SIBO (small intestinal bacterial overgrowth) is a condition wreaking havoc on your digestive process. This overgrowth of bacteria that normally lives (and is supposed to stay) in your large intestine creeps into your small intestine, causing bloating, sleepiness after meals, gas, and other discomfort. While the discomfort can be significant, this is a hard to diagnose condition. The good news is that if you find a doctor who will properly test you to confirm a diagnosis, it is simple to treat.
The most common way to test for SIBO is a hydrogen and methane breath test. This test is non-invasive, but takes 2-4 hours and is usually administered in a gastroenterologist's office.
The day prior to the test you avoid certain problem foods and high-fiber foods, and eat a very bland diet (chicken broth, plain chicken, white rice, etc.). Your health care provider administering the test then provides a small, virtually tasteless solution containing the sugars that feed the bad bacteria in the small intestine. Your breath is tested every 15 minutes or so by blowing into a tube, which captures how the solution has affected you. These numbers are recorded, and once you have completed the test, the dietitian or doctor will discuss your results with you.
Hard to Diagnose ...
So why is SIBO hard to diagnose? Frankly, it is because many health care providers do not think to test you for SIBO. In the absence of the test, your symptoms will likely be written off as irritable bowel syndrome and a "sorry for your symptoms, we don't know the cause, hope you feel better" to send you on your way. Another common misdiagnosis is lactose intolerance.
You, as the educated and empowered consumer that you are, may have to request the test. The challenge, then, is finding a doctor who will run the test and who knows how to interpret the results. As mentioned above, a gastroenterologist can likely administer the test in her/his office.
... But Simple to Treat
The good news is that this condition has a few treatment options that actually work (differentiating it from IBS, which is often hard to treat and very uncomfortable). The first and most common treatment is the antibiotic rifaximin, commonly used to treat traveler's diarrhea. It acts only in the small intestine, as opposed to a systemic antibiotic, and essentially puts a salve on the bad bacteria, eventually making it die off. Your doctor may begin you on a 10-day regimen, though you can stay on this longer if you continue to experience symptoms. This works for a lot of patients, though some patients may need diet modifications, such as cutting out FODMAPS, as well.
Probiotics - Yes or No?
As we have mentioned before on the blog, probiotics may not be for everyone. Repeat after us: probiotics may not be for everyone (gasp!) and may actually worsen your SIBO symptoms.
SIBO is an overgrowth of bacteria, so adding more bacteria to the body may cause even more problems. Ask your doctor or dietitian about probiotics to determine whether they are right for you. You know your body best, though, so pay attention to see if you notice a correlation between your symptoms, such as bloating, after eating probiotic foods.
What Are Risk Factors for SIBO?
A few important risk factors that may increase the likelihood of SIBO are:
- Inflammatory Bowel Disease (especially Crohn's Disease)
- Celiac Disease
- Past surgery somewhere along the digestive tract
- Irritable Bowel Syndrome
- Long-term antibiotic use
Digestive Problems Affect Your Entire Life
We are unique among living beings in that eating is a social affair. Discomfort during or after eating can have embarrassing and difficult-to-manage repercussions. Ask your doctor questions, see a dietitian to discuss dietary modifications, and commit to getting your condition or disease under control! Optimal digestion provides the foundation for a healthy body that functions optimally and wards off infection and disease. What is better than that?