Some Symptoms of SIBO

• Q: Why have I got a diagnosis of SIBO and my predominant symptom is constipation, yet my friend has also been diagnosed with SIBO, but she suffers from diarrhoea?

A: SIBO is an umbrella term for an overgrowth of bacteria and archaea (similar to bacteria) that can reside in the small intestine.  The two main gases that are tested for, and will give a positive diagnosis of SIBO if the values are high in the first 100 minutes, are hydrogen gas and methane gas.  Seeing as you suffer mostly constipation, there is a good chance that you have an overgrowth of methane producing archaea, whereas your friend could have an overgrowth of hydrogen producing bacteria.

If you are found to have high values in the combined gases, you may experience variable stools, i.e. at times you have diarrhoea and at times you have constipation.

To complicate the issue, you might have an overgrowth of hydrogen sulphide producing bacteria, that are as yet not being tested for,  that can manifest as diarrhoea in the small intestine or constipation in the colon.

• Q: Is the treatment the same for all type of SIBO?

A: On the whole, unfortunately, the treatment is different for all three gases.  This is the main reason why testing is so important. 

• Q: I have gastric reflux and my doctor has prescribed a proton pump inhibitor known as Nexium. I have been taking it for approximately 2 years because every time I go off it, my symptoms return. But lately I have been feeling bloated and I heard this could be related to my medication. Is this true? 

A: Nexium, as you rightly pointed out is a proton-pump inhibitor. It  is designed to reduce the stomach acid produced by the parietal cells.  When this drug was put on the market, doctors were warned to not prescribe it longer that a few weeks of  daily intake; the main reason being because stomach acid is vital for digestion, absorption of key nutrients such as vitamin B12, zinc, heme iron, calcium and magnesium, to stimulate secretion of digestive enzymes from the pancreas and bile from the gall bladder, and to kill the micro-organisms entering  via your mouth.  Indeed, studies are now emerging that longterm use of this drug can be associated with the onset of Alzheimer’s Disease  

If you are taking this medication longterm, you will have limited ability to kill the bacteria entering your body from air, water and food, and this will contribute to a bacterial overgrowth in the small intestine.  When this occurs, the bacteria produce gas, and the chances that you feel bloated and uncomfortable some time after a meal, become heightened.