SIBO (small-intestinal bacterial overgrowth) is exactly what it sounds like — excessive bacteria in your small intestine. It may sound like having bacteria in your digestive tract is normal, and it is — but only to a certain extent. Let's take a look at what SIBO is and what we can do about it.
Your digestive tract
Your digestive tract is responsible for handing the food and drink you take in, from your mouth to your esophagus to your stomach. From there, it's pushed to and through the small intestine, then through the large intestine (which includes the colon) — and then whatever is left over exits your body in the form of poop.
The small intestine is responsible for slowly breaking down the food we eat so its nutrients are absorbed into the bloodstream. Dr. Josh Axe, a nutritionist, tells SheKnows that in a healthy system, the small intestine is home to some bacteria, but not a lot — you'll generally find the highest concentrations inside the colon.
This is why SIBO can be such a huge problem. If there is bacterial overgrowth in the small intestine, it can affect how your gut deals with nutrients, which means if there's a problem with excess bacteria in this part of your body, then you're not getting what you need to keep you healthy.
SIBO & your gut
"When in proper balance, the bacteria in the colon helps digest foods and the body absorb essential nutrients," says Axe. "However, when bacteria invades and takes over the small intestine, it can lead to poor nutrient absorption, symptoms commonly associated with IBS, and may even lead to damage of the stomach lining."
This can lead to a number of unpleasant symptoms. SIBO symptoms can include:
- Excess gas
- Abdominal bloating
- Abdominal distension
- Abdominal pain
Also, keep in mind that a small number of people with SIBO may experience constipation instead of (or worse yet, in addition to) diarrhea.
As you can see, these symptoms may sound an awful lot like a ton of other abdominal maladies, which can make it hard to pin down — even for your physician. Your doctor might want to rule out other conditions (such as diabetes or celiac disease) before jumping to SIBO testing, but your mileage may vary according to your doc's preferences.
Direct bacterial sampling from your small intestine and culturing any bacteria found is one way to diagnose SIBO, but this involves anesthesia and a scope. Another option is the hydrogen breath test, which is not invasive and only requires a pretest fast. Exhaling into a balloon and then consuming some of the test substance (some sort of sugar, usually) is followed by more balloon breathing, which is then tested for hydrogen and methane.
Dr. Mahmoud A. Ghannoum, a professor of dermatology at Case Western Reserve University who specializes in medically important fungi and bacteria, explains that treatment depends on its underlying cause. It can be as relatively noninvasive as a diet change (such as is necessary for those who have celiac disease) or as involved as surgery for those who have a problem in the anatomy of their small bowel.
Additionally, in patients who have experienced weight loss or other signs of nutritional deficiencies, Ghannoum says nutritional support is another aspect of SIBO treatment. Nutritional recommendations are usually based on the individual patient, but many find relief from their symptoms by following a low-FODMAP diet.
And finally, the other step of treatment should target and eliminate the bacterial overgrowth. "Antibiotics reduce or eliminate the bacterial overload and reverse the mucosal inflammation associated with overgrowth and malabsorption," he notes. In some cases, patients get better and stay better after antibiotic treatment, but others see their symptoms return when their course of antibiotics are complete and must take antibiotics repeatedly — or even continuously.
Help can be found
If you've been experiencing uncomfortable and distressing abdominal symptoms, a visit to your doctor is in order. While some people have a hard time getting a solid SIBO diagnosis and treatment plan, help can be found, and hopefully, you'll be feeling back to your old self soon.