IBS, or Irritable Bowel Syndrome, is often the diagnosis given to children & adults when they experience bloating, flatulence, and loose stools or constipation. Your bowels certainly are irritable, but the real question remains: WHY?
A diagnosis that is becoming more and more used by healthcare providers is something called SIBO, or Small Intestinal Bacterial Overgrowth. It is estimated that 65-70% of people with a diagnosis of IBS actually have SIBO. Essentially what’s happening in SIBO is that way too much of certain types of bacteria are living in the small intestine, and they are fermenting the carbohydrates you’re eating. This causes the production of gas, causing bloating and flatulence. People with SIBO often feel as though they are always, always bloated, or that they feel like they are pregnant. These bacteria also create by-products in the small intestine, which irritates the lining of the gut, which can cause diarrhea.
On the other hand, the Migrating Motor Complex, aka MMC, can be compromised in SIBO. The MMC is responsible for contracting the intestines to continue moving the bolus through it so a bowel movement can be expelled. If the MMC isn’t working optimally, constipation can occur.
SIBO still isn’t fully researched and accepted by all healthcare providers, but the general consensus is that the best & safest way to diagnose SIBO is through a breath test. The breath test will evaluate what types of gas and how much is being produced by the intestines. Once we know if the results from the test are positive for SIBO, we can begin treatment.
Conventionally, Rifaximin is the antibiotic of choice for SIBO for both children & adults. However, strong antimicrobials (such as garlic, berberine, oregano, neem, and more) have been shown to be just as effective, yet come with fewer side effects! However, one should not self-treat for SIBO as treatment will differ based on the results of your breath test. Children also need to be monitored by an ND if choosing the natural route for treatment, because dosing for children is much different than adults.
If you end up treating for SIBO and feel much better after (yay!), you aren’t in the clear yet. Now that we’ve eradicated the bacteria in the gut, we need to replenish the gut with good bacteria and optimize the digestive tract to prevent a re-occurrence. Unfortunately, the re-occurrence rate for SIBO is quite high, so prevention is the key!
If you experience IBS and haven’t seen a naturopathic doctor about it, it might be your time to find one. You may have SIBO or another condition that can be treated to get you feeling your best.
Adrienne Elgie, B.H.K.
Intern at the Canadian College of Naturopathic Medicine