Your guide to Small Intestinal Bacterial Overgrowth or SIBO

Updated: May 11

Closely associated with irritable bowel syndrome, SIBO or small intestinal bacterial overgrowth is exactly that, an overgrowth of microorganisms that normally reside in the lower part of the gut (colon). Symptoms can be debilitating and unfortunately recurrence is common but anyone with gut issues, food sensitivities, autoimmune disorders and malabsorption symptoms (eg anemia) should be assessed for SIBO. Here's an important summary of this potentially devastating condition.

What are the symptoms and key indicators of SIBO?

Irritable bowel symptoms such a....

  • Bloating and gas

  • Belching and flatulence

  • Abdominal pain and/ or cramps

  • Diarrhea or constipation on both

Other symptoms include:

  • Heartburn

  • Nausea

  • Food senstivities

  • Headaches

  • Joint pain

  • Respiratory Symptoms

  • Skin reactions

  • Malabsorption symptoms eg. anemia, steatorrhea

  • Brain symptoms such as brain fog, poor memory, depression/anxiety

  • Note: Systemic symptoms are due to hyper-permeability of the gut causing malabsorption, toxin release into the blood stream and an inflammatory and immune response.

Key indicators include:

  • A dramatic but short term improvement in IBS or gut symptoms after a course of antibiotics.

  • Chronic gut symptoms occurring after a long term course of broad spectrum anti-biotics (eg. amoxicillin, penicillin, erythromycin, doxycycline, ciprofloxacin or norfloxacin).

  • Worsening of GI symptoms from probiotic use or consuming fermented foods.

  • Worsening of symptoms when increase fibre or take prebiotics (as food for commensal bacteria).

  • When someone with coeliac disease reports insufficient improvement from a strict gluten-free diet.

  • Development of chronic gut symptoms after taking protein pump inhibitors (usually used for reflux & heart burn eg. losec or omeprazole) or after taking opiates (eg. oxycodon, heroin, morphine, methadone, codeine and pethidine).

  • Chronic low iron or ferritin levels with no other cause.

  • Chronic gut symptoms after a bout of viral gastroenteritis or bacterial food poisoning (post-infectious IBS).

What disease and disorders are associated with SIBO?

  • Irritable Bowel Syndrome (IBS)

  • Inflammatory Bowel Disease (IBD)

  • Gastro-esophageal relfux (GERD)

  • Celiac and gluten sensitivity

  • Autism

  • Fibromyalgia

  • Acne rosacea

  • Diverticulitis

  • Interstitial cystitis

  • Restless legs syndrome

  • Diabetes

  • Hypothyroidism

  • Scleroderma

  • Cirrhosis & hepatic encephalopathy

So what increases your likelihood of SIBO?