What Is SIBO and Do I Have It?

SIBO stands for small intestinal bacterial overgrowth. We have lots of bacteria present throughout our entire intestine. However, most bacteria sits in the large intestine and not the small intestine. SIBO is basically an overgrowth of various types of bacteria in the small intestine.

This overgrowth make its hard for the small intestine to do it’s job, including digesting food, absorbing nutrients and producing nutrients. SIBO can also cause structural damage to your small intestine and lead to leaky gut. (source)

Leaky gut is when the intestinal lining becomes permeable and large protein molecules, such as food, gets into the bloodstream. When these particles get into the bloodstream, the body treats them as intruders and starts attacking. This can lead to autoimmune disease, food allergies or sensitivities and inflammation. (source)

Risk Factors for SIBO:

Low stomach acid
Irritable bowel syndrome or digestive problems
Taking a lot of antibiotics
Chronic constipation or poor moving bowels
Celiac disease
Crohn’s disease
Prior bowel surgery
Heavy alcohol use
Oral contraceptive pills (Just another reason to get off of the pill!)
Chronic stress
Another close family member, who you live with, has SIBO (While SIBO is not contagious, many people who live together end up contracting it.)

Personally, I was given antibiotics for years to treat my acne. Needless to say, I was always constipated and really just thought that was normal. I think I eventually read something that said you should be going at least once a day or you’re considered constipated. At my worst, before I stopped the antibiotics, I was going once every 5 days! It was miserable. Not to mention, I was having other digestive problems, had low stomach acid and was on the pill for a long time. So, that’s pretty much what I think contributed to my SIBO.

SIBO Symptoms:

Stomach pain or discomfort
Bloating, gas or burping
Diarrhea or constipation
Heartburn or nausea

Because SIBO commonly leads to leaky gut, here are some leaky gut symptoms that could also mean you have SIBO.

Leak Gut Symptoms:

Food sensitivities
Headaches
Joint Pain
Fatigue
Acne
Respiratory symptoms, such as asthma
Mood symptoms, such as depression
Anemia
Weight Loss
Autoimmune disease

To help you decide if you might have SIBO, check out this list for more symptoms and associated conditions.

I first thought I might have SIBO while listening to a podcast. One of the featured doctors said that 90% of the people that came into her office with adult acne had SIBO. After doing my research, I realized that I also had a lot of the other symptoms, including gas, burping, constipation, heart burn and joint pain. I really thought these symptoms were odd because I had been following a Paleo protocol and was still having digestive symptoms. So when I found a Functional Medicine Practitioner in my area, I walked in saying, “I’m pretty sure I have SIBO.”

How To Find Out If You Have SIBO:

Your doctor can test you for SIBO with a breath test. The test is usually taken at home. After two days of following the specified diet, you drink 8oz of a lactulose solution. You then breathe into a few designated bags over the next 2-3 hours. After you’re done, you mail the box off to the lab to test your breath.

Basically, the diet starves the bacteria and then the lactulose solution feeds them, causing the bacteria to give off gases. When you breathe into the bags, they collect any gases that the bacteria have given off. You will either produce methane gas or hydrogen gas if you have SIBO.

There are different types of SIBO, methane producers, hydrogen producers or people who produce both (like me!). Usually, people who suffer from constipation are methane producers and people who suffer from diarrhea are hydrogen producers. Methane producers are typically harder to treat. This is why it’s a good idea to have the test done while seeing a Functional Medicine Practitioner. You will get a better idea of what you have and what actions need to be taken to treat it.

How To Treat SIBO:

Obviously, I’m not a doctor, but I can tell you what my Functional Nurse Practitioner is having me do.

Follow a Low-FODMAP diet. FODMAP is an acronym that stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. These are short-chain carbohydrates that feed the bacteria and cause gas and bloating. So, while treating SIBO you want to stay away from these foods and follow a Low-FODMAP diet. So, what foods are Low FODMAP and what’s High FODMAP? There are a lot of conflicting lists out there, but my favorite is listed to the right, in a downloadable PDF. I have also found that I have to use my best judgement for my body. If I eat something and have symptoms, I know to stay away from it.
Take herbal antimicrobials. This is where your Functional Medicine Practitioner really guides you. So far, I have done 2 different rounds of herbals. Depending on how bad your SIBO is, you may have to do quite a few rounds. One round of herbals usually lasts 4 weeks and you will have to remain on the Low-FODMAP diet for that time.
Take pharmaceutical antibiotics. Rifaximin is the most common prescription drug used to treat SIBO. It is a good option if sticking to the Low-FODMAP diet is difficult for you. You only have to stick to the diet as long as you take the drug, about 2 weeks. So far, I have done one round of Rifaximin. I did feel that it improved my symptoms quickly, however I felt extremely tired on the medication, which is most likely due to the die-off of the bacteria.

SIBO is still largely under-diagnosed. Many people don’t seek help for their symptoms and many doctors don’t know how common it is. That being said, if you think you may have SIBO, I recommend seeing a Functional Medicine Practitioner. Look for practitioners that specialize in digestive issues or just call up the office and ask if they test for and treat SIBO.

So in conclusion, here’s a quick list of your action steps:

Look through the above risk factors and symptoms to help you decide if you might have SIBO.
Find a Functional Medicine Practitioner in your area that tests for and treats SIBO.
Take a breath test to see if you have SIBO and what kind it is.
Work with your Functional Medicine Practitioner to see what kind of treatment plan you should follow.
Cure your SIBO and live a happier and healthier life!

I am currently undergoing my second SIBO test to see if what I have done so far has reduced or even eliminated my SIBO. I am thinking that I might have to do one more round of herbals, because my SIBO was severe when I first started. However, my symptoms have improved so much. It’s an amazing feeling not to have to deal with the gas and bloating anymore! *Update: My SIBO is gone! My test results came back and I beat it! Now I just have to work on my leaky gut and dysbiosis. I’m on the road to recovery.

You don’t have to live with your symptoms either. If you’re thinking that what you’re feeling isn’t normal, it’s probably not and you don’t have to live with them. As always, it is important to see a doctor before diagnosing yourself or taking any tests or medications. Let’s get healthy together and live better lives!

Do you have SIBO? What have you done to treat it? Where are you at in your healing journey?