Is it IBS, or SIBO?

Irritable Bowel Syndrome (IBS) and Small Intestine Bacteria Overgrowth (SIBO) are two common gut issues with similar symptoms. Unfortunately, SIBO is often misdiagnosed as IBS and in turn, treated incorrectly. In fact, it is estimated that up to 80% of those suffering from IBS actually have SIBO!

What is IBS?

IBS is the most common gut disorder. However, IBS is not a disease. By definition, a disease has to have a known cause. IBS is characterized by an accumulation of unexplained digestive symptoms. Common symptoms include bloating, abdominal pain, cramping and irregular bowel movements. However, there is always an underlying imbalance or overgrowth that triggers these symptoms in the first place. The problem with conventional medicine is that the investigation often stops at the IBS diagnosis. You may be told to follow a low FODMAP diet, or to take prescription medications. But this simply puts a bandaid on the problem, not addressing the underlying conditions causing the symptoms in the first place.

What is SIBO?

SIBO occurs when there is an overpopulation of bacteria in the small intestine. This overgrowth can cause escalating symptoms including, malabsorption, and gas + bloating. There are actually three different types of SIBO—hydrogen-dominant, methane-dominant, and sulfide-dominant—which refer to the main type of gas produced by the unwelcome bacteria in your small bowel. Common causes of SIBO include low stomach acid, H. Pylori infection, and impaired digestion. SIBO is characterized by nutrient malabsorption, poor digestion, excessive bloating immediately after eating, nutrient deficiencies and upper abdomen pain. While a higher fiber diet is commonly recommended when dealing with IBS, it often worsens digestive symptoms when the root cause is SIBO. Some also notice a worsening of symptoms in the evening versus the day.

Is treatment the same?

Both IBS and SIBO can be treated using protocols targeted at correcting the root cause of the issue. This is often individualized and specific to the person being treated. In the case of SIBO, specific herbal antimicrobials are used depending on the type of SIBO someone has! In certain situations an elemental diet is needed to starve the bacteria and allow for bowel rest + healing.

So which one could I have?

The best way to differentiate between the two is through functional testing. The GI-Map can indicate a SIBO overgrowth, however, it can not diagnosis it. A SIBO breath test must be done to confirm if it is in fact SIBO, and identify which type of SIBO it is.

When it comes to gut issues – test don’t guess! Getting to the root cause of your gut upset is the best way to relieve your symptoms for good.

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Written by Julie Balsamo & Rebecca Russel