In SIBO, bacteria that are normally found in the colon migrate to or overgrow in the small intestine, where they ferment carbohydrates from food, producing gas and toxins. This leads to painful, stuck gas and bloating anywhere from 20 minutes - 1 1/2 hours after meals. SIBO irritates the lining of the small intestine where most nutrients are absorbed so can lead to malabsorption in addition to inflammation and damage to the gut lining. Common Symptoms Include:
Bloating (especially after meals) Trapped gas and belching Abdominal pain or discomfort Diarrhea, constipation, or both Nausea Heartburn or acid reflux Fatigue Nutrient deficiencies Weight gain
SIBO is the most common underlying cause of IBS (Irritable Bowel Syndrome).
Causes / Risk Factors Food poisoning (post-infectious IBS) Hypothyroidism Dysbiosis (gut flora imbalance) Chronic stress/anxiety Scar tissue from abdominal surgery Traumatic brain injury Crohn’s disease Use of PPIs or antibiotics
Diagnosis SIBO is diagnosed using a lactulose or glucose breath test, with lactulose being the preferred option. Prior to testing, patients follow a 1–2 day preparation diet to improve accuracy. Dr. King provides a home test kit for convenience. On the day of the test, you drink a lactulose solution and collect breath samples every 20 minutes over a 3-hour period. Reputable labs measure hydrogen, methane, and carbon dioxide levels—elevations in hydrogen or methane indicate bacterial overgrowth in the small intestine.
Treatment
SIBO is a symptom of an underlying imbalance. It does not resolve until the underlying imbalance is corrected. Antimicrobial therapy and Low FODMAP diets are used to improve symptoms, but do not resolve SIBO. Addressing the root cause, such as dysbiosis, thyroid issues, anxiety, stress, and food poisoning, is necessary for it to permanently resolve.
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