So, you’re feeling crummy. Gut pain, bloating, gas and spending way too much time in the bathroom.
And finally, you have gotten a diagnosis of IBS.
But you’re not yet feeling better with the changes you’ve tried so far. So frustrating!
Did you know that up to 78% of those with IBS also have been diagnosed with SIBO (1)? When symptoms overlap, it can be tricky to know which condition is causing you grief. You may be wondering whether you could you have both SIBO and IBS? Knowing which condition you have, or if you have both, is important to guide what treatment will help you feel better, faster.
What is SIBO?
SIBO is short for Small Intestinal Bacterial Overgrowth. We are supposed to have gazillions of organisms living in our large intestine – they help with digestion, our immune system and mood regulation, to name a few important functions – but we feel symptomatic when we have the wrong balance of organisms in our large intestine or too many congregate in our small intestine. This overgrowth might warrant a diagnosis of SIBO.
SIBO causes us to feel really crummy (we know from painful, firsthand experience) because of the bacteria causing a ruckus in your small intestine. The bacteria might be digesting your food. Seriously rude! They can also break down the lining of your small intestine, reducing your ability to make digestive enzymes and – even worse – making your gut more permeable, aka “leaky gut.”
Different dietary interventions for SIBO exist. They may help to manage symptoms while you are working to address the root cause. Dietary options for SIBO include the low-FODMAP diet, the SIBO Bi-Phasic Diet and the Specific Carbohydrate Diet (SCD). All of these diets reduce carbohydrates that can be fermented by the bacteria in the small intestine.
You can read more about SIBO here.
SIBO symptoms can vary from one person to another and even from one day to the next. Your symptoms might include:
- Bloating – especially 1-2 hours after a meal
- Mixed – Constipation & Diarrhea
- Belly pain
- Nutrient deficiencies, such as anemia
SIBO doesn’t like to be alone. SIBO often occurs with other conditions, including celiac disease, chronic fatigue syndrome, ulcerative colitis, low thyroid function and – drumroll please – IBS.
What is IBS?
IBS stands for Irritable Bowel Syndrome. IBS can rear its ugly head in a number of ways and can be a challenge to diagnose. What may baffle you and your doctor is that your gut tissue can look completely normal, even though you have ongoing symptoms that are compromising your quality of life.
The hallmarks of IBS include miscommunication between your gut and brain. The brain and gut communicate 24/7 via multiple pathways. If your digestion is compromised, you’re more likely to feel stressed and anxious and vice versa.
Many people with IBS also have hypersensitivity in their gut. For example, normal levels of gas may register in the brain as pain. Or you may feel full – even painfully so – before you would choose to be finished with your meal.
Just like with SIBO, symptoms can vary from one person to the next. Your IBS symptoms might include:
- Belly pain
- Bloating and gas
- Diarrhea, constipation (or both – ugh!)
- General fatigue
Which risk factors overlap?
- Older age
- Narcotic use
- Use of proton pump inhibitors (antacid medication)
- Low hemoglobin (marker of iron deficiency)
What might cause you to have both SIBO and IBS?
There is one thing that can cause both SIBO and IBS – food poisoning or traveler’s diarrhea. If you get a bug – for example, at a restaurant or while traveling – your gut may go into overdrive to flush the pathogen out. Diarrhea, pain and cramping may follow suit. The pathogen can cause longer term issues with the nerves in the gut, which can develop into IBS and/or SIBO. More likely, several factors working together increase your risk of having SIBO and IBS. Many of our clients have multiple root causes.
And frustratingly, the two conditions can go hand in hand. If you’re not able to address all root causes, you can get stuck in a cycle of remission and recurrence of these conditions. Let’s get to the bottom of this, once and for all! SIBO vs. IBS: how do you know?
- Ask your gastroenterologist for a SIBO breath test. The microorganisms are active, living critters and they release gasses, just like we do. However, they release different gasses that you can measure.
- After addressing SIBO and the root cause, you may still have IBS but many of our clients’ digestive symptoms resolve after addressing SIBO and they no longer have to manage IBS.
- If you don’t have SIBO, we help you look for other potential reasons for digestive upset such as food sensitivities, food allergies, low enzyme function, dysbiosis and more. We won’t stop digging!
Getting to the root cause(s)
It can be tricky to know how to take the right steps to relieve your symptoms if you don’t know yet what is causing you to feel so crummy to begin with. Effective interventions depend on knowing whether you have SIBO, IBS or both along with the root cause (or causes).
Some risk factors you cannot change: your age, your genetics and other health conditions. However, plenty of risk factors are modifiable. These might include:
- Changes in your gut bacteria
- Your diet
Your treatment plan should be comprehensive and include strategies well beyond just food modifications. Since stress is so closely linked to digestive health, finding strategies that reduce stress for you is key.
It is important to find the right strategies that feel good to you. If you’re not enjoying or buying into the yoga or the meditation that you’re trying, it’s probably not going to be as effective. You might try deep breathing, scheduling a massage or acupuncture session or enjoy soothing music while having a luxurious soak in the bath. Strategies to improve your symptoms and quality of life go far beyond the kitchen. Together, we can help you map out a plan to address why you are having SIBO and IBS and from there, get long-term results with the right interventions.