is IBS-D linked to SIBO

[spiderman5674]

hey so i got a lot of stomach noises, aches ,diarrhoea and have acne too. I was wondering if my IBS is actually a sign of SIBO and what can be done to get rid of SIBO?

[JayJJ23]

So Ibs and SIBO can feed each other meaning the symptoms of one can trigger the other.

[xjrs]

There are no accurate tests for SIBO. Logically, if you take probiotics and after the initial trial period (generally 3 months), the probiotics make your symptoms far far worse, that may be an indicator (since you are adding bacteria on top of bacteria in the small intestine). My gastro said that true SIBO cases are rare. There has been a whole industry developed around this. Since there aren't accurate tests, there are many false positives. The treatment can be brutal and completely unnecessary if you don't have it.

You also won't have SIBO unless you have one of the predisposing factors, which are:

Stasis: dysmotility – problems with muscle contraction in the gastrointestinal tract

Surgery (loops, vagotomy, bariatric)

Short Bowel Syndrome

Stuck open ileocecal valve (which sits between the small and large intestine) allowing bacteria from the large intestine to flow back into the small intestine

Achlorhydria – no stomach acid – unlikely if you can experience acid reflux. Additionally a faecal elastase test would show if you aren’t breaking down proteins correctly (which require stomach acid for digestion)

Hypochlohydria – low stomach acid – see above – the only real test is a PH test directly into your stomach, but many practices do not carry this out and home testing is inaccurate

PPIs – proton pump inhibitors for GERD/acid reflux – this is particularly related to long term use

Malnutrition – excess bacteria in the small intestine can compete for nutrients that your body needs

Collagen vascular disease – immune system inflammation e.g. arthritis

Immune deficiency

Advancing Age

Chronic Pancreatitis – this causes constant abdominal pain/fatty stools

Chronic antibiotic use

IgA Deficiency – identified from GP blood tests

Coeliac Disease – identified from GP blood tests

Crohn’s Disease – identified through GP tests and colonoscopy if GP tests indicate referral is needed

NASH – non alcoholic fatty liver disease –identified from GP blood tests

Cirrhosis

Fibromyalgia – widespread pain

Rosacea

It might be worth discussing this list with your GP or gastro.

[spiderman5674 in reply to xjrs]

Thanks for this

I have been on antibiotics around 8 times in recent years and also have been on PPI for a long time. Honestly I do believe I have SIBO and it being linked to all my problems. The doctor said i may have dysbiosis but I asked them what I could do and they did not answer this as they said there is no cure

[xjrs in reply to spiderman5674]

That wasn't very helpful of your doctor. Dysbiosis just means a gut bacterial imbalance where bad bugs are dominating over good in the gut, which is true for many people with IBS symptoms. You could give probiotics a go (which is meant to help with dysbiosis) - Alflorex worked best for me. If that makes your symptoms worse and not better in time, then you could go to your doctor armed with this information and ask for a gastro referral and to discuss the possibility of SIBO with them.