Your IBS could actually be SIBO says expert - symptoms to spot
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The condition in question is known as Small Intestinal Bacterial Overgrowth (SIBO) and occurs when too much bacteria grows in the small intestine. This bacterial overgrowth, which can be of both good and bad bacteria, subsequently causes a range of uncomfortable symptoms. The problem, say experts such as Dixon, is that patients are often misdiagnosed with IBS instead of SIBO. In fact, so widespread is this misdiagnosis that studies suggest around 80 percent of patients with IBS actually have SIBO. As the condition is comparatively unknown questioned Dixon on how to tell SIBO apart from IBS and how the condition is treated.

Regarding symptoms, the main difference between IBS and SIBO is bloating. Although IBS also causes bloating, Dixon said: “With SIBO the bloating is higher up because it’s in the small intestine which is above the large intestine so the bloating is right under the ribs.”

In contrast, with IBS the bloating is further down due to the positioning of the large intestine.

On the bloating, Dixon added: “People tend to bloat very quickly after food, and it tends to be after carbohydrate rich foods.”

Other symptoms of SIBO include nausea and acid reflux, these symptoms can get worse if a patient is diagnosed with IBS instead of SIBO.

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What happens if the SIBO is left untreated?

Since there could be thousands of patients who have been misdiagnosed with the wrong condition, asked what the ramifications could be regarding potential complications of leaving SIBO untreated.

Dixon said untreated SIBO “can cause systemic issues because SIBO causes inflammation, the gut bacteria become imbalanced and when you’ve got inflammation in the gut, that disrupts the immune system in the gut which leads to inflammation so it can lead to joint disorders or neurological disorders”.

As a result, an untreated SIBO can affect overall health by reducing the strength of the immune system overall.

Fortunately, although SIBO is much less well known than other conditions, there are still treatments available on the NHS to help patients.


The most common of these is an anti-microbial known as rifaximin described by the NHS as a “promising, easily handled, and safe drug for the short-term treatment of small intestinal bacterial overgrowth” which can be prescribed by an NHS GP.

Other treatments include antibiotics, although Dixon warned that, while effective, they also “kill off healthy bacteria” in contrast to rifaximin which doesn’t.

Furthermore, there are also alternative ways to manage or treat SIBO including through dietary changes and the treatment of the underlying casue of the condition.

How do you test for SIBO?

SIBO is tested for using a breath test. There are several types of SIBO and which type someone has will depend on the gas they emit when they breathe out.

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What are the risk factors for SIBO?

In common with other conditions such as IBS, there are several risk factors for SIBO including:
• Stress
• Anxiety
• Endometriosis
• Crohn’s disease
• A history of food poisoning
• Chronic conditions.

Is it possible to cure SIBO?

On this, Dixon said: “You can eradicate SIBO, but it can relapse if you don’t address what caused it in the first place.

You need to be working on gut repair and calming any inflammation in the gut.”
What this means is that SIBO can be treated, but to be fully eradicated the cause of the condition must be treated as well.

By doing this, patients can reduce the risk of a relapse and use of medication.

What about SIBO awareness?

“I think lots of people don’t believe in SIBO,” said Dixon: “I think they think it’s a general bacterial overgrowth in the whole gut, I think it’s old-fashioned thinking in a way.”

Overall, then, Dixon’s opinion is that there isn’t enough awareness around SIBO, a condition which could be affecting thousands of patients around the UK.

SIBO, though not one of the most serious in the gamut of medicinal conditions globally, is nevertheless worthy of the attention of more according to experts in the field.

Through greater discussion of SIBO, the hope is that more patients will start asking for a test and start the journey towards a SIBO free life.

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