60% of people diagnosed with IBS have this disease instead
Those of you who have had telephone consultations with the Helpline Team here at Immunecare may have heard us talking about SIBO - Small Intestinal Bacterial Overgrowth as an alternative diagnosis for some cases of IBS. As a Company we have recognised this for the past 15 years, and it is now coming more to the forefront. Unfortunately, most GPs have never heard of it. I have even spoken to private Functional Doctors (those that are Medically trained and qualified, but have an Holistic philosophy on treatments.
This is the story of a SIBO sufferer:
Those of you who have had telephone consultations with the Helpline Team here at Immunecare may have heard us talking about SIBO – Small Intestinal Bacterial Overgrowth as an alternative diagnosis for some cases of IBS. As a Company we have recognised this for the past 15 years, and it is now coming more to the forefront.
Unfortunately, most GPs have never heard of it. I have even spoken to private Functional Doctors (those that are Medically trained and qualified, but have an Holistic philosophy on treatments.
This is the story of a SIBO sufferer:
“For ten years I looked pregnant. Between 1997 and 2007 my bloated belly peered over my waistband as I tried to hold it in. I wasn’t overweight or malnourished. Instead, doctor after doctor gave me the same diagnosis: Irritable Bowel Syndrome, which of course is no real diagnosis at all. It just means that they cannot find anything functionally wrong.
About 60% of people that have been diagnosed with IBS actually have this horrible condition instead. Its chief symptoms, apart from bloating, are constipation or diarrhoea, with malabsorption, pain, fatigue and sometimes depression joining in.
It is hardly taboo – several celebrities have revealed they suffer from IBS: actress Kirsten Dunst and model Tyra Banks to name a few. But are we being told the truth? Do we all really have IBS?
Four years ago, I began to suspect not. All my symptoms had intensified, in particular, the pain. I tried cutting out some of the known triggers: wheat, alcohol and cheese. I tried yoga and meditation – stress is thought to worsen the condition. But still I looked pregnant, and I grew suspicious something else was wrong. Desperate and fed up, I went to my GP and begged to be referred to a gastroenterologist.
He prodded at my protruding belly in search of cysts or tumours. He asked about my symptoms and how long I had suffered from them. He ran blood and urine tests to check for diabetes or signs of various cancers. Crucially, he took me seriously.
Having eliminated the most serious possible causes, he referred me for a test at London’s St. Thomas’ Hospital, for something called Small Intestinal Bacterial Overgrowth (SIBO).
The test involved drinking a lactulose solution and waiting twenty minutes. Then every 20 minutes for two hours breathing into a tube to measure the hydrogen and methane levels in my breath. This test can be done at home, and you do not need a Doctor’s prescription for it.
The first test was positive. I had never heard of it. So back at home, I plundered Google in search of answers. The same symptoms kept coming up as for IBS: constipation, diarrhoea, bloating, pain and fatigue. Why had none of the doctors I had seen ever mentioned this condition?
So what is it? And how many other IBS sufferers could in fact have SIBO? SIBO is a condition whereby the small intestine, which normally has very few bacteria in it (compared with the Colon or Large Intestine), becomes colonised with too many bacteria. In healthy people, stomach acid and the waves of muscular contraction in the small intestine flush most bacteria into the bowel. But with SIBO that doesn’t happen.
Why? Mostly, it is because of four different types of underlying conditions.
- The first is when stomach acid is not produced because of gastric surgery, such as a bypass, or old age.
- Another vulnerable group is people who’ve had multiple operations on their intestines with parts cut out or joined together, such as those with Crohn’s disease, or adhesions from endometriosis.
- Thirdly there are people who have other gut disorders.
- And, finally, people who have had multiple courses of antibiotics.
In my early 20s I had a succession of antibiotics for tonsilitis – eventually they were removed – which may explain my diagnosis. But, there are also those who do not fall into any of these categories who think they have IBS but test positive for SIBO, with none of the underlying factors.
A 2005 study published in the journal of Alimentary Pharmacology and Therapeutics found a staggering link between the condition: 98 IBS sufferers were given the hydrogen breath test for SIBO and 64 tested positive. This suggests a huge proportion of those who think they have IBS actually suffer from SIBO.
SIBO can be cured, but it is not easy. Firstly a low FODMAP diet should be undertaken for four weeks. This discourages growth of bacteria in the small intestine, and allows for proper gut motility to sweep away excess bacteria. At the same time, you can take antibiotics (Rifaxamin, Neomycin or Metronidazole) or natural antibiotics like Lactoferrin for two to four weeks. The jury is out on whether Probiotics help, but it is a good idea to take them once the courses of antibiotics are finished. Then you can retest using the breath test to see if you have got rid of the SIBO.
The treatment works. After a few courses of antibiotics my symptoms all but vanished. Concerned about taking them long-term, however, I started taking probiotics instead every day, and only taking antibiotics every year or so.
Sticking to the dietary guidelines is not easy when – as I do – you have a problematic cupcake obsession. But, annoyingly, limiting carbohydrates has proved to be the most effective way of managing the condition. Although I give in now and again, cutting out cake, I can report with some sadness, is the only way to avoid looking like I’m six months pregnant!”