SIBO: what it is, symptoms, causes and treatment

In addition to discomfort, this condition can cause malabsorption of nutrients. In this article, we explain what SIBO is, the related causes, as well as how it is diagnosed and treated.

SIBO: what is it?

SIBO, or Small Intestinal Bacterial Overgrowth, occurs when there is an abnormal increase in bacteria in a part of the bowel where these are usually present in lower quantities.
Under normal conditions, the small intestine completes food digestion and delivers nutrients to the body using enzymes and controlled quantities of gut microbiota. 
When there is bacterial overgrowth in this area, bacteria compete with the body for nutrients and may ferment carbohydrates prematurely, which can lead to gas, flatulence and bloating. SIBO may also cause malabsorption of essential fats and nutrients, such as vitamin B12 and iron, which can affect nutritional status. If the underlying cause is not treated, these symptoms can persist and become chronic.

SIBO: symptoms

The symptoms of SIBO can vary from person to person and, in many cases, are confused with other digestive issues. We list below some of the most common signs:

Bloating

Abdominal bloating is one of the most common signs. Many people experience abdominal pressure or distension, especially after meals.

Gas and abdominal pain

Excessive gas and abdominal pain or cramps are also common. This discomfort can be mild or more severe, and may recur throughout the day.

Changes in bowel function

SIBO can cause diarrhoea, constipation or a combination of the two. In some people, symptoms can last for weeks or months. In cases where the warning signs include blood loss, anaemia or prolonged changes in bowel function, the physician may recommend a colonoscopy to rule out other causes.

Fatigue and malabsorption

When nutrient absorption is impaired, symptoms can include fatigue, low energy and signs of nutritional deficiency. In some cases, weight loss or vitamin deficiencies can also occur. As some symptoms are similar to situations of food allergy/hypersensitivity, the physician may consider this possibility during the assessment.

SIBO: diagnosis

Glucose or lactulose breath tests are the most common methods. These tests measure hydrogen and methane in exhaled air, gases that can increase in the event of SIBO. The physician may also prescribe additional tests and exams to determine the cause of the symptoms and rule out other disorders. In some cases, the physician can also recommend an abdominal ultrasound to help rule out other causes for the symptoms.

SIBO: treatment

Treatment depends on the cause, severity of the symptoms and general condition of the patient.

Antibiotics

In many cases, the gastroenterologist may prescribe a specific antibiotic, selected according to the clinical condition. Self-medicating is not advised.

Dietary adjustments

The patient’s diet may also require some adjustments. A low-FODMAP diet (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) can help reduce discomfort in some people, but this should be recommended by a nutritionist to avoid unnecessary restrictions. Nutritional support can help define the best dietary plan for each case.

Treating the underlying cause

Treating the underlying cause is essential to reduce the risk of recurring episodes. In the case of constipation, altered intestinal motility, diabetes or another related disorder, this problem should be addressed simultaneously.

SIBO: take care of your gut health with Joaquim Chaves Saúde

SIBO is a treatable condition, but an accurate diagnosis and specialist care are essential to control symptoms and reduce the risk of recurring episodes. If you suffer from persistent bloating, gas, abdominal pain or changes in bowel function, seek a medical assessment.

At Joaquim Chaves Saúde, you can count on gastroenterology consultations, exams and tests that help identify the cause of your symptoms, with support from a multidisciplinary team whenever necessary. Schedule your consultation or test and take the first step towards getting the right care.