This post is the first in a three-part series on Small Intestine Bacterial Overgrowth focusing on SIBO symptoms, root causes and testing. Make sure to read Part 2 on natural treatments and herbal supplements and Part 3 on SIBO diet plans. For a more up-to-date and thorough resource, check out my new book SIBO Made Simple.
About a year ago, I started noticing some mysterious symptoms creeping back into my life.
Having been through half a decade of digestive woes, I didn’t pay much attention to the occasional bloating and constipation. Didn’t consider how my usual diet – full of healthy foods that, in theory, supported good gut health – was starting to make me feel off after meals. Didn’t even worry that my habitual burping, and more than occasional tooting, was becoming a regular companion soundtrack to our nighttime Netflix binges.
There was so much easy rationalizing. I was drinking more homemade kombucha, which was fizzy. I was going semi-horizontal after meals, which was bad for digestion, but could eventually be corrected. And I was getting more and more comfortable in my relationship, which meant maybe it didn’t matter if I just let ‘er rip.
It wasn’t until later in the year, once my book tour downgraded to a more manageable pace, that I was able to pay attention to my daily habits and see myself more clearly. And what I saw was an inner tube in my abdomen.
If you’re familiar with my Hashimoto’s story, you’ll know that vanity was the original straw that broke the camel’s back and forced me to take my symptoms more seriously. My skin was such a raging mess I would have tried anything, even a year of intense monthly lifestyle changes, to make it better.
Once I started to put the physical pieces together—the outward with the inward–I decided to see a functional medicine doctor for a full workup. And the prognosis I received was SIBO: small intestine bacterial overgrowth.
What is SIBO?
Small intestine bacterial overgrowth is exactly what it sounds like. It’s a type of dysbiosis, which simply means an imbalance in the trillions of bacteria that dominate the gut. In the case of SIBO, however, the issue is not necessarily the imbalance between good, beneficial bacteria and bad, pathogenic bacteria (though that could be part of it). Rather, the main problem is location, not type.
Though critters colonize all sections of our alimentary canal, the majority of it is found in the large intestine (also known as the colon), where it assists in the final step of the digestive labyrinth and prepares for evacuation.
The small intestine, on the other hand, is where your food intermingles with digestive juices and nutrients are absorbed into the bloodstream. It’s not a place where bacteria belong or have a function. In fact, as is the case with SIBO, the presence of too many critters gets in the way of nutrient absorption and causes a host of other issues.
Since these are living organisms with their own palates and cravings, bacteria in your small intestines means there are other people at the dinner table competing for food and taking sustenance for themselves.
And when there’s not much nourishment to be had, they turn to the next best thing: you.
SIBO Symptoms and The IBS Connection
When unwanted bacteria begin feasting on your intestinal lining in the small intestines, the result is often leaky gut, an increased permeability of said lining. The byproduct of leaky gut disease, where larger food particles (instead of just essential nutrients) seep into the bloodstream, is often food sensitivities and autoimmunity.
Though you can have leaky gut, food sensitivities, and an autoimmune disease without SIBO, it is not unusual for it to be a root cause. For example, according to one study published in the American Journal of Gastroenterology, 66 percent of patients with celiac disease who maintained a gluten-free diet, and still had unfortunate symptoms, tested positive for small intestine bacterial overgrowth.
Some of these unfortunate symptoms that point specifically to SIBO include: bloating, gas, burping, reflux and other discomfort after meals. Constipation and diarrhea are common, though usually you only go down one of those lanes. You can find a full checklist of symptoms, root causes and risk factors in my book, SIBO Made Simple.
The reason for the distended belly is because of all the gases the bacteria release when they eat. Your small intestine was not designed to withstand the build-up, and the gases tend to get trapped, or released anyway they can through reflux and burping, or out the other end. You can also experience nausea from slowed stomach emptying due to the traffic jam.
If the miscellaneous gastro symptoms I just described sound like the usual description for IBS, you’re right. The problem with diagnoses of IBS—the most common gastro “syndrome” in the world—is that they are usually BS. It’s meant to be a diagnosis of exclusion, only reached when all other possibilities are ruled out. A collection of symptoms, not a root cause.
The majority of these sufferers are actually experiencing SIBO in disguise (or, staring right at you, so long as you know what to look for)–60 percent of all IBS cases are caused by SIBO!
