Persistent gas and diarrhea could mean SIBO. Where does this problem come from?

SIBO, or bacterial overgrowth in the small intestine, develops when too many bacteria develop in the small intestine. Less than 10,000 bacteria per milliliter of fluid is considered normal. Until recently, it was believed that there were no bacteria in the small intestine at all. The latest study from 2020, published in Cellular and Molecular Gastroenterology and Hepatology, indicates that bacteria live there that are of great importance for the health of our body.

The small intestine is where food is digested and nutrients are absorbed. Today it is also known to be part of the immune system, thanks to the content of so-called lymphoid cells (cells of the immune system), which help fight infections and regulate the immune system.

Symptoms that may indicate SIBO

Bacterial overgrowth syndrome in the small intestine can cause a number of unpleasant symptoms. Characteristics include:

• Persistent gas is one of the most common symptoms of SIBO.

Bacteria living in the small intestine feed on undigested food and produce methane or hydrogen. The formation of hydrogen is associated with the presence of carbohydrates in the diet, which, after consumption, begin to ferment. It causes overflow problems gas and bloatingwhich appear approximately 1-2 hours after eating a meal rich in carbohydrates.

• Recurrent diarrhea

The presence of hydrogen in the small intestine causes not only gases, but also diarrhea. The by-products of carbohydrate fermentation create an osmosis-like effect, drawing water into the intestines and causing diarrhea. Hydrogen can also damage the intestinal mucosa, causing a deficiency in lactase, which is used to break down and digest lactose.

• Frequent belching as a symptom of problems with the small intestine

The gas accumulating in the small intestine is looking for a way out, hence the frequent belching in this disease. Due to its high intensity, it can be tiring and embarrassing for patients.

• SIBO is accompanied by cramps and pain in the abdomen.

SIBO is also a common symptom cramps and pain in the abdomenresulting from developing inflammation in the digestive tract. The pain is due to excessive distension of the intestines, in which gas accumulates.

• SIBO is also a food intolerance.

One of the symptoms of SIBO is food intolerance, mainly to gluten, lactose, fructose and histamine. This is due to a violation of intestinal motility caused by SIBO. It inhibits digestion properly and causes them to stay in the digestive tract, which exacerbates inflammation.

Diagnosis of SIBO is not easy

Bacterial overgrowth syndrome requires a complex diagnosis, which is not easy, since its symptoms are also found in other diseases of the digestive system, for example, food intolerance. There are three main ways to diagnose bacterial overgrowth in the small intestine. These include:

• Hydrogen breath test is a fast, non-invasive and safe diagnostic method. However, such a test is not considered highly reliable because SIBO is only one possible cause of malabsorption.
• Biopsy is an invasive test that takes samples of fluid from the small intestine.
• Antibiotic test - consists in the beginning of the treatment of SIBO with antibiotics and the assessment of the response to the administered drugs.