IBS: Is SIBO the Cause?

Digestive issues and disorders can wreak havoc on a person’s way of life. Symptoms including stomach cramping, diarrhea, constipation, gas, bloating, and abdominal pain that happen chronically signal that something is not right in the digestive tract. There are many reasons these symptoms may be occurring including food sensitivities, irritable bowel syndrome (IBS), ulcerative colitis, Crohn’s disease, and SIBO. Digging down and treating the root cause of the dysfunction with functional medicine can ultimately help you not just mask your digestive symptoms, but help restore normal function stopping the symptoms at the source. This month we’ll be looking at digestive disorders and some of the common root causes underlying these disorders beginning with irritable bowel syndrome.

What is Irritable Bowel Syndrome (IBS)?

IBS is diagnosed based on the Rome Criteria. The Rome Criteria states that a patient must have 6 months of abdominal pain followed by 3 days of pain per month for 3 months. Moreover the patient must have improvement with defecation, change in frequency of passing stools, and change in consistency or form of stool to be diagnosed with IBS. There are also different types of IBS: IBS-C (constipation type), IBS-D (diarrhea type), and IBS-M (mixed type) with changes between constipation and diarrhea.

What causes IBS?

According to one of the leading physicians on SIBO research, Dr. Mark Pimentel, one of the root causes of IBS is food poisoning. Typical organisms that cause food poisoning include E. coli, Campylobacter jejuni, shigella, and salmonella. Even an episode of diarrhea that you might have thought was not a big deal could have been the beginning of chronic GI dysfunction. One of the fascinating pieces of information to come out of the research is that approximately 50% of IBS patients suffer from SIBO (small intestine bacterial overgrowth).

How does food poisoning create an environment for SIBO?

What we know from the research is that pathogenic organisms like the ones mentioned above create a toxin called cytolethal distending toxin (Cdt B). In response to the Cdt B toxin being released by bacteria a cascade of events happens in the body, starting with the immune system producing antibodies to the toxin (anti-ctd B antibodies). These antibodies cross react to a protein in the small bowel called Vinculin. When this happens your body then develops anti-vinculin antibodies. These anti-vinculin antibodies cause damage to the nerves of the gut that are designed to keep the contents of the small intestine moving. By damaging the nerves to the small intestine, that portion of the bowel does not move as much which leads to overgrowth of bacteria that is not supposed to be there. This can result in SIBO.

What do I do if I am experiencing chronic gastrointestinal dysfunction?

If you find yourself experiencing chronic stomach cramping, diarrhea, constipation, gas, bloating, and/or abdominal pain, contact us about testing for SIBO. In our office we use the current gold standard for SIBO testing, which is lactulose breath testing. This breath test helps us identify which type of SIBO is occurring (hydrogen, methane, and/or hydrogen sulfide). Once we know this information, our doctors create a specific protocol for you to restore balance in your intestinal microbiome. SIBO can be stubborn and chronic taking time to treat; however, our doctors will guide you through the process of treatment and make changes as necessary based on your experience. Please reach out to our office to discuss your questions with one of our doctors.

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