may remain elevated for 2-3 years following these events.
SIBO Complications
While SIBO may not increase the risk of developing bowel cancer, it can have an impact on health and quality of life.
Not only can SIBO trigger symptoms of anxiety, low mood and fatigue but it can also lead to nutrient deficiencies. These deficiencies can be due to malabsorption as well as the result of under eating due to the wide range of foods triggering symptoms.
Common nutrient deficiencies include:
- Vitamins A, D, E and K
- Iron
- B12
Tips for SIBO Prevention
Initially, avoiding or limiting the SIBO risk factors is a key way to reduce the likelihood of developing SIBO. However, once SIBO has been diagnosed and successfully treated, preventing reoccurrence can be a priority and central focus.
These strategies include:
- Probiotics and prebiotics
- Prokinetics
- Leaving time between meal
- Digestive support
- Appropriate levels of fermentable and non-fermentable fibre
- Optimising sleep
- Stress management
Conclusion
The symptoms of SIBO may be similar to IBS symptoms, but the presence of this gut condition can require a more targeted treatment.
This reinforces the importance of working with an experienced SIBO and gut health specialist who can identify the cause of symptoms and assist with addressing them.
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