SIBO - the number one cause of IBS
By Dr Ashley Damm, ND on Thu, Nov 14 2019
Do you feel bloated after meals? Suffer from irregular or uncomfortable bowel movements? Do fiber or vegetables upset your stomach? Or maybe you’ve been diagnosed with Irritable Bowel Syndrome (IBS), and told it’s something you’ll have to manage for the rest of your life?
It's estimated that 25% of Canadians suffer from IBS. Unfortunately, many of the standard treatment options are not effective and do not address the root cause. This includes things like laxatives, anti-diarrhea medications, and even anti-depressants!
There is a significant association of IBS with Small Intestinal Bacterial Overgrowth (SIBO). This study demonstrated 84% of IBS patients tested positive for SIBO, treatment of SIBO improved their symptoms. Numerous studies since have demonstrated the connection between IBS and SIBO.
What is SIBO?
SIBO is the build-up of your gut microbiome in your small colon. Normally, your gut microbiome normally resides in the large colon. Our microbiome is important for many things. They help maintain the health of our gut lining, produce vitamins and interact closely with our immune system. However, while having a healthy, diverse microbiome is necessary, having them in the wrong area can lead to digestive troubles.
Common symptoms of SIBO
- Abdominal bloating or discomfort after meals
- Excessive burping or gas
- Irregular bowel movements (chronic loose stool, constipation, or alternating)
- Bowel urgency
- Fatty, sticky bowel movements
- Worse with high fiber or sugary foods.
Causes of SIBO
The number one cause of SIBO is an impaired "migrating motor complex" (MMC). The MMC is a wave that sweeps through your digestive tract, pushing and propelling things forward (i.e. food particles, bacteria in the wrong place, etc). If this wave doesn't work properly, bacteria from the large colon can begin to creep upward into the small colon. The most common cause of an impaired MMC is a history of gut infection (food poisoning, traveler’s diarrhea and/or parasites).
Other potential co-existing problems include low stomach acid, impaired bile secretion, structural issues, or concurrent gut conditions such as Crohn’s colitis, ulcerative colitis or celiac disease.
How to test for SIBO
The first step is to test. This tells us which type of bacteria is present and ensures appropriate and targeted treatment. The gold standard treatment is a non-invasive lactulose breath test. Samples are collected over a 3-hour window.
If we suspect a coexisting gut infection (i.e. a parasite or pathogenic bacteria), a stool test may also be needed. This can be treated beforehand or at the same time, to prevent reoccurrence of SIBO.
Treatment for SIBO
You’ve tested and you’re positive, now what? A tailored treatment plan is constructed. Generally, there are three steps:
- Eradication - removal of the bacteria that is present in the wrong spot
- Restore your MMC - to prevent reoccurrence
- Heal your gut, restore healthy bacteria and stomach acid levels - to optimize digestion
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- Dr. Ashley Damm, ND