Other symptoms to look for are a result of the absorption issue: being underweight and anemic. As a consequence of all the shared meals with your bacteria, nutrient deficiencies are common, especially with vitamin B12, decreased ferritin and increased folic acid.
Lastly, brain fog, depression and anxiety can occur as a result of the damaged cell wall affecting the brain. It’s not personality or stress alone. It’s a symptom of the gut’s circumstance.
Here’s a symptom cheat sheet:
- Abdominal bloating
- Gas: belching and flatulence
- Abdominal pain and cramps
- Constipation, Diarrhea, or both
- Heartburn
- Acid Reflux
- Nausea
- Food Sensitivities
- Headaches
- Joint Pain
- Fatigue
- Eczema, rosacea or rashes
- Anxiety and depression
- Malabsorption / nutrient deficiency
- Anemia (Iron or B12)
- Weight Loss
What Causes SIBO?
So if SIBO is an underlying cause of IBS, leaky gut, and autoimmune disease, what is the underlying cause of this bacterial overgrowth?
Diet certainly affects the balance of bacteria in our bodies. But one of our internal functions must go haywire in order for our bacteria to enter the small intestines and become stuck there.
Contrary to what some may think, the migration of bacteria from the colon doesn’t just happen. The small intestine is its own organ with a front and back door–completely separate chambers from the large intestine. Which means (unless their is an issue with said backdoor, the ileocecal valve) the problem must occur earlier on in the digestive process.
On the front end, the main culprit to explore is low stomach acid, usually a result of popping one too many Peptos, Prevacids or other Proton Pump Inhibitors in one’s lifetime.
Though certain drug companies have tried to convince you otherwise, your stomach acid is very necessary for maintaining gut health, preventing food poisoning, and generally, making sure that outside bacteria get killed before making their way into the small intestine.
But even if some unwanted bacteria get through that initial hurdle, our migrating motor complex (MMC) should ensure that it gets pushed down and out. This internal function also protects against back flow from the large intestine.
Which is why Dr. Allison Siebecker, who’s arguably one of the world’s leading experts on SIBO, believes that the root cause of SIBO centers around the malfunction of the MMC. The question, as she puts it, is why aren’t the bacteria being removed, not why are they there.
The Root Cause of the Root Cause: Why the MMC Goes Haywire
The Migrating Motor Complex only activates during a fasting state, between meals and overnight, and relies on nerve cells to kick it into gear.
The most common cause of low MMC function is food poisoning, also known as post-infectious IBS. When harmful bacteria enter the small intestine (often as a result of low stomach acid) they release a toxin that damages the nerve cells that trigger your MMC.
Often times you’ll feel better from food poisoning a day or two later. The deeper symptoms related to the MMC may take months to arise, which is why doctors don’t always link it to SIBO.
The second cause is structural—a kinking of the intestines (blind loop syndrome), an impasse or strictures from abdominal surgeries (hernia, C-section, appendectomy, endometriosis, etc.), or other organs pressing on it. Here are some strategies for overcoming this type of root cause.
Finally, another important cause: hypothyroidism can slow the migrating motor complex (!!). There’s still a little ambiguity regarding the connection, but several studies have chronicled the link between sibo and hypothyroidism. And the most common GI complaint among low functioning thyroid sufferers is constipation, a result of slowed motility.
I also talk about how hormone treatments like IVF can contribute to issues with the MMC if you don’t focus on egg retrieval recovery with your gut in mind.
It’s worth noting that most people experience constipation when the MMC is not functioning properly, but you can have poor motility in the small intestine and still experience diarrhea if there’s fast motility in the large intestine.
The good news is that SIBO only becomes chronic when the underlying cause is not addressed. The bad news is there is a high probability of relapse, especially when the underlying cause is not fixable. I will get into how to address some of these issues during part two of this series that focuses on treatment. There is also an entire chapter in my book (30 pages!) on designing the treatment plan that’s right for you, including a handy chart on everything in my medicine cabinet arsenal.
How Do You Test For SIBO?
The main SIBO test involves drinking a synthetic sugar solution and breathing into a tube at various intervals thereafter. It is fairly time consuming, but not unpleasant in the grand scheme of gastrointestinal tests!
