Small intestinal bacterial overgrowth (SIBO) and irritable bowel syndrome (IBS) are two conditions that are closely linked and often coexist in individuals. Both conditions can cause similar symptoms, such as abdominal pain, bloating, gas and diarrhoea or constipation. However, while IBS is a functional disorder of the gut and often a diagnosis when there is no other known cause for the digestive symptoms a person is experiencing, SIBO is a specific condition where there is an overgrowth of bacteria and archaea in the small intestine.
Irritable Bowel Syndrome (IBS)
IBS is a common condition that affects millions of people worldwide, and it is more prevalent in women than men. It is characterised by chronic abdominal pain and discomfort, as well as changes in bowel habits. The exact cause of IBS is not known, but it is thought to be related to a combination of factors, including changes in gut motility, gut sensitivity, and the gut-brain axis.
Small Intestine Bacterial Overgrowth (SIBO)
SIBO, on the other hand, is a condition where there is an overgrowth of bacteria in the small intestine. This overgrowth can occur due to a variety of factors, including low stomach acid, a weakened immune system, and changes in gut motility. The bacteria that overgrow in SIBO can ferment carbohydrates and produce gas, leading to symptoms such as bloating, gas, and abdominal pain.
The Relationship Between SIBO and IBS
The link between SIBO and IBS is well established, with studies showing that up to 84% of individuals with IBS also have SIBO (1). In fact, some experts suggest that SIBO may be the underlying cause of IBS in many cases. A study published in the Journal of Clinical Gastroenterology found that 82% of IBS patients who were treated for SIBO saw an improvement in their symptoms (2).
If you are a woman suffering from painful symptoms and have been told that you just have IBS and there is nothing you can do about it, it is important to understand that SIBO may be contributing to your symptoms. SIBO can be diagnosed through a breath test and treated through a combination of antibiotics, diet, and lifestyle changes.
SIBO treatment and diet options
The first step in treating SIBO is to address any underlying factors that may be contributing to the overgrowth of bacteria, such as low stomach acid or changes in gut motility. This may include taking supplements to support stomach acid production or addressing any underlying autoimmune conditions.
Next, a specific diet that is low in fermentable carbohydrates, such as the low FODMAP diet or SIBO Bi Phasic Diet, can be helpful in reducing the overgrowth of bacteria and relieving symptoms. A study published in the Journal of Gastroenterology and Hepatology found that a low FODMAP diet led to a significant improvement in symptoms in IBS patients with SIBO (3).
In addition to dietary changes, antibiotics, antimicrobials or the Elemental Diet may be prescribed to target the overgrowth of bacteria and/or archaea in the small intestine. However, it is important to note that the killing treatment phase should be used in conjunction with diet and lifestyle changes for the best results, and not as a standalone treatment. A study published in the Journal of Gastroenterology found that a combination of antibiotics and a low FODMAP diet was more effective in treating SIBO and improving IBS symptoms than antibiotics alone (4).
Lifestyle changes can also play a key role in treating SIBO and IBS. Stress management techniques, such as mindfulness and meditation, can help to reduce inflammation and improve gut motility. Regular exercise and adequate sleep are also important for overall gut health.
Next steps
SIBO and IBS are closely linked conditions that often coexist in individuals. While IBS is a functional disorder of the gut, SIBO is a specific condition where there is an overgrowth of bacteria in the small intestine. If you are suffering from painful symptoms and have been told that you just have IBS and there is nothing you can do about it, it is important to investigate if SIBNO is the underlying cause of them. SIBO can be diagnosed through a breath test and treated through a combination of antibiotics, diet, and lifestyle changes. It is important to work with a healthcare provider who is experienced in treating SIBO to develop a personalized treatment plan that addresses your specific needs. If you are ready to learn more about SIBO, sign up to my online SIBO course today. Learn more here.
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The Relationship Between SIBO and IBS References
- Pimentel, M., Chow, E. J., Lin, H. C., Mirocha, J., & Kane, S. V. (2003). Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome: a double-blind, randomized, placebo-controlled study. American Journal of Gastroenterology, 98(9), 412-419.
- Pimentel, M., Park, S., Mirocha, J., Kane, S., & Kong, Y. (2006). The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial. Annals of Internal Medicine, 145(8), 557-563.
- Staudacher, H. M., Whelan, K., Irving, P. M., Lomer, M. C., & Waring, P. W. (2011). Mechanisms and efficacy of dietary FODMAP restriction in IBS. Nature Reviews Gastroenterology & Hepatology, 8(10), 709-715.
- Pimentel, M., Lembo, A., Chey, W. D., Zakko, S., Ringel, Y., Yu, J., & Mareya, S. M. (2011). Rifaximin therapy for patients with irritable bowel syndrome without constipation. New England Journal of Medicine, 364(1), 22-32.
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