Irritable bowel syndrome has been a diagnoses of exclusion for many years. If the symptoms are severe enough you are referred for a colonoscopy or an endoscopy, and if tests are clear you are given the diagnosis. If the symptoms are mild enough, no testing is done and the diagnoses is given. This is an umbrella term however. In my practice I see varying causes of IBS since we are looking at the root cause. SIBO, or small intestinal bacterial overgrowth, is one very common cause of IBS. MDs do not have access to other GI tests like a SIBO breath test, or lack knowledge that SIBO is something that can be treated. I see many people with irritable bowel syndrome that show typical signs of SIBO. We test for it and treat accordingly. But WHY do they have it is the big question?
Symptoms of SIBO
Common symptoms of SIBO are bloating, either with no known trigger food or very predictable trigger foods such as garlic, onion, greens, apples etc, abdominal pain, heartburn, either chronic constipation or diarrhea. Other associated conditions are rosacea, cystic acne, chronic pain, IBD, and even hypothyroidism! The list goes on. This is why I ALWAYS ask you about your gut!
What Causes SIBO
There are many causes of SIBO that have been shown but I want to point out the most researched and most common causes. One of these may relate to you.
Food poisoning - aka bacterial gastroenteritis. This is actually the #1 cause of SIBO. When you get food poisoning your body produces certain antibodies that decrease the motility of your gut. The wave of motility is called your migrating motility complex (MMC) and it is a very important housekeeping function of your gut to clean everything out in the directly of your bowels. When the MMC is disrupted certain “bad” bacteria in your large intestines can ascend upwards into your small intestines and start fermenting foods they aren’t supposed to (aka SIBO). Note - if you’ve had food poisoning once you are more likely to get it again due to the production of these antibodies so please be careful.
Stress - This is the most common cause I see in practice. When we have chronic stress our bodies are in fight or flight mode and not rest and digest mode. This leads to a decrease in stomach acid, digestive enzymes and bile production. Stomach acid and enzymes suppress the growth of bacteria and they are also helpful in stimulating the MMC. Stress also affects the enteric nervous system (that gut-brain connection) which stimulates the MMC.
Abdominal strictures or adhesions - Scar tissue can occur from abdominal surgery, Crohns or Colitis or even endometriosis. The scar tissue then interrupts the proper flow of the gut, aka the MMC.
As you can see all those causes have an affect on the MMC in our gut. The list does go on unfortunately including issues such as hypothyroidism, opiate use and even traumatic brain injury.
If you suffer from the above symptoms, have been diagnosed with irritable bowel syndrome but given no treatment, or have digestive issues and have dealt with any of the issue above do not hesitate to get in touch. Let’s get to the root cause of your digestive concerns and help you feel better for good!
In health & happiness,
Dr. Karen