The test measures the levels of hydrogen and methane in your breath as the sugar solution makes its way through various parts of your intestines.
Carbs are your bacteria’s number one food source, and symptoms of bloating are caused by the gases they produce as they eat our food. Hydrogen and methane can only be produced by bacteria so their presence in your breath is a dead giveaway. The timing is what indicates whether it is in your small or large intestine. It usually takes two hours to progress to the latter.
The tests only vary in the type of sugar solution used: glucose or lactulose. There are pro’s and con’s to each, and some doctors after receiving a negative result, will try the other.
Glucose can only test the first two to three feet of the intestines, because after that it’s absorbed into the body. But you tend to get a better, clearer reaction from it, so long as the bacteria is actually in that area of the intestines. Lactulose is the safer bet if you want to test for bacteria beyond that point, where it is more likely to hang out.
One thing to note is that doctors and labs still lack a definitive consensus on what levels constitute a positive result. If you come up negative and doubt that diagnosis, it may be worth trying the other sugar (lactulose or glucose) or taking your results to another specialist for a second opinion.
If you treat your SIBO and still have symptoms but come up negative on the SIBO test, there’s likely another diagnosis at play. Most of the time we have more than one digestive problem. And if the connection between SIBO and other conditions is any indication, that is usually true of our whole health picture.
Today, it’s fairly easy to order an at-home SIBO test. I did the 2 hour and 15 minute, 10-tube lactulose breath test from Commonwealth Diagnostics. You can order here or by phone. Just note that if you don’t have a doctor prescribe it, you will likely have to pay out of pocket ($250). Here are some other labs that offer the breath tests as well.
The most important thing to note about breath tests is you MUST prepare properly before you take it. This includes stopping certain medications the week before. My book has a very helpful checklist for everything you need to do to get an accurate result.
What Are My SIBO Treatment Options?
There are many options for treating SIBO, both through antibiotics, herbal supplementation and diet, or a combination of all three. It often varies for the individual case, and can take a few tries to hit on the right recipe. There are also a host of other supplements that can greatly improve SIBO symptoms like digestive enzymes or probiotics, though the latter is a little complicated when it comes to SIBO.
For those who are curious, I did a 4-week course of Biotics herbal antibiotics FC-Cidal and Dyscbiocide, coupled with this low FODMAP diet meal plan and a few other lifestyle changes.
The next post in this series will cover the many options out there for SIBO treatment, and the final installment will do a deep dive on how diet factors into getting rid of this pesky bacterial overgrowth and healing the gut.
OTHER SIBO RESOURCES
- The SIBO Made Simple book (now on shelves everywhere!) takes all the learnings from 50+ interviews with practitioners and distills the advice into a 350 page practical roadmap with 90+ recipes.
- The SIBO Made Simple Podcast covers each puzzle piece of SIBO and breaks it down into easily digestible terms. Here are some topics we cover:
- SIBO Breath Testing
- The Elemental Diet
- Post-Infectious IBS & Food Poisoning
- Methane & Hydrogen Sulfide SIBO
- Candida & Yeast Overgrowths
- Leaky Gut & Autoimmune Disease
- SIBO & Hypothyroidism
- SIBO & Celiac Disease
- Mast Cell Activation Syndrome
- Heavy Metals, Mold & Other Toxins
- CBD Oil & SIBO
- The Low FODMAP Diet
- The Bi-Phasic Diet
- SIBO & Intermittent Fasting
- Skin Issues and SIBO
- Probiotics and Prebiotics for SIBO Treatment
- Healing Structural Issues
- Fertility & SIBO
- Histamine Intolerance & SIBO
- How SIBO Effects Depression and Anxiety
- Acupuncture for SIBO Healing
- Busting Biofilms
- Dr Allison Siebecker’s site is hub of amazing information, SIBOinfo.com
- SIBO 2.0: How to Find the SIBO Treatment That’s Right For You
- SIBO 3.0: The Best Diets and Lifestyle Changes to Treat, Heal and Prevent SIBO From Recurring
- My FREE Low FODMAP Weeknight Meal E-Book
Get more SIBO info right in your ear…
SUBSCRIBE and LISTEN to the SIBO Made Simple Podcast!
