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6 Signs That SIBO Might be the Root Cause of Your IBS

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6 Signs That SIBO Might be the Root Cause of Your IBS. Studies show that over 50% of patients diagnosed with IBS actually have an underlying imbalance called SIBO, or small intestinal bacterial overgrowth. The majority of our gut bacteria should be in the colon. When the bacteria migrate backwards into the small bowel or when there is low stomach acid or poor pancreatic enzyme production, bacteria in the small bowel can overgrow and cause symptoms, such as diarrhea, gas, or bloating.

Six signs you might have SIBO

You notice that fiber worsens your constipation
You notice an improvement in IBS symptoms when taking antibiotics
You feel more gas and bloating when you take probiotics that contain prebiotics
You have celiac or are gluten intolerant and do not have 100% resolution of symptoms on a gluten-free diet
You develop chronic symptoms of gas, bloating, constipation or diarrhea after taking pain medications, like opiates.
Your blood work shows chronically low iron or ferratin with no known cause

Top 6 Symptoms of SIBO

Abdominal bloating and distension
Constipation
Diarrhea
Abdominal pain or discomfort
Acid reflux or heartburn
Excessive gas or belching

How do I know this isn’t just leaky gut?

While SIBO usually manifests with local GI symptoms, a leaky gut will manifest with systemic complaints that affect the immune system. Keep in mind that is is not uncommon to have both SIBO and leaky gut simultaneously. And very often if you have SIBO for a long period of time, you will develop a leaky gut. Here are some systemic signs of a leaky gut:

Multiple food sensitivities
Skin rashes, acne or rosacea
Respiratory symptoms, like asthma
Allergic symptoms or increase in seasonal allergies
Fatigue
Brain fog or poor concentration, especially after meals
Any autoimmune disease
Joint pain or arthritis
Headaches or migraines
Remember SIBO can cause leaky gut syndrome but not everyone with SIBO has leaky gut. About half of the patients diagnosed with SIBO will also have leaky gut. Most of the time if SIBO is treated, leaky gut will heal itself!

10 conditions that may predispose you to have SIBO

Hypochlorhydria (low stomach acid)
Pancreatic insufficiency
Decreased motility in small intestine
Bowel obstruction
Diverticula
Surgical bowel resection or bariatric surgery
Food poisoning (Post infectious IBS)
Nerve damage that affects the GI tract
Drugs, like opiates
Any disease that slows motility (diabetes, hypothyroid)

Other disorders that may be associated with SIBO

Rheumatoid arthritis
Ankylosing spondylitis
Scleroderma
Hashimoto’s thyroiditis
Rosacea
Restless leg syndrome
Pancreatic insufficiency
Liver disease
Diabetes
Crohn’s disease
Celiac disease
Fibromyalgia
Kidney failure
Liver disease
Diverticulosis

How to Diagnose SIBO

• Ask your doctor to order the Lactulose Breath Test (preferred over glucose as it will test the entire small bowel vs. just duodenum)
• You may also need to check a comprehensive stool analysis and urinary organic acids, which may point in the direction of other dysbiosis but are not directly assessing small bowel bacterial overgrowth

How do we treat SIBO?

Diet options

• Paleo diet or autoimmune paleo diet
• Low FODMAP diet
• Specific Carbohydrate Diet
• GAPS Diet
• Avoid all alcohol
• Use caution with probiotics/prebiotics
• Use caution with fermented foods as they can increase histamine
• Homemade Elemental Diet by Dr. Siebecker

Antibiotics

• H2 Predominant SIBO: Xifaxan
• Methane Predominant SIBO Xifaxan plus neomycin or tindamax

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