What is SIBO?
SIBO occurs when bacteria that normally reside in the large intestine migrate and multiply excessively in the small intestine. This overgrowth can interfere with nutrient absorption and lead to various gastrointestinal symptoms. Factors contributing to SIBO include impaired gut motility, structural abnormalities, and certain medical conditions.
Where can I get help for SIBO in Ireland?
At GastroLife, we offer comprehensive diagnostic testing for SIBO and other gut health concerns. Get in touch with our expert team to start your journey toward better digestion and long-term wellness.
How is SIBO diagnosed?
The most common diagnostic method for SIBO is the hydrogen and methane breath test. This non-invasive test measures the levels of hydrogen and methane gases produced by bacteria in the small intestine after ingesting a sugar solution. Elevated levels of these gases can indicate bacterial overgrowth.
What types of SIBO exist?
There are three types of SIBO, based on the gases the bacteria produce:
- Hydrogen-dominant SIBO – often causes diarrhoea
- Methane-dominant SIBO (now known as IMO) – more likely to cause constipation
- Hydrogen sulfide SIBO – often causes very foul-smelling gas and may present with both diarrhoea and constipation
What are the common symptoms of SIBO?
Symptoms of SIBO can vary but often include:
- Bloating and abdominal distension
- Gas and flatulence
- Abdominal pain or discomfort
- Diarrhoea or constipation
- Nausea
- Fatigue
- Unintentional weight loss
- Nutrient deficiencies, such as vitamin B12 deficiency
These symptoms can overlap with other conditions, making accurate diagnosis and consultation with a medical professional crucial.
What causes SIBO?
Several factors can contribute to the development of SIBO, including:
- Impaired gut motility (e.g., due to diabetes, hypothyroidism, or scleroderma)
- Structural abnormalities in the gastrointestinal tract
- Use of certain medications, such as proton pump inhibitors
- Previous gastrointestinal surgeries
- Chronic pancreatitis
- Immune system disorders
Is SIBO the same as IBS?
No, but the two are closely linked. Research shows that up to 60–80% of people with IBS may actually have SIBO. Diagnostic testing is crucial to get the right diagnosis and treatment.
Is SIBO contagious?
No, SIBO is not contagious. It develops due to internal imbalances or structural issues, not from contact with another person.
Can stress cause or worsen SIBO?
Yes. Chronic stress can negatively affect digestion, gut motility, and immune function, making the small intestine more susceptible to bacterial overgrowth.
Is SIBO more common in women?
Yes. Women are statistically more likely to have SIBO, possibly due to higher rates of IBS, hormone fluctuations affecting motility, and increased likelihood of autoimmune conditions.
Can hormonal imbalances affect SIBO?
Absolutely. Hormones such as progesterone and oestrogen influence gut motility. Hormone fluctuations can slow gut transit during certain phases of the menstrual cycle which can worsen symptoms or contribute to SIBO in women.
Does SIBO always cause weight loss?
Not always. Some patients lose weight due to malabsorption, while others gain weight due to altered gut metabolism or increased appetite caused by dysbiosis and inflammation.
Can exercise help manage SIBO?
Moderate exercise supports healthy gut motility and can reduce stress, which may help prevent recurrence. However, intense exercise during active SIBO treatment may increase inflammation or stress the body.
Are there long-term complications from SIBO?
If left untreated, SIBO can lead to:
- Chronic nutrient deficiencies (B12, iron, fat-soluble vitamins)
- Osteopenia or osteoporosis (due to malabsorption of calcium and vitamin D)
- Anaemia
- Neurological symptoms (from B12 deficiency)
- Systemic inflammation (Gut permeability)
Can alcohol worsen SIBO?
Yes. Alcohol can disrupt the gut microbiome and damage the intestinal lining, potentially worsening SIBO. Fermentable alcohols (beer, wine) can also feed the overgrown bacteria.
What is a prokinetic, and why might I need one?
The use of probiotics in SIBO treatment is controversial. While probiotics can be beneficial for gut health, they may exacerbate symptoms in some SIBO patients by introducing more bacteria into an already overpopulated small intestine. It’s advisable to consult with a healthcare provider before starting probiotics
Can food poisoning lead to SIBO?
Yes. One of the leading theories for post-infectious IBS (and SIBO) is that food poisoning damages the migrating motor complex (MMC), which is responsible for clearing the small intestine between meals.
Can SIBO affect mental health?
Yes. The gut and brain are closely linked via the gut-brain axis. SIBO can contribute to:
- Brain fog
- Anxiety
- Depression
- Mood swings
How is SIBO treated?
Treatment for SIBO typically involves:
- Antibiotics: Medications like rifaximin are commonly prescribed to reduce bacterial overgrowth.
- Dietary Changes: Implementing a low FODMAP diet can help manage symptoms by reducing fermentable carbohydrates that feed bacteria.
- Addressing Underlying Causes: Treating conditions that contribute to SIBO, such as improving gut motility or managing chronic diseases.
It’s essential to work with a healthcare professional to develop a personalised treatment plan.
Should I retest after treatment?
Yes, many practitioners recommend retesting 1–2 weeks after completing treatment to ensure SIBO has been eradicated. Some practitioners however suggest a longer period. Retesting helps guide next steps and prevent recurrence.
Is SIBO linked to other conditions?
SIBO has been associated with various conditions, including:
- Irritable Bowel Syndrome (IBS)
- Chronic fatigue syndrome
- Fibromyalgia
- Rosacea
- Celiac disease
The relationship between SIBO and these conditions is complex and may involve shared underlying mechanisms.
Do I need to be gluten-free if I have SIBO?
Not necessarily, but many people with SIBO find they tolerate gluten poorly. Removing gluten during treatment may help reduce inflammation and support healing, especially if there is coexisting leaky gut or gluten sensitivity. It is advisable to consult with a medical professional before removing gluten completely from your diet.
Can I get SIBO from taking antibiotics?
Yes, ironically, overuse of broad-spectrum antibiotics can disrupt the gut’s natural bacterial balance and promote overgrowth in the small intestine, especially if taken without probiotics or follow-up care.
What kind of specialist treats SIBO?
SIBO can be managed by:
- Gastroenterologists
- Functional medicine practitioners
- Registered dietitians or clinical nutritionists with expertise in gut health
If you’re experiencing persistent gastrointestinal symptoms such as bloating, gas, abdominal discomfort, or changes in bowel habits, it’s important to consult a healthcare professional. Early diagnosis and treatment of SIBO can prevent complications like nutrient deficiencies and improve quality of life.