Disclaimer: this website offers health, wellness, and nutritional information for educational purposes only. Information provided is not intended as a substitute for the advice provided by your physician or other healthcare professional. Always speak with your physician before trying any new treatment.
This is a real eye-opener. I hope you feel better! If the herbal antibiotics don’t work, would you ever consider standard prescribed medication?
definitely. but in clinical trials, the herbal antibiotics have performed just as well.
I know I am late posting on this thread, but I am trying to find out if anyone experiences neurological symptoms as a result of SIBO. I am prepping to test for SIBO but also going to have an MRI to assess for MS – as I am having balance issues and brain fog & a crazy vibration sensation thru my body most of my waking hours. I am also post Lyme, which makes everybody look at me like I am a hypochondriac when I have a symptom arise!
Phyllis, I am still battling a blazing case of SIBO and yes, I was having neurological symptoms, too, diagnosed in Fall of last yr but I know I had been living with it for at least a yr before learning I had SIBO. I just had an electromyography test to ck the nerve signal conduction throughout my body… I have definite nerve damage. I have weird twitching mostly in my arms, some in my legs, & noticeable weakness in my hands. Bloodwork determined I have the GM1 antibody attacking my nervous system, going for intensive IV treatment soon. Don’t know if all this is related to SIBO? When I asked what could bring on the nerve issue, I was told possibly a virus or infection…hello SIBO! I also have difficulty breathing and know I have mildly scarred airways and lungs, as well as a paralyzed L vocal cord. Still trying to determine if all of this is related and stemming from the SIBO.
Thanks for your reply! The neuro symptoms are concerning. I have what I refer to as “brain glitches”- as if the power flickers & an almost constant vibration sensation in my entire body. Lyme wreaked havoc on my immune system. It CAN predispose to MS but also SIBO. I feel like docs think I’m just crazy! It’s awful.
Phyllis,
I know exactly what you mean about the constant vibration sensation, the type like you are riding in a car, me too. Get yourself checked for a neurological issue. For me, they found a particular antibody is attacking my nervous system for which I need intensive treatment now. I’ve been complaining about this for months! My doc thought maybe put me on anxiety meds… We are not imagining these things, they are real. Fortunately a very sharp neurologist picked-up on some hollowness between my thumbs and index fingers, ordered an electromyography (nerve conduction) test, and found I have nerve damage throughout my body. The immune gets turned on and doesn’t turn off. The treatment hopefully will allow the nerves to heal. I am glad I found out about this before I became any more debilitated, as the fine motor function in my hands, particularly the right, is quite compromised even now. Was ckd for Lyme but neg, though that can raise heck with your immune system. When I asked what could have caused this, they told me a virus or some type of infection, and you’ve had both SIBO & Lyme. No harm in checking, as mine staredt with the vibration sense, then gradually moved into weird twitching in my arms, some in my legs, even my eyelid, along with the vibration, like I’m ready to run a race when I’m just trying to relax.
Wow! This describes so many of my symptoms. Wish I could chat with you. Hope you’re feeling better.
I have never posted on a health forum, but I read your post and your symptoms are so similar to what I experienced after the appearance of an erythema migrans on my hip in 2015, I am posting now. My first symptoms were balance and brain fog. After a course of doxycycline which appeared to help the initial symptoms, additional symptoms of intention tremor and vibration sensitivity appeared (e.g., electric toothbrush). I saw an infectious disease specialist in order to get a referral to a neurologist and he dismissive of the possibility of infection, telling me it was BPPV and that the erythema migrans that I had photographed was a bruise. Fortunately, the neurologist prescribed a course of cefuroxime that arrested the progress of the symptoms. A subsequent MRI showed mineralization in my cerebellum. The symptoms gradually resolved and a follow-up MRI showed no change. I did not have any kind of digestive problems until 2019. Make sure that you follow up with that MRI.
Thanks for your reply & the info. This Lyme has wreaked havoc on my system! It’s very scary. I’m a fairly “healthy” individual but I feel like death most days since my infection. I am approaching 2 years in July. Ready for relief- however, skeptical it will come. MRI on Tuesday… fingers crossed for answers! Best wishes to you.
Phyllis did you ever figure out what was causing the vibrations?
Hi Phoebe, how are you?
Nice and interesting article. For a long time I suffer from digestive problems. I’d like to ask you about your belching symptom. Did it go so far that you burped even after a sip of still water?
