Information on SIBO

SIBO, which stands for small intestine bacterial overgrowth, occurs when the level of non pathogenic bacteria we normally have in our small intestine increases beyond what it should be.  

SIBO is a common cause of Irritable Bowel Syndrome (IBS) and is often present when a person’s digestive symptoms don’t clear and/or worsen with well indicated dietary changes or supplements.

The bacterial overgrowth with SIBO impacts digestion and absorption and leads to an excess production of hydrogen and/or methane gas (through the fermentation of carbohydrates by the intestinal bacteria).  This gas production allows for effective diagnosis of SIBO through a hydrogen or methane breath test.  

The symptoms associated with SIBO include: gas, bloating, diarrhea, constipation, or alternating diarrhea and constipation, heartburn/reflux, nausea, and systemic symptoms including joint pain, low energy, skin concerns, headaches.  

SIBO is also likely occurring when digestive symptoms worsen when taking a probiotic that contains prebiotics, when there is a short term improvement in symptoms after taking an antibiotic, when constipation is worsened by increased fiber intake, when celiacs experience low improvement in digestive symptoms when following a gluten free diet, and when a person has chronic low ferritin with no other cause. 

Part of the concern with SIBO is low small intestine motility/movement which promotes bacterial overgrowth.  One way to address low motility is to aim to space meals apart by 4-5 hours and to drink only water in between meals.

The main way to address SIBO is to reduce carbohydrate intake.  Carbohydrates are the food/energy source for the intestinal bacteria and the fermentation of carbohydrates produces the gas which contributes to the digestive symptoms seen with SIBO.  As well, reducing the primary food source for the bacteria may support a reduction in the overgrowth of the bacteria.  The specific carbohydrate diet (SCD) and gut and psychology syndrome (GAPS) diet are considered the most effective dietary treatments for SIBO.