Irritable Bowel Syndrome?
You may have Small Intestinal Bacterial Overgrowth (SIBO)
What is SIBO and what does it mean for me if I have an IBS diagnosis?
April is IBS awareness month. I love to talk about this subject because I feel like I can give people hope. Many people I speak to have been diagnosed with irritable bowel syndrome, and they are feeling pretty hopeless. They feel like there is nothing they can do, and that there is no cure.
If you have been diagnosed with this condition, you may well have been suffering with it for years and, while a diagnosis can – at first– offer comfort in finally having a recognised problem, the satisfaction is short lived because often that’s where all support ends, and you’re left no further forward in reducing your symptoms and feeling better.
The difficulty begins because IBS is essentially meaningless; it’s a catch-all term used to encompass a huge variety of digestive issues. An umbrella term for a group of symptoms.
Testing through the NHS often rules out any serious disease or disorder, which is really important. But the problem is that once you have an IBS diagnosis you are often left to get on with it, told to take some peppermint capsules and to maybe try some probiotics.
This is where I come in!
It is important to look at the root causes of your IBS symptoms. There are so many things to think about (see my previous blog on IBS for more information). For now though, let’s take a look at SIBO – Small Intestinal Bacterial Overgrowth
Around 80% of people with IBS will have SIBO.
You might have heard about good (and bad) bacteria in the gut. Really what experts are talking about is the balance of bacteria in the large intestine: the colon. This bacteria shouldn’t be in the small intestine. Each day the body should perform a flush to sweep bacteria from the small intestine and into the large intestine.
This flush is called the ‘migrating motor complex’.
For a huge variety of reasons (historic food poisoning being the most common, but also low levels of stomach acid or adhesions play a role, among others) the bacteria are not swept away.
They stay in the small intestines and ferment carbohydrates (FODMAPS), causing gas, belching, bloating, pain and a variety of other symptoms, including constipation and/or loose stools, and even anxiety.
A breath test can establish if there are gasses in the small intestine. Different bacteria produce different gasses. The NHS does recognise SIBO, and some doctors will offer a breath test. But many are still unaware that it is a problem.
An article on transform England NHS states that an estimated 13 million people in the UK suffer with IBS and that 80% of these (up to 10.8M) have SIBO. Getting access to a breath test through the NHS is limited though, and many people are being undiagnosed.
We know that SIBO is a problem for many people with IBS.
We know that it is essentially bacteria living in the wrong place (hanging out in the small intestines, instead of the large). There are many things that can lead to SIO. Low stomach acid, underactive thyroid, endometriosis, bacterial overgrowth in the large intestines, constipation, overuse of anti-biotics, food poisoning, structural defects to name a few.
What can we do?
Testing and beyond
First of all it’s important to get tested, which can be tricky as it’s a difficult place to get to. Right in the middle of the stomach and the large intestines.
Breath tests can help to show what kind of gas you are breathing out (after a special diet and drinking a lactulose solution that helps to release the gasses).
I usually start with a stool test with my clients as I feel this give a broader picture of what is going on. The stool test can give indications of SIBO, and If I suspect this is an issue I will then do a breath test.
Once you have a diagnosis you can then start to address the bacteria in the small intestines. This can be done with specific herbs, nutrients, and dietary changes. It’s important to look at the root cause of SIBO, otherwise it will just come back again. Increasing digestion, addressing bacterial balance in the large intestines, working on stress and underactive thyroid can help to reduce recurring SIBO.
A word about low FODMAPS
Many people with IBS are told to follow a low FODMAP diet, and some find that it helps to reduce their symptoms. This is because these FODMAP foods are fermentable carbohydrates, and they feed the bacteria in the small intestine. If we eat lots of FODMAP foods we are feeding this bacteria which increases levels of gas resulting in IBS symptoms.
The problem is that avoiding these foods doesn’t get rid of the bacteria, it just decreases the amount of them and as soon as you eat normally again your symptoms are likely to come back.
A low FODMAP diet is really restrictive, and long term can impact the health of the large intestines, as well as result in nutrients deficiencies (and it’s really boring!).
This type of diet can be used short term, to help reduce symptoms while you work on reducing the bacteria, and getting everything working as it should be.
If you have been diagnosed with IBS and are unsure what you can do about it it’s really important that you dig a little deeper and try to find out what else might be going on.
Small Intestinal Bacterial Overgrowth could be something you need to work on.
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I am running a FREE challenge in May and I would love for you to join me!
The Fearing Food to Food Freedom Challenge will help you to become more aware of what might be causing your IBS and digestive issues and will help move you one step away from fearing food and towards food freedom.
Click here to learn more