Stomach pain, diarrhoea and constipation are all symptoms of the common condition irritable bowel syndrome, that affects the digestive system. IBS is not the same as inflammatory bowel disease (IBD) however, even though some of the symptoms may be similar. According to the NHS, the main types of IBD are Crohn's disease and ulcerative colitis.
But there are other conditions that can also cause these kinds of symptoms, such as coeliac disease and a little known condition called small intestinal bacterial overgrowth (SIBO). You can read about the symptoms of coeliac disease here.
According to research, 13 million people in the UK suffer with IBS and it is estimated that a further 80% of these people also have SIBO.
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What is SIBO, its causes and symptoms?
According to the NHS, small intestinal bacterial overgrowth is the presence of excessive numbers of bacteria in the small bowel area. It is thought that it is usually the result of surgery or a particular disease that damages the tubes and organs involved in the digestion and their immunity from toxins. This causes gastrointestinal symptoms, such as:
- diarrhoea
- abdominal pain
- flatulence
- bloating
- weight loss
- nausea
Several risk factors have been associated with SIBO:
- surgery in the bowel area, such as a small bowel resection or gastric bypass
- Irritable bowel syndrome
- diabetes
- Some medications such as proton pump inhibitors (reduce stomach acid)
Connective tissue disorders such as fibromyalgia, Ehlers-Danlos syndrome and rheumatoid arthritis who are predisposed to relapsing symptoms of small intestinal bacterial overgrowth.
It isn't a condition which is easily identifiable because it shares so many of the symptoms with other stomach conditions, like IBS and IBD. To be diagnosed with SIBO, a physician should consider other conditions and exclude them before considering SIBO.
There are no current diagnostic investigations for SIBO, and it is based on the symptoms, history, risk factors and exclusion of alternative conditions. There is also a test called the lactulose breath test,.
According to Gastro Lonon, treatments for the condition include addressing any of the risk factors that could be causing SIBO, as well as antibiotics. SIBO is a condition that could return after treatment, so it is recommended that people with the condition follow a low FODMAP diet.
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