You just came back from your visit with your naturopathic doctor and he/she suspects that you have small intestinal bacterial overgrowth (SIBO) or intestinal methanogen overgrowth (IMO) based on your symptoms.
Bloating. Flatulence. Constipation. Diarrhea.
What are the next steps to learn more, get an official diagnosis, and most importantly start feeling better?
- You need specific testing to verify your SIBO diagnosis.
- Try avoiding foods that are feeding the bad bacteria in your gut, which you can do by following a specific diet.
- Follow prescribed treatment protocols to eradicate your SIBO and heal your gut for good.
Not sure how to get started? Keep reading to learn more.
How Do You Test for SIBO?
There are three main tests that I conduct for my patients dealing with SIBO.
1. Breath Test
The breath test is easy to perform and can be done from the comfort of your home with a prescribed test kit. You need to blow into a mouthpiece and collect breath samples over a 2-3 hour period and then send the kit to the lab for analysis.
The breath test can measure the amount of both hydrogen and methane gas that’s present in your breath, but unfortunately most labs are not set up to measure hydrogen sulfide gas. Based on your results, we’re able to determine the specific type of SIBO you’re dealing with (hydrogen or methane dominant) and tailor your treatment accordingly.
However, if you do have hydrogen-sulfide producing bacteria, you may end up with a false negative result. To learn more about the three different types of SIBO, read part one of this blog post here.
While a blood test is more invasive than a breath test, this test can give us accurate and informative results. It’s also less invasive than other tests like colonoscopies and ultrasounds.
2. GI-MAP™ Test
The most popular test performed in my practice for all patients dealing with digestive health issues is the GI-MAP™ stool test.
The GI-MAP™ test looks for DNA fragments of a variety of microorganisms (both good and bad) in a single sample of your poop. It also gives us valuable information on how well you digest your food and if you have any intestinal inflammation or gluten intolerance.
The GI-MAP™ test is highly sensitive and can pick up a lot of details that other tests miss; it can help me to tailor your treatment plan to target your specific digestive imbalances.
3. Blood Test
After learning about which type of SIBO you have, it’s often important to understand the root cause of your SIBO, i.e. how did I get this in the first place? That’s where this blood test comes in. A blood test like the IBS Smart can determine if your SIBO was triggered by food poisoning or another infection.
What Are the Treatments for SIBO?
While we can treat your SIBO using herbal antibiotics and natural remedies, there are other ways to treat SIBO. Treatment options include:
1. Prescription Antibiotics
The most common form of treatment for SIBO is prescription antibiotics, especially in conventional medicine. It’s important that your doctor knows the type of SIBO you have so that you’re prescribed the correct antibiotic.
The most common antibiotic used is Rifaximin. It can withstand your stomach’s acidic atmosphere and makes its way into your small intestines where it can target harmful bacteria. The benefit of Rifaximin is that unlike other antibiotics it doesn’t impact your healthy bacteria/microbiome and therefore has very few side effects.
How does it do this?
Rifaxmin is only active in the small intestine and does not make it into your large intestine where your healthy bacterial populations/microbiome reside. The downside of Rifaximin is that it is often difficult to get a prescription, it’s quite costly, and it won’t have full effects on methane-producing bugs.
Since the vast majority of prescription antibiotics may obliterate the beneficial bacteria along with the harmful bacteria, it’s often important to supplement a prescription antibiotic with prebiotics and probiotics after treatment.
2. Low-FODMAP Diet
The Low-FODMAP Diet is a diet that’s low in FODMAP foods.
FODMAP stands for:
FO: fermentable oligosaccharides
AP: and polyols
High-FODMAP foods that contain these chemical compounds are mainly fermentable carbohydrates. With SIBO, your small intestine has a hard time digesting carbohydrates, which can lead to digestive upset like stomach pain and cramping.
High-FODMAP foods include:
- Fruits such as apples, cherries, peaches, mangoes, blueberries, and avocados
- Vegetables such as asparagus, cauliflower, garlic, onion, and mushrooms
- Dairy products such as cottage cheese, cream cheese, ricotta cheese, yogurt, and milk
- Beverages such as coconut water, chamomile tea, and Chai tea
- Legumes such as black beans, kidney beans, lentils, and baked beans
For the next 30 to 90 days, I work with my patients on eating a low-FODMAP diet. After the allotted time, I help my patients re-introduce specific foods back into their diet.
Avoiding FODMAP foods gives your gut time to heal. You’ll also starve the harmful bacteria that cause SIBO.
3. Mind-Body Techniques and Lifestyle
Stress can cause a variety of issues, even digestive upset. To help with this, it’s important to incorporate mind-body techniques. Here are some practices you can adopt:
- Focus on eating and not multitasking while you’re eating
- Chew your food properly
- Avoid stress
- Get at least seven to nine hours of sleep per night
The key to truly healing your gut is taking a holistic approach that you can maintain in your everyday life. These practices will help you do just that.
4. Digestive Help
Your digestive system needs some help when you’re dealing with SIBO. I commonly use digestive enzymes to help the body break down foods. Digestive enzymes can reduce your symptoms like flatulence, bloating, and diarrhea and aid in the overall SIBO treatment and removal.
5. Prebiotic Fiber
Lastly, taking a prebiotic fiber can help to treat your SIBO. Prebiotic fibers are different than antibiotics and probiotics – they’re plant fibers that can stimulate beneficial bacteria in your gut.
The prebiotic fibers are difficult for your body to digest, so they travel safely to your gastrointestinal tract and act as food for your gut bacteria.
A common prebiotic fiber is partially hydrolyzed guar gum. It helps to feed the bacteria in your small intestine and reduces symptoms like diarrhea in SIBO patients.
These are just five SIBO treatments of many. Everyone’s SIBO journey is different, so I recommend working with a functional medicine or naturopathic provider to completely eradicate SIBO for good.
Say Goodbye to SIBO for Good
I know that SIBO isn’t comfortable to deal with and can seriously impact your daily quality of life… While some people may say the symptoms you’re experiencing are “normal” – you don’t have to suffer in silence any longer.
If you think you have SIBO or you know that you still have SIBO, I’m currently accepting new patients. I’ll work with you to co-create a treatment plan that works specifically for your needs so you can beat SIBO for good.
Did you learn something about SIBO testing and treatments from this blog post? Comment down below, I’d love to hear from you.
I believe in you!
Dr. Laura Brass