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Alyssa Simpson RD, CDE, CLT
Alyssa Simpson

RD, CDE, CLT​

How Do I Know If I Have SIBO? Painful Signs To Watch Out For

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registered dietitian weight loss tips

Have you been struggling with digestive symptoms? Clients come to me all the time frustrated and confused by digestive problems like indigestion, bloating, cramps, diarrhea, constipation, and gas.

Many of them have been to doctors, only to be told that there’s nothing actually wrong with them.

It can be maddening!

Doctors can only look at the results of the tests they actually perform. Under-tested conditions like SIBO and IBS go unnoticed. And the frustrated patient continues to suffer unnecessarily.

So for the next few blog posts, I’m going to dive into SIBO — the symptoms, the diagnostic process, and the treatment options.

If you are struggling with unexplained digestive problems, SIBO could be the culprit. Let’s dive in!

What Is SIBO Anyway?

SIBO stands for Small Intestine Bacterial Overgrowth. Let’s break down what that actually means.

SI is for Small Intestine

The small intestine makes up one part of your digestive system. It’s basically a tube that when stretched out, would be about 20 feet long. Once your stomach has done its job of breaking down your food, the small intestine takes over. In this stage of digestion, your food is mixed with additional digestive juices and nutrients are absorbed into your bloodstream.

As these digestive processes happen, your small intestine moves your food along toward the large intestine.

B is for Bacterial

When you think about bacteria, you may remember your childhood case of strep throat or that time they pulled ALL the romaine lettuce from grocery store shelves — for weeks. But bacteria isn’t always bad. 

Your large intestine holds loads of beneficial bacteria that help digest your food, produce certain vitamins, and strengthen your immune system. You may have heard this referred to as your microbiome. And this is why we take probiotics — to keep the bacteria population in your large intestine healthy.

But before your food gets to your large intestine, it passes through your small intestine. And the environment there is very different. Your small intestine should not have a lot of bacteria.

O is for Overgrowth

Sometimes bacteria show up where they aren’t invited. In the case of SIBO, they are hanging out in your small intestine. In fact, they are having a party and bringing all their friends. That’s where the “O” in SIBO comes from. Your small intestines are not meant to house too much bacteria.

But when conditions are favorable, bacteria growth can get out of control. And you have SIBO.

What Are the Symptoms of SIBO?

Symptoms of SIBO can vary widely from person to person. Here’s a list of the most common:

  • Stomach pain or excessive feelings of fullness after eating
  • Ongoing feeling of fullness
  • Gas
  • Bloating
  • Cramps
  • Nausea
  • Diarrhea
  • Constipation
  • Indigestion
  • Loss of appetite
  • Unintentional weight loss

Just because you have some (or even all) of these symptoms doesn’t necessarily mean you have SIBO. But it’s a possibility you may want to explore with your practitioner. If SIBO goes unchecked, it can lead to poor nutrient absorption, vitamin deficiencies, weakened bones, kidney stones, and more unpleasantness.

How Do I Know If I Have SIBO?

If you suspect you have SIBO, your best bet is to see a practitioner who will test you for it. But ask first. Not all practitioners are on board the SIBO train. 

In my practice, I use the breath test to diagnose SIBO. This test is non-invasive and very effective. 

How does the breath test work?

When bacteria in your gut break down carbohydrates, they release the gases hydrogen and methane. The hydrogen and methane molecules travel through the bloodstream into your lungs. Then they leave the body through your breath. The SIBO breath test detects these methane and hydrogen molecules when you exhale.

In order to get accurate results from your breath test, it’s super important that you stick to the prescribed prep diet for 24 hours prior to the test. If you’re taking the test with me, I’ll make sure you know all the details! 

At the beginning of the test, you’ll breathe into a tube. Then you’ll drink a sweet drink. And no, you don’t get to choose which one. This drink is specially formulated for this test. It will provide carbohydrates for the bacteria to break down. Once they do, they’ll produce methane and hydrogen.

After you consume the drink, you’ll breath into the tube at regular intervals over the course of 3 hours. 

The results of this test can tell not only if you have bacterial overgrowth, but also the severity and location. Then if you’re working with me, we’ll use your test results to guide your personalized treatment. I’ve helped so many clients through this process that I can look at your results and know EXACTLY which medications and herbs will work best for your specific case of SIBO!

What Causes SIBO?

Research is still catching up with the causes of SIBO. But there are conditions that can contribute to this bacterial overgrowth. 

Bacteria multiply in the right conditions. And when conditions in your small intestine are favorable to bacterial growth, you get SIBO. 

Many things can lead to these prime bacterial growth conditions including:

  • Compromised immune function
  • Unbalanced pH in your small intestine
  • A small intestine that isn’t efficiently moving the food through
  • Low levels of stomach acid (This is more common than you think)
  • Physical abnormalities of the small intestine

And once the bacteria start to multiply out of control, the symptoms of SIBO show up. 

But the symptoms of SIBO don’t end with your small intestine.

Anything that goes wrong at one stage in your digestion affects everything else down the line. If you have problems in your small intestine, the food isn’t going to be broken down properly. Then when it reaches your large intestine, you’ll likely experience symptoms like diarrhea or constipation as well.

How Do I Treat SIBO?

Our automatic response when we are in pain is to focus on getting that pain to stop. And many of our modern medicines are designed to do just that. Medications often focus on relieving or masking symptoms. 

But symptoms are always a clue. Our bodies use discomfort to tell us that something isn’t working properly and needs our attention.

As a functional nutritionist, my goal is always to find the root cause of your symptoms. SIBO causes lots of uncomfortable (and sometimes embarrassing) issues. And there are definitely things that we can do to get you feeling better quickly. But it’s important to figure out what caused the bacterial overgrowth in the first place.

Once we address the root cause of your symptoms, we can treat your SIBO with a personalized combination of medication and diet. The SIBO diet can be complicated. But stay tuned! Next week’s blog post will break down the do’s and don’ts of the SIBO diet.

If your digestive problems are interfering with your life, let’s connect. I’m committed to helping you find your root cause and finally get relief.

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