When it comes to gastrointestinal conditions, Irritable Bowel Syndrome (IBS) is commonly over diagnosed when the root of the problem is something entirely different that is both diagnosable and treatable.
Unfortunately, in recent years, Irritable Bowel Syndrome (IBS) has become a somewhat ubiquitous diagnosis. It seems as though anyone who has gas, stomach pain, diarrhea or constipation gets labelled with it, and is told that all they can do from now on is manage their symptoms or perhaps try food eliminations. This leaves people pecking away on the internet desperately trying to self treat with all manner of diets, probiotics, enemas - you name it.
IBS does of course exist, but studies show that a vast portion of those given this diagnosis in fact 30 - 85% of those diagnosed with IBS, actually have SIBO (small intestinal bacterial overgrowth) which can cause the exact same symptoms. WHAT!!??? Indeed, it is a major new area emerging in gastroenterology.
Thus it should then come as no surprise that I recommend you get tested for SIBO if you’ve been diagnosed with IBS, especially if you are having a hard time managing your symptoms and your quality of life is impacted. It’s treatable for goodness sake... life without bloating is in reach!!
What is SIBO?
SIBO is a gastrointestinal condition that arises when an abnormally high number of coliform bacteria appear in the small bowel. While it has the same symptoms as IBS (mainly diarrhea or constipation, gas, abdominal pain and bloating) it is treatable … there actually is a solution.
In order to understand SIBO, it helps to get some basics down in terms of how our intestines function.
The stomach liquifies food and then the small intestine breaks it down further so that nutrients can be absorbed across the lining into our bloodstream. Once this occurs, the excess waste moves into the large intestine, where the water is reabsorbed and a stool is formed. During this process, fermentation occurs and bacteria play a crucial role in this process.
In a healthy gastrointestinal tract, millions of bacteria are found in the large intestine, while only a tiny fraction is meant to be in our small intestines - and of only very specific types of bacteria. In SIBO, bacteria that is not supposed to be in the small intestine is living there and causing symptoms which result from the bacteria off-gassing methane and hydrogen (read: bloating) from munching on fiber and metabolizing it. This leads to the gas, bloating, cramping, diarrhea and/or constipation, even heartburn and stomach pain - all of which (and more) can be present in SIBO.
What causes SIBO?
Currently, we know that the main cause of SIBO is that the Migrating Motility Complex (MMC) is damaged and under-functioning. This is a microscopic movement of food DOWN through the digestive tract, so when damaged we can self inoculate getting bacteria that is normal to be found in the large intestine into the small intestine where it does not belong. A number of factors can damage your MMC - antibiotics, food poisoning, a bad round of stomach flu and possibly other health conditions and genetics. More research is on-going in these crucial areas.
Why is SIBO under diagnosed?
The truth is I don’t know. Naturopathic doctors are educated about it as are many family doctors and gastroenterologists in the US, the UK, Australia, but it is rare that Canadian doctors are SIBO literate. I cannot speak to why, but it has really got to change. On a positive note, I am observing that more and more patients who take their test results to their doctor are finding that their doctor has heard of sibo or is even somewhat informed. This is a great sign that things are starting to evolve in the right direction.
Visiting a licensed naturopathic doctor is the optimal approach when working towards getting a comprehensive diagnosis of your gastrointestinal issues. We play a vital adjunctive role in your care and are often diagnosing conditions and infections. Naturopathic doctors use various functional diagnostics (some out of the US, some Canadian) to assess for gastrointestinal conditions that are very rarely ordered by MDs in our country at this point in time. For SIBO specifically, you need a test kit that includes lactulose breath testing (not glucose) that is ordered by an ND or MD, however, it may be determined by taking a careful history that other tests are indicated.
When I work with SIBO patients I prescribe as per the current research typically involving antibiotics, botanical antibiotics and various other interventions that heal your gut. I have my SIBO patients go through a Preparation phase, an Eradication phase, then a gut healing Recovery phase. Sometimes other type of work/ assessment are also indication such as:
- Eradicating yeast
- Cleansing and restoring homeostasis in the digestive tract
- Healing the digestive tract to ensure optimal nutrient absorption
- Restoration of digestive enzymes and stomach acid
- Customized dietary and lifestyle recommendations
Consulting with Dr. Smith
If you live in Toronto and are unsure whether your IBS diagnosis is correct, book a consultation with Dr. Smith who will take your history and properly ascertain whether it makes sense to test for SIBO, or if your digestive issues may be tied to other conditions such as:
- Other types of dysbiosis
- Candida / yeast overgrowth
- Crohn’s Disease
- Ulcerative Colitis
- Gastro-esophageal reflux (GERD)
- Stomach/Intestinal Ulcers
- Colon Cancer
- Poor fat digestion/fat malabsorption
- True IBS!
Call (416) 929-0707 to book a complimentary 15-MINUTE meet and greet discussion with Dr. Smith, ND.
Dr. Smith has expertise in the emerging area of treating SIBO (and other gastrointestinal conditions), and is open to discussing your health goals and any questions you may have regarding your situation.