Irritable bowel syndrome (IBS) is one of the most common digestive disorders in our modern world with symptoms of abdominal pain, discomfort, irregular stool passage and bloating to name a few. My experience in clinical practice has also painted it to be the umbrella you’re placed under when all pathology testing comes back ‘normal’ and you’re told it is all in your head.

So if nothing is actually “wrong” with you, why then without fail do you get asked if you’re pregnant at least once per week, live with your pants cutting into you by the afternoon, or constantly need to excuse yourself due to gas or a sudden urge.

Well there is more to the IBS umbrella than the medical community would have you believe and that’s what I’d like to share with you today.

Research has shown that up to 84% of IBS cases are actually SIBO or SIFO – Small Intestinal Bacterial/Fungal Overgrowth especially if you are female, of older age, a proton-pump inhibitor (PPI) user, have low haemoglobin or regularly suffer with bloating or flatulence. Other common signs and associated symptoms are below:

• Constipation, diarrhoea or both
• Restless legs at night
• Bloating within 1 hour of a meal
• Digestive symptoms improve on antibiotics
• Fibre can make you feel worse
• Burping, reflux of GORD
• Lactose intolerance
• Fructose intolerance
• Gluten intolerance
• Fibromyalgia or unexplained joint pain
• Skin rashes
• Asthma or other respiratory issues
• Chronic bladder pain
• History of food poisoning or traveller’s diarrhoea
• History of B12 deficiency
• Foul smelling gas
• Food sensitivities
• Iron deficient with no known cause

Ok – so now we have a new and potentially more confusing title, what are we actually talking about?

Well, the bulk of our microbiome, or gut bugs, should reside in the large intestine/colon and ideally represent a delicate rainforest comprised of various bacteria, fungi, viruses and other organisms that work together to confer an array of benefits to the host, us, from mucus production to protect and feed the cells of the colon, to energy production, vitamin synthesis and immune regulation. Sometimes, however, these bugs can travel upstream for a number of reasons and inhabit the small intestine, which is absorptive – meaning it breaks down and absorbs foods and nutrients.

With proliferation of bacteria in this region we lose digestive capability of many of our enzymes and damage can occur to the sponge-like surface of the intestine resulting in malabsorption, nutrient depletion and potentially an overactive immune response resulting in food intolerances.

Further to this the bacteria consumes our food and produces gas, often methane – bring on the rotten egg smell, which gets trapped causing pain or forces its way up – belch, or down – flatulence.

Reasons why it happens

• Dysfunctional ileocecal valve, namely the door between the small and large intestine
• Disrupted or lack of migrating motor complex, which sweep out any accumulation of bacteria from the small intestine in-between meals
• Post infectious gastroenteritis
• Overconsumption of simple sugars/carbohydrates, providing a perfect feeding ground
• Medications such as PPIs, opiates, beta agonists or calcium channel blockers
• Chronic stress, often resulting in reduced stomach acid and reduced motility (movement) of the intestine creating stagnation
• Scarring or adhesions from surgical intervention

If this all sounds familiar to you where do you go from here?

SIBO is most accurately diagnosed via functional breath testing, looking for presence of common gas produced by the critters now inhabiting the small intestine region. From there we start work to send them back to where they came from and leave you with your pants still happily done up at the end of the day.

Like to know more?

Check out my testing options here, or book a consultation with me for a comprehensive digestive health analysis.