Irritable Bowel Syndrome (IBS) and Small Intestinal Bacterial Overgrowth (SIBO) are two common conditions that affect the digestive system. It can sometimes be challenging to distinguish the difference between the two as they have many overlapping symptoms. In this post, we’ll break down the key differences between IBS and SIBO, explore their symptoms, testing methods, and discuss how naturopathic treatments can help address each condition effectively.
What is IBS?
Irritable Bowel Syndrome (IBS) is a functional disorder that results from a miscommunication between the digestive system and the brain, causing disruption in normal digestive processes. It’s characterized by chronic gastrointestinal symptoms that occur without any actual structural issues in the gut.
For a diagnosis of IBS, a person must experience recurrent abdominal pain at least once a week for the past three months. The pain must also be associated with at least two of the following symptoms:
- Related to passing stool
- A change in stool frequency
- A change in stool consistency or appearance
There are several subtypes of IBS based on the stool characteristics:
- IBS-D (diarrhea-predominant): Abdominal pain accompanied by loose, mushy, or watery stools at least 25% of the time.
- IBS-C (constipation-predominant): Abdominal pain accompanied by hard, pellet-like stools at least 25% of the time.
- IBS-M (mixed): Abdominal pain associated with fluctuating stool consistency, with a combination of both diarrhea (over 25% of the time) and constipation (over 25% of the time).
- IBS-U (unclassified): Abdominal pain without a clear pattern in stool type, or with well-formed stool.
It’s important to note that IBS is frequently misdiagnosed. For instance, if a colonoscopy comes back normal and no structural or inflammatory issues have been identified, you might get a diagnosis of IBS. However as we have learned, if there is no experience of abdominal pain, then it cannot be IBS. Since there is no testing method for IBS, and the condition is diagnosed solely based on symptoms, it may be helpful to work with a healthcare provider who is well versed in digestive health, such as a naturopathic doctor or gastroenterologist. They can help rule out other conditions and ensure an accurate diagnosis is made before deciding on the appropriate IBS treatment.
What is SIBO?
Small Intestinal Bacterial Overgrowth (SIBO) occurs when bacteria that is usually found in the large intestine begins to overgrow in the small intestine. This can happen because of disruptions in the mechanisms that normally work to keep bacterial levels in check, such as immune function, stomach acid, bile, digestive enzymes, and peristalsis (the movement of food through the intestines). This results in
SIBO symptoms, including abdominal pain, bloating, diarrhea, constipation, excessive gas, or even malabsorption.
The key to differentiating between IBS and SIBO is proper symptom assessment and testing. SIBO is often diagnosed using a carbohydrate breath test, which measures how bacteria in the small intestine metabolize lactulose or glucose. This process produces hydrogen or methane gas that can be detected and measured in the breath.
However, breath tests can be tricky, with false positives or negatives being common. This means a test might indicate SIBO when it’s not actually present, or may fail to detect SIBO when it is present. Additionally, some individuals with SIBO may have no symptoms at all, while others who seem to experience all the SIBO symptoms may not test positive for it. This is because excessive bacteria in the small intestine does not always result in symptoms. It also depends on the type of bacteria that’s overgrowing, because some strains are more likely to create damage & inflammation, ultimately leading to SIBO symptoms.
Given these limitations, breath tests should be used as part of a broader diagnostic approach. Testing for other factors that are associated with SIBO may provide more valuable insights. Depending on the individual and their health concerns, this may include assessing for nutrient deficiencies due to malabsorption, abdominal imaging (endoscopy for example), and evaluating immune function or pancreatic activity. Working with a knowledgeable healthcare provider can help you gain a better understanding of your symptoms and offer effective SIBO treatment.
Naturopathic Treatment: Effective Solutions for IBS and SIBO
As you may have noticed, SIBO symptoms may look very similar to IBS symptoms. SIBO and IBS can even happen at the same time. However, understanding that there are different underlying reasons for the two conditions is crucial for effective management.
Naturopathic treatment for IBS: Aims to restore the gut-brain connection and reduce gut hypersensitivity. This may involve making dietary modifications, working on eating habits, psychological therapies, and utilizing strategic supplements and/or medications to relieve symptoms.
Naturopathic treatment for SIBO: Focuses on reducing bacterial overgrowth, restoring balance to the microbiome, and addressing any associated factors contributing to, or resulting from SIBO. Key approaches include antimicrobial therapy, probiotic support, improving intestinal motility, correcting nutrient deficiencies caused by malabsorption, and supporting digestive function by optimizing the “digestive juices” (stomach acid, bile, and digestive enzymes).
Working with a naturopathic doctor
Navigating digestive issues like IBS and SIBO can be overwhelming, but with the right support, symptom relief is possible. A naturopathic doctor takes a holistic approach by thoroughly assessing your health history, symptoms, diet, and lifestyle to guide you through the most appropriate testing and treatment options. With personalized care that goes beyond just symptom management, they’ll help you feel confident in finding a treatment plan that’s right for you.
Looking for a naturopathic doctor for IBS or SIBO? Contact Dr. Viktoriya Zabigaylo, ND or book a free 15 min consultation. Dr. Viktoriya Zabigaylo is a naturopathic doctor offering IBS treatment and SIBO treatment in Mississauga.
*The above information is not intended as medical advice or to replace medications. Please schedule an appointment to discuss your health concerns and individualized treatment options.
