Bloating - Is it SIBO?

Small intestinal bacterial overgrowth, or SIBO, is a digestive disorder in which our gut microbiome is overgrown with naturally occurring bacteria. The biggest symptom of SIBO is bloating. Patients present with bloating, gas and burping, abdominal pain and all  complaints worsens throughout the day. However, it does not have to be the only symptom present. Other concerns I commonly see in my practice are constipation and/or diarrhea, abdominal pain, cramping, food sensitivities, headaches/brain fog, heartburn and previous or suspected IBS diagnosis. In fact, it is estimated that 70% of IBS patients also have SIBO.

When a patient presents with these symptoms, I rule out simple causes, such as constipation and dehydration. Dehydration is often an underlying cause of constipation, just as lack of fiber intake can be an easy fix for loose stool/diarrhea. 

If the bloating/symptoms worsen with foods high in easily fermentable carbohydrates - dairy products, beans and whole grain food products, this is another sign it may be SIBO. The bacteria digest the foods listed above and create gas as a byproduct, hence bloating being the most common symptom. 

Previous medical history also guides if SIBO is the causative factor to digestive upset. Frequent use of antibiotics, history of head injury (especially multiple), eating disorders, frequent exercise and hypermobility syndrome all increase the likelihood someone may develop SIBO. 

Based on the past history, current symptoms and physical exam I may recommend breath testing (the diagnostic tool for SIBO) or do a treatment trial of herbs to mitigate symptoms. Often, we are not only treating overgrowth, but also the root cause for the overgrowth. 

Think you may have SIBO? Find a naturopathic doctor to work with to treat the overgrowth and the root cause of dysfunction.