Can diet cause SIBO?

[Mereri]

Hello everyone,

was diagnosed with SIBO last year after a positive breath test. Took an 8 week course of rifaximin (550 mg, twice a day) and assumed all was well. SIBO seems to have come back this year (positive breath test), and I am repeating the course of antibiotics. This time I've been told to take probiotics after finishing the antibiotics to get some good bacteria.

...What could be causing SIBO? I've read various health websites that seem to say different things. I had blood tests, stool tests, MRI, endoscopy + biopsy the first time I was diagnosed, and everything was normal. Not celiac or diabetes, no previous surgery, no history of PPIs.

I read that stress can cause SIBO? That could certainly explain the first diagnosis, but the previous year has not been particularly stressful, so I don't think it could explain SIBO coming back. I saw one website say diet can cause SIBO, however most suggest diet (such as low FODMAP) is a symptom management thing and not a potential cause.

So can diet cause SIBO? Because I do enjoy sugary foods, so if this can cause SIBO, seems like the most likely explanation...

[Angusmerlin]

I use 70 ml SYMPROVE fluid (online) 15 mins before eating every morning. Advised by a Gastric Professor . It helps calm my gut .

[xjrs]

SIBO breath tests are not accurate. However, presumably Rifaximin helped last time, so this might be a pointer. SIBO will keep coming back unless the underlying cause is treated.

This is the cause list that I am aware of (and you mention some already, so you may be aware of this list):

Note that the first four causes of SIBO in the list below should be identifiable through a small bowel MRI scan:

- 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