Are SIBO and IBS the same thing? What is the connection?

SMALL INTESTINAL BACTERIA OVERGROWTH (SIBO) and IRRITABLE BOWEL SYNDROME (IBS)

Do you have IBS or SIBO??

When I first began searching for an answer to my severe stomach pain, I remember reading all about “IBS” online.  

Since most of what I read was vague and didn’t seem to have a “cure”, I found it confusing, frustrating, and disappointing.  Being in constant pain, it was only a matter of time until I found myself sitting in the chair at my doctor’s office looking for answers.  

But instead of finding them, I ended up listening to my primary care physician explain to me that I had IBS, a blanket diagnosis with no known cause and no discovered cure.  She took the time to share details about the IBS medicines I should try to alleviate symptoms, the dietary protocols I could explore (Low FODMAPS was their suggestion), and the tests I could take to ensure it wasn’t something more serious.  

However, as she sat there talking, I distinctly remember thinking to myself, “I’m twenty two and healthy - why the hell do I have IBS?”
After digging deeper and learning a ton through my own SIBO journey, I discovered that studies have shown that over 80% of patients diagnosed with "IBS" actually test positive for SIBO.

While there is no “definitive” conclusions that SIBO is the direct cause or effect of IBS, it is important to note that the two are often very commonly linked and most individuals who are diagnosed with “IBS” do test positive for SIBO.

What is IBS?

Irritable bowel syndrome (IBS) is the most commonly diagnosed chronic functional gastrointestinal disorder. It affects females approximately twice as often as males and is most frequently diagnosed in individuals between the ages of 30 and 50 years - though it has been found recently in those of younger ages, especially women.  Many of the friends and connections that I’ve made through my own journey have been in their teens or early to late twenties - it has certainly become a growing diagnosis in the younger age groups. Symptoms include cramps, constipation, feeling like you haven’t finished a bowel movement, alternating between diarrhea and constipation - and more.  

The IBS & SIBO Link - Bloating

Since bloating is a unanimous symptom for IBS sufferers, whether they had constipation or diarrhea as their main symptom, it led researchers to look for a possible deeper problem.

The idea that SIBO may explain bloating in IBS is because of a correlation between the pattern of bowel movement and the type of excreted gas.

So how do you know if your IBS diagnosis may, in fact, be SIBO? 

  1. Fiber makes your constipation worse

  2. You notice an improvement in IBS symptoms when taking antibiotics

  3. You feel more gas and bloating when you take probiotics that contain prebiotics

  4. Your blood work shows chronically low iron or ferritin with no known cause

In Summary:

If you’ve been diagnosed with IBS and are treating it either through prescription and diet - and still experience severe discomfort, nausea and bloating, you may have SIBO.

If you have had tests like an endoscopy, a colonoscopy, blood work, or even an MRI that come back "normal", I would highly suggest being tested for SIBO with a lactulose SIBO breath test.

The treatment for both SIBO and IBS that I suggest is similar - diet change, stress reduction, and self-care practices.

Guidelines to follow when you have (or think you have) SIBO

For a full “good food” and “food to avoid” breakdown, download the BeatSIBO Specific food guide here. This has been the best guideline for me, one that I’ve established through personal experience, trial and error, and nutritionist advice. I highly recommend the protocol, and follow it myself.