What exactly is SIBO, and how serious is it?

Small Intestinal Bacterial Overgrowth (SIBO) is a condition where an excessive number of bacteria accumulate in the small intestine, leading to digestive discomfort and nutrient malabsorption. While bacteria are a normal part of the digestive system, they are primarily found in the large intestine.

When an overgrowth occurs in the small intestine, it can interfere with normal digestion and cause a range of symptoms, including bloating, diarrhoea, constipation, abdominal pain, and gas. SIBO is often associated with underlying conditions such as irritable bowel syndrome (IBS), Crohn’s disease, coeliac disease, and diabetes, as well as anatomical abnormalities or previous gastrointestinal surgeries.

The causes of SIBO are linked to impaired motility of the small intestine, which allows bacteria to remain in the area longer than they should. Normally, wave-like contractions, known as peristalsis, help move food and bacteria through the digestive tract.

If this process is disrupted due to nerve damage, structural abnormalities, or chronic illnesses, bacteria can multiply excessively in the small intestine. Other risk factors include chronic use of proton pump inhibitors (PPIs), which reduce stomach acid and create an environment where bacteria can thrive, and conditions that slow digestion, such as hypothyroidism.

Diagnosis of SIBO is often made using a breath test, which measures hydrogen and methane gases produced by bacteria in the small intestine. A high level of these gases suggests bacterial overgrowth.

Treatment typically involves a combination of antibiotics or antimicrobial herbs to reduce bacterial levels, dietary modifications to limit fermentable carbohydrates that feed bacteria, and lifestyle changes to promote healthy digestion. The low FODMAP diet is commonly recommended to help alleviate symptoms, along with prokinetic agents to improve gut motility.

Managing SIBO effectively requires addressing both the bacterial overgrowth and the underlying causes to prevent recurrence. Since relapse is common, long-term strategies such as maintaining a balanced diet, optimizing gut health, and managing conditions that contribute to poor digestion are essential. Consulting a healthcare professional is crucial for accurate diagnosis and tailored treatment, ensuring a comprehensive approach to restoring digestive health and preventing future complications.