Approximately 3million people in the UK are affected by irritable bowel syndrome (IBS). It is now thought that 60-70% of IBS cases are in fact due to SIBO.
So what actually is SIBO? SIBO stands for small intestine bacterial overgrowth. As the name suggests this means there are too many bacteria growing in the small intestine.
Most of our gut bacteria live in the large intestine and there should normally be a much smaller population of bacteria in the small intestine. However, for various reasons, the bacteria in the small intestine overgrow and cause lots of problems. The bacteria themselves are not necessarily “bad” species – it is a case of too many growing in the wrong place!
These bacteria ferment food particles which enter the small intestine, depriving us of nutrients and causing damage to the lining of the small intestine. The symptoms of SIBO are ones you would associate with IBS – bloating, constipation or diarrhoea, abdominal pain, heartburn and nausea are the most common.
The overgrown bacteria produce gas – hence the bloating associated with SIBO. There are three types of gases which can be produced, depending on the type of bacteria overgrowing. These are hydrogen, methane or hydrogen sulphide, sometimes SIBO sufferers have more than one type of gas being produced. As a general rule, hydrogen SIBO is associated with diarrhoea and methane SIBO with constipation.
Currently, the best test we have readily available is breath testing. If you have a G.P. who will refer you to a gastroenterologist, you may be offered a SIBO breath test free of charge by the NHS, although unfortunately this is still not the norm.
However, if SIBO is not yet recognised by your G.P., you may not get a referral. In this situation, a private test may be the best option. These are available through private health practitioners and can now also be bought directly as home testing kits.
Home testing kits take 3 hours to do at home and test for production of both methane and hydrogen. There is a special preparation diet to follow the day before then on the day of the test, after drinking a lactulose solution, the test is completed by breathing into special bags at intervals over 3 hours. The test measures the quantity of gases produced and this determines whether the result is classed as positive for hydrogen or methane gas. Tests are often best interpreted by experienced practitioners.
If a test is positive, it is recommended to consult a practitioner for support as dealing with SIBO alone can be tricky. There is lots of info out there on various blogs, social media etc, however SIBO is more likely to be successfully dealt with when tackled in a specific sequence. There is definitely both a science and art to dealing with SIBO as symptoms and causes vary so much between people. The key is to identify the root cause.
If you would like more information about SIBO testing, or are struggling to deal with SIBO yourself, please get in touch.
Ref: Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome – An Update.
Will Takakura and Mark Pimentel. 2020