Feeling bloated or constipated? The likely culprit – Part 2
Written by Anil Bajnath, MD
Dear Longevity Insider,
In SIBO, the bacterial overgrowth is typically not very big in size. The most common bacteria found in SIBO is small-colony (type of) bacteria. Of those, the most common type that we see is methane-producing bacteria. If you produce too much methane gas, it can cause constipation and also contribute to your gassiness. The methane produced can also irritate the gut lining which can cause SIBO symptoms to worsen.
SIBO is similar to irritable bowel syndrome (IBS). You see, SIBO causes disruptions to the movement of food through your gastrointestinal (GI) tract. SIBO can also cause inflammation and pain. SIBO does not always show up on a stool test since many SIBO cases do not produce SIBO bacteria in the stool.
SIBO can also be associated with small intestinal yeast overgrowth (SIYO) also known as small intestinal fungal overgrowth (SIFO). SIYO and SIBO often occur in conjunction with one another. SIBO and SIYO also lead to an impaired immune system, inflammatory responses, and nutrient malabsorption.
IBS & SIBO
In my practice, we have noticed that many patients that come to see me with IBS complaints have SIBO. When diving down to the root cause of why a person has IBS, SIBO is a common culprit. The pathogenesis of IBS, once thought to be largely psychogenic in origin, is now understood to be multifactorial.
SIBO is estimated to occur in 15% of otherwise healthy people, with SIBO prevalence rising to 45–90% in IBS patients. SIBO leads to carbohydrate malabsorption and can cause osmotic diarrhea, leading to small-bowel distension, bloating (gas), urgency, and worsening of IBS symptoms. SIBO has been associated with carcinoid tumors. SIBO is likely to cause systemic manifestations of IBS. It also causes intestinal dysmotility, and SIBO-induced carbohydrate mal-absorption worsens lactose intolerance. SIBO can lead to a vicious cycle involving SIBO and the IBS symptoms that SIBO causes.
FUNCTIONAL & PERSONALIZED APPROACH TO SIBO
Although the medical profession has only recently begun to recognize it as a distinct entity, many functional medicine physicians will tell you that SIBO is common and that proper testing and treatment can resolve the condition. Some popular tests include:
- Duodenal aspirate cultures.
- Lactulose or glucose breath tests.
In duodenal aspirate cultures tests, SIBO is discovered by placing a tube into the small intestine and withdrawing fluid for cultures. Single or multiple samples may be taken from the stomach, duodenum, jejunum, or ileum, depending on your SIBO symptoms.
This test has a very high level of accuracy in diagnosing SIBO because it actually tests for SIBO directly in the small intestine.
Lactulose or glucose breath tests are done to diagnose SIBO indirectly. SIBO is discovered by looking for 1) elevated levels of hydrogen and/or methane gas in the breath, 2) the presence of SIBO symptoms, or 3) both. SIBO can be present even if test results are negative (normal), because SIBO occurs intermittently. A positive test result means that SIBO is present, but a negative test result does not necessarily mean SIBO is absent.
SIBO is nothing to dismiss, but I encourage everyone to consult with their primary physicians about getting tested.
To your longevity,
Anil Bajnath MD
CEO/Founder, Institute for Human Optimization
Chief Medical Officer, Longevity Insider HQ