I hiccup or burp a lot after eating. I have SIBO. It’s usually one hiccup, no sound. Very annoying. I’m working with a dietician specializing in SIBO & digestion problems.
Hello. I have this symptom as well. Even through treatment. I’m hoping it’ll resolve once I heal myself.
Fabulous information and resources, thank you!
Also, I enjoy reading your posts almost more than any other health writer. I love that you have such a great sense of humour. So important
thank you Janice. that means so much!
When will post 2 be out?
this week 🙂
I was diagnosed with sibo last March. Had very similar symptoms, but frequency and diarrhea were my most unbearable ones. It really started to effect my day, and the pain and cramping made it that much worse. When I saw my naturopath about my symptoms she had me do a food sensitivity test, and last the breath test. Resulting is dairy sensitivity and sibo. I was prescribed a antibiotic for 2 weeks, and then a course of a natural antibiotic (berberine) and 3 types of probiotics for 3 months. She then switched me to a different natural antibiotic and I continue with probiotics. I have altered my diet, but I know I could be better about it. My symptoms start to arise in times of stress, but I have not experienced the severity of my symptoms before treatment. I look forward to reading the best of this series. It is such an underdiscussed and unknown disease.
I’m so glad you’re feeling better Samantha! Stress is a huge contributing factor. You’re so right to recognize that. Good luck!
Hi! Could you share with us which 3 probiotics your doctor prescribed? I went to cedars Sinai (the hospital that you’d think knows everything sibo related) and to my surprise the doctor did not want to prescribe any probiotics after the antibiotic. So I feel the same again, if not worse. I’m retesting next week.
VSL packets is what he put me on. I hear good things about Megaspore.
https://microbiomelabs.com/products/megasporebiotic/
I also went to Cedars Sinai. Dr. Pimentel’s research doctor. She also said stop probiotics. I’m working with a dietician & she’s had me try pre-biotics. I’ve had this a few years. The best thing I did was find a dietician specializing in SIBO. We Skype. Sara Kahn in New York. [email protected]
I have been severely sick its pain everywhere . Since March my body just went out of control trouble breathing pain in my stomach so bad couldn’t eat ,lost so much weight went 1like 158 to 135 now and I was diagnosed methane Sibo in October. After taking antibiotics, which was all I was given and thats it , about a month later I became sick again and still are. I was never told about anything else but ,here take these 2 antibiotics thats it. I can feel its back and im not getting no help besides being given another course of antibiotics again,which my insurance is fighting against giving me the one ,so I’m stuck still in so much pain. I am completely disabled .im 37 year old and I feel like I’m dying . I was intrigued reading your message and what was given to you .so if you could give me any help or advice I could definitely use and appreciate it. Thank you.
Hello
how is the natural antibiotics working for you ?
I’ve been on them for two days and I feel more brain fog .
my symptoms got worse while taking them FOR SURE. but they worked! I tested negative.
I had surgery for a small bowel obstruction 2 years ago. I’ve had problems since and finally found a gastroenterologist who diagnosed SIBO after testing. I finished up with the 2 weeks of antibiotics about 3 weeks ago. I’m still having pretty severe diarrhea. I’m assuming that either the antibiotics didn’t work or it’s side effects from Neomycin.
Has anyone else had this experience? I’m trying to eat low FODMAP but I’m obviously not doing it right. I’m getting retested next month and also some labs.
Hi Ann! WhAt symptoms did you have with the small bowel obstruction? I feel that I might have this and doctors aren’t listening. Thank you
Chronic intermittent constipation for several years. Feeling like my bowel had just stopped working many times. Was told by M D to take Miralax. This seemed to work intermittently. Then without warning I just “blew up” and my abdomen was literally hard as a rock. The pain was the worst I’ve ever felt. I was in the hospital 2 1/2 weeks and they still couldn’t find where the obstruction was. Was finally discharged. Couldn’t eat much without diarrhea and pain. 2 months later I finally got a doctor to operate (after loosing 25 lbs).
