What is SIBO? Small Intestinal Bacterial Overgrowth Explained by our ND

None of us have been blessed with totally perfect gut health. Be it travelling, nerves, or eating something that disagrees with you (we’re looking at you, chocolate milk), we all know what it’s like to deal with digestive upset. 

It’s normal to experience symptoms like bloating, gas, and nausea occasionally. But when these things become a regular occurrence and interfere with your day-to-day life, you should consider letting an expert help you out. 

A Naturopathic Doctor like Dr. Saira Kassam, our ND at HealthOne, can take a closer look at the symptoms you’re dealing with. She’ll then be able to diagnose what exactly you’re dealing with – such as dysbiosis, IBS, or the topic of this blog post: SIBO!  

Keep reading to learn the basics about SIBO and what you should do if you think you might have it.  

What is SIBO?

SIBO stands for small intestinal bacterial overgrowth. You might assume that all bacteria are bad – but in your gut, they’re actually very important.  

“The role of bacteria in the gut is to absorb vitamins and minerals, regulate hormones, support your immune health, and remove any toxins that shouldn’t be there. The ideal balance should be 50% friendly bacteria and 50% bad bacteria, but this balance can often be upset or disrupted by different things,” Dr. Kassam explains. 

What causes SIBO?

SIBO occurs when bacteria from your large intestine travels to the small intestine. This creates an imbalance in the bacteria, and as a result, you can experience some or all of the symptoms of SIBO. "It can happen to anybody, but typically one of the main reasons is after surgery,” she adds. “Stress is another one, antibiotic use, a high-sugar diet, mould exposure, and hormonal imbalance.”

SIBO Symptoms

So, how do you know if you might be dealing with SIBO? Dr. Kassam shares that the most common symptoms include:  

• Abdominal bloating. “This is usually more in the upper abdomen vs. Lower,” she says.
• Flatulence.
• Burping.
• Nausea.
• Heartburn.
• Diarrhea.
• Constipation.
• Excessive fatigue.  

The tricky thing is that a lot of these symptoms are also indications of other digestive issues. This is why it’s so important to visit a professional who specializes in treating gut health. Once they get a better understanding of your unique needs, they can take the appropriate steps to diagnose and treat your condition. 

SIBO Breath Test

A doctor can identify SIBO in a variety of different ways. The first and most direct way is with a SIBO breath test, which works by identifying the levels of methane or hydrogen in your gut. You’ll breathe into a tube, either at home or in a clinic, and the results will help the doctor determine whether or not you have SIBO. 

Does that mean a SIBO breath test is required for every patient? Not exactly. “For patients who are showing all the signs of SIBO, I usually try to treat it first because there are protocols we can take to provide relief,” she explains.  

She’ll recommend a series of antimicrobials to kill off the excess bacteria, and may also give the patient a tincture to further remove the overgrowth. This is often paired with diet changes and supplements to further support the gut. “Usually we treat for a month – and the patient will come back letting me know if they’ve improved. If not, I’ll change the antimicrobials and we’ll do a different plan,” she says.  

A third but less popular option is to do a GI-MAP stool test. "It doesn’t necessarily tell you that you have SIBO, but there are certain bacteria that will show up on the test that might lead us to suspect that you have it,” she explains. Since the overgrowth of bacteria takes place in the upper abdomen, it’s favorable to do the breath test over the stool test for the highest degree of accuracy.  

SIBO Treatment

When a patient is diagnosed with SIBO following a breath test or stool test, Dr. Kassam will create a treatment plan that includes antimicrobials and natural remedies. “The thing about SIBO is that it has a high reoccurrence rate, so the goal is to kill the overgrowth of bacteria,” she explains. It can take anywhere from 3 months to a year to fully recover depending on the severity.  

The ultimate goal is to get rid of the uncomfortable upper abdominal bloating, gas, and other symptoms. “Once those things have been resolved, we’ll work on a recurrence plan – so I put them on things that are going to help them make sure they don’t get it back,” she explains. Patients will typically see Dr. Kassam more often at the beginning of treatment, then space their visits out to every 6 months or every year once they’re feeling better. 

SIBO Toronto

As a Naturopathic Doctor, Dr. Kassam’s approach to working with patients includes so much more than just treating symptoms. She’s here to be part of your healthcare team for life! 

If you come in with digestive issues but the root cause isn’t SIBO, she’ll continue working with you to uncover the root cause and create a plan of action. Figuring out what’s happening with our bodies can be tough, but when you visit a professional who genuinely cares about your well-being, you can be sure you’re on the right path.  

Click here to book an appointment with Dr. Saira Kassam. 

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