Small intestinal bacterial overgrowth (SIBO) is a common condition which causes a range of digestive symptoms.
SIBO is difficult to diagnose so we don’t know exactly how common it is. It is also thought that many people do not report the symptoms to their doctor and even if they do – the symptoms are similar to Irritable Bowel Syndrome. This means that you may not be diagnosed correctly (1).
What Is SIBO?
SIBO is occurs when you have an abnormally high level of bacteria is your small bowel (6). This is the part of your gut which does the majority of your digesting.
Normally, this bacteria lives in your colon and not your small bowel.
What Are The Symptoms of Small Intestinal Bacterial Overgrowth?
If you have this condition then you will typically experience diarrhoea, flatulence, stomach pain and bloating (6).
What Causes SIBO?
when an increased or abnormal amount of bacteria is found in the small bowel. It can often cause symptoms of malabsorption such as stomach pain, bloating, diarrhoea and weight loss (1).
How To Get A SIBO Diagnosis
Current testing for SIBO involves a breath test (1).
Doctors will use both a hydrogen and methane breath test to both diagnose and then guide their choice of antibiotic (8).
You can read more more about breath tests here.
How To Treat Of SIBO
If you have a diagnosis of SIBO then you will need antibiotics from your doctor to treat this (8).
However, only 68% of people have been found to have symptom improvement or relief (1). This is likely to be partly due to not knowing exactly what sort of bacteria is causing the problem and so the antibiotic can not be matched specifically (2).
There is a 3 step approach to SIBO treatment (2);
- Prevention of a further occurrence
The Specific Carbohydrate Diet
The specific carbohydrate diet claims that by consuming only carbohydrates which feed good bacteria, the bad ‘overgrowth’ bacteria will die off (3). Unfortunately, the diet is extremely difficult to follow and has no scientific proof to work in SIBO at all.
The Elemental Diet
The elemental diet is a diet which provides all your food components broken down into their simplest forms. The diet is liquid in form and needs to firstly be advised by a specialist dietitian and then prescribed by your GP.
The diet works as the broken down liquid food is absorbed at the start of your digestive system. It therefore avoids making its way down towards that bad gut bacteria, providing it with more food. The bad bacteria then starves and dies away (2).
In one study, 85% of the participants had normal breath tests after 22 days on the elemental diet (4).
Although there is good evidence behind this diet, it is generally only used for individuals that do not tolerate the antibiotics. This is because of the cost and difficulty of sticking to the liquid elemental diet (2).
The Low FODMAP Diet
There is currently no scientific studies looking at the use of the low FODMAP diet in SIBO. Therefore it is difficult to say just how affective the diet would be.
If you have symptoms of SIBO then please speak to your Doctor. It is important that you firstly get a diagnosis and that any underlying medical cause is addressed.
After this period, your doctor will discuss treatment options with you and if an elemental diet is a possible solution then you will need to see a specialist dietitian. Remember, a specialist dietitian can also help to address and manage any underlying causes e.g. IBS.