Crazy! Thanks for your response. A doctor I saw recently did tell me I’d probably be in the hospital if I had a blockage but I thought it was still a possibility. My symptoms is I don’t fully empty my bowels in the morning. Instead I go and go and go… but not Diarrhea. And that causes my sweat to smell terrible. I don’t know if it’s because the poop sits inside me long or because of the bacteria. All doctors I’ve seen are clueless about the cause so it’s depressing
That sounds frustrating. I hope you find an answer soon. Ann
Thank you so much for this intro to SIBO! I have been diagnosed with IBS and recently have been having abdominal pain. My tests came back as positive for SIBO. Still trying to determine more, however this was a great intro on what SIBO is and why it might be happening in my body. I’m going to refer my mom to your website since I feel this is the best information on the web when it comes to SIBO!
thank you michelle! so happy you’ve found it helpful.
Hi Phoebe,
Thanks so much for educating me about SIBO. I think I may have it – was diagnosed with Celiac Disease about a year ago and am still symptomatic after going gf. My gastroenterologist said she could treat me for SIBO but didn’t recommend testing for it. Here’s what she had to say: “There are breath tests on the market to test for the presence of SIBO but they don’t work very well. Our group evaluated the test characteristics and decided not to buy into the technology at this time. Instead, if patients have symptoms that are suggestive of SIBO, we make an assumption that you may have it and give you a 2 week antibiotic course to treat and monitor to see if you get better (this was also the management algorithm when I was in training at UCSF).”
What do you think? Should I try the antibiotics without testing for SIBO?
Thanks!
Chase
Thank you for sharing. There are definitely practitioners who feel this way. However, every SIBO specialist I have talked to emphasizes how hard it is to treat properly if you don’t know which type of SIBO you have – hydrogen or methane. If your doctor just wants you to put you on the rifaximin and see what happens, and you’re comfortable with that, go for it. If it doesn’t work though, you might want to get the test. Also, if you’re still symptomatic, it could be SIFO – fungal overgrowth and not SIBO.
Hi Chase,
I was just seen at UCSF by an gastroenterologist on July 1st. I was told I had symptoms of SIBO. When I asked to be tested, she said they don’t do it there. She put me on 550mg of Xifaxan 3 times/day for 14 days. I contacted my primary and he said to do it. My bloating has gotten worst after 10 doses. and was told to take Gas or Simethicone to counter the gas. She can’t do the colonoscopy and endoscopy until Sept. when she has available appointment. She also put me on Align probiotics. Are the tests expensive?
I was in the hospital for 5 days for adhesions bowel obstructions in Marcha and they recommended surgery to remove them which I emphatically said no to. I don’t know what to do.
I learned a lot tonight from your writing. Thank you so much.
What kind of sibo did you have? Methane or hydrogen? Thanks!
hydrogen
This is so helpful! I am new to the blog and am sure you have written about this before, but do you have recommendations for probiotic supplement sources/brands? After reading this post I realize I use the same one from Costco that I have always used, and maybe it is time I branch out. You may already have a post about this: can you point me in the right direction? Thanks so much!
here you go! https://feedmephoebe.com/best-probiotic-supplements/
Hello Pheobe,
Your page and reviews/ information is a breathe of fresh air. I have been dealing with extreme bloating for years..I did abuse laxitives and have stopped for over a year and have been working with a specialist that has me on a rotation with the herbs you took however he suggests I carb load for the 3 days I take them to “feed” the bacteria…my symptoms are worse then ever 🙁 so distended can I ask if this sounds like a “good” protocol or cycling the herbs you mentioned while on a low fodmap diet? Any advise is SO appreciated!!
definitely listen to episode of the podcast with Nirala Jacobi and the first one with Dr Siebecker.
I received a diagnosis of SIBO following a breath test after seeking help for severe bloating and frequent belching which arose during a lengthy round of antibiotic treatment for suspected prostatitis. The bloating/ belching for the most part resolved but I chose to proceed with rifaximin treatment as I was continuing to experience frequent pelvic pain and hip pain I associated with the SIBO and its effects. After one day I am experiencing belching and bloating again and am concerned. Any advice on whether this could be SIFO and not being treated properly or what the effects of die off are? Probiotics seemed to exacerbate pelvic/urinary issues so I discontinued them.
Hello, Do you know anything about lactitol tests? are they reliable? Thanks!
Hi there, interesting read. I’m not sure if my symptoms are exactly the same, but they seem close. I don’t know what the symptom “bloating” is supposed to feel like – my stomach feels sick, sore and the pain feels a bit like i’ve drank too much water/extreme hunger/anxious (butterflies) feeling. I’m also hypothyroid and get dull headaches. Toilet breaks aren’t too bad but can come on quickly. Does that sound like SIBO to anyone else? I’ve got a lactulose test scheduled but I thought I’d ask anyways!
Hello Phoebe,
I stumbled upon your site, so glad I did! Just diagnosed (Hydrogen-Methane lactulose test) w/SIBO, whopping 4x over normal. I’m 64, have multiple issues (1 yr old paralyzed L vocal cord & thickened lg airways making it hard to breathe (had breast cancer radiation 2015 that caused this), kept having over 50 horrific laryngeal spasms where I couldn’t breathe at all, told ‘silent heartburn causing the burning in my vocal cords, put on/tried several different H2 & PPIs for this killer ‘silent’ heartburn (though I never had heartburn before!), kept complaining of ‘heat’ coming up my throat (I now know was SIBO gases), kept complaining (full yr!) of ‘pressure’ under on my L side under the last rib (felt like I was punched & the fist was left in there), recent fleuro ‘sniff’ test finally found a seriously elevated (but working) L diaphragm (but not why?), leading to a very highly positive H2-Meth test. If all this isn’t enough, now I’m so sick from a high-dose flu shot 4 wks ago that I feel like I am dying. Waiting for Xifaxan to be approved by my ins. Done a ton of reading (your site most helpful!), started Mastic Gum 3 days now and SIBO diet as best as I could figure in prep for the ‘kill’ stage. Docs seem useless (and I’m at Yale Univ!), your site has been life-saver for these 3 days. I’ve been reading it all! Any tips you can send my way in these infancy SIBO kill days? I’m erring on the side of ‘don’t eat it’ and looking up everything for FODMAP. My throat is so terribly raw which leads to more breathless spasms…any safe relief?
Great info. Did you follow the recommended protocol on the biotics website? They recommend 2 weeks kill, 2 weeks rebuild with probiotics, then repeat. I’ve never heard of switching like this. Is this what you did?
Phoebe, I realize how late I am to respond as to when you posted this article. I have Hashi’s and I’m hypo. I literally just started treating the hypo after knowing for 10 years about the diagnosis, and I’m only treating because I saw a FMD for it. My regular MD wouldn’t treat based on my numbers. I have been sugar-free and grain free for going on two years. I’m fairly certain I may have SIBO at play with my body. I’ve lost 120# in the year and a half that I’ve been sugar and grain free. I had also just recently tried strict AIP (with the exception of some erythritol and certain spices) to try to get to the bottom of my frequency and D. I can’t pinpoint anything exactly, except maybe asparagus, too many berries at once, cauliflower? Both those are guesses. I’ve literally logged everything I’ve put into my mouth for nearing two months. My question is, if I can get this FMD to order a breath test, how sick is this sugar solution going to make me? I’m here to tell you, when honey passes my lips or anything of that sort, I’m a mess for a day or two. But I only have D. No stomach cramps, no bloating, no nothing. If it weren’t for the D, I’d be moving right along and not complaining for a second. It’s so unpredictable. That’s my problem with this whole thing. But drinking a sugar-based liquid for the test? I’d be lying if I said I’m fine with it….not for any other reason than I think it’s going to make me terribly sick since I’m sugar-free. The other side of me says, just assume I have it and treat it with the herbals for D and see what happens. Coincidentally, I did have to be hospitalized overnight last June for what appeared to be an ischemic/dead place in my lower small intestine or what they thought was a blood clot. Nothing came of that with a barium swallow. Everything was negative.. The doctor attributed it to a kink in my bowel from losing all the weight I had lost, and I’ve never had any problem since. My issue now is that I’m still losing and not trying to. I’m pretty sure my nutrients aren’t getting into my system.
All speculative, of course. Thoughts?
Wow!
I am new here too.
I have a diagnosis of MMM (mucus membrane pemphigoid) which is an autoimmune disease. It primarily attacks ALL of my mucus membranes (very painful blisters all over), IgG deficiency and hypothyroidism.
My newer doctor (a functional MD) suspects I have SIBO (taking the test to confirm next week), but