Have your ever experienced constipation, diarrhea or been bloated with gas and did everything from restricting foods you thought were causing the gas, taken probiotics to stop the gas, taken fibre, laxatives to anti-diarrheal medications and been diagnosed with irritable bowel syndrome (IBS) and nothing it working. It may that that they symptoms you are experiencing are due to an underlying gut imbalance called SIBO. Studies have shown that up to 70% of patients diagnosed with IBS in fact have SIBO 7,8.
SIBO is characterized by the abnormally high counts of multiple organisms in the small intestine. Common species associated with SIBO include streptococci, Bacteroides, Escherichia and Lactobacillus 9. Inflammation is caused by invasive strains of bacteria 10. Facultative anaerobes can injure the intestinal surface by direct adherence and production of enterotoxins. Aerobic bacteria produce enzymes and metabolic products that can induce epithelial cell injury 11.
SIBO can cause a host of problems in the intestine due to enterocyte damage resulting malabsorption of carbohydrates, fats, proteins and vitamins to production of toxins to altered small bowel motility 12-17.
Treatment of SIBO generally involves a course of antibiotics and dietary restrictions. Patients who suffer from recurrent symptoms after a course of antibiotic therapy may be considered for a promotility drug and/or further evaluated for an alternative diagnosis.