Why testing for SIBO is essential

SIBO (small intestinal bacterial overgrowth) is an overgrowth of commensal bacteria (native to the gut) in the small intestine, they move to the wrong location and overgrow. Being in the small intestine allows them early access to fibres and starches, as they eat this food, they ferment it causing excess gas.

For more info on SIBO read my previous article.
“Bloating, pain, gas, constipation or diarrhoea…Could it be SIBO?”

Although SIBO can be an underlying cause for up to 80% of IBS (irritable bowel syndrome) cases, testing is still essential. I do not treat SIBO without a (LBT) lactulose breath test or glucose breath test proving this patient has SIBO.

“Why?” I hear you ask.

You can’t diagnose SIBO by symptoms alone

Even though when I am sitting with a patient in the clinic listening to their symptoms, I can have a pretty good idea if they have SIBO, I still test. SIBO shares symptoms with at least 20 other bowel issues and conditions, so although I can have a strong gut feeling I am not always right. I have had cases where I strongly suspected SIBO and the results were negative.

SIBO treatment needs to be specific to the type

The treatment you are prescribed will depend on the results of your breath test. We test for hydrogen and methane and based on which gases are elevated, whether it’s one or the other or both, I will select the types of herbal antimicrobials we use and it possibly gives a guide as to how long we treat for initially. There are herbs that are more effective against the bacteria that produce hydrogen and other herbs that are specific for the archaea that produce methane.

SIBO can be complex & people respond differently

Treatment involves the use of herbal anti-microbials as well as supplements to support the function and health of the gut. I do not want to put patients on a SIBO protocol if they do not have SIBO, as it can be costly and unnecessary. You can’t base treatment on symptoms alone, as every patient responds so differently.  Also, if you do not know what overgrowths you are treating, you are selecting herbs based on symptoms, this means you will be guessing the whole way through your treatment. Guessing whether the herbs are the right ones at the right dose, have you treated for long enough if your symptoms are not improving. If you then decide to test for SIBO, you have no benchmark for the treatment you have already completed.

Retesting prevents overtreatment

Retesting can be just as important, as it prevents overtreatment. Over the years I have seen many patients who have been kept on anti-microbial or antibiotic treatments with other practitioners or self-prescribed, simply because their symptoms were not improving. But this can be a very big mistake, again basing treatment decisions on symptoms alone and it can cause damage to the microbiome of the gut. Many of those patients were treating the wrong overgrowth or even had negative SIBO test results and it was actually something else causing their symptoms.

Which test you use, is also important

Ensuring the lab, you use is of a high standard when it comes to breath testing and interpreting the results is also very important. Here are some things to consider:

1.       You want to use a lab that gives you preparation instructions that will make the test clear to read.

2.       Is the test, measuring methane & hydrogen (some tests only measure hydrogen) and carbon dioxide as a quality control to ensure good sample collection?

3.       Does the lab use the right amount of sugar substrate? You want to use a lab, that uses 10g of Lactose, 75g of glucose, and 25g of fructose (if also completing the fructose breath test) for their tests.

4.       Are the breath samples every 20 min for 3 hours, as this gives the most reliable results. Some labs only take samples over 2 hours and recommend samples to be taken every 30 min.

5.       My last tip is, that no matter the lab you use, you get a practitioner who specializes in SIBO to read the results. As there are nuances to reading a breath test and some labs report a negative test, when it is actually positive or they do not account for IMO (intestinal methanogen overgrowth), which needs to be treated.

If you have any questions about SIBO & how I can help you, send me an email or message me on the socials.

Danielle

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A bit about me!

 I am Danielle Elliott a qualified Naturopath and the owner of Tummy Rescue.

I have been helping kids & adults improve their health for over 16 years, with the last 11 years concentrating on helping patients with any kind of gut disorder. I began focussing on everything gut related after my husband was diagnosed with Crohn’s Disease. And lucky I did……as my husband and both our kids have Coeliac Disease and my daughter has a dairy allergy.

So…. I am well and truly where I am meant to be!

I love being able to help people to soothe and calm their symptoms, investigate the causes and support and improve their gut function.

I also get to write educational pieces to train practitioners and am often interviewed for podcasts and summits, which is another really rewarding part of my work. I love educating people (this is something I do in every consult), because I do believe knowledge is power. It gives you the tools to make the changes you need to!

So, when you opt-in to my E-book, you are beginning on a journey of learning and discovery, of how you can reduce your symptoms of bloating, gas & pain and improve your gut health.

I would be honoured to help you along the way.

Danielle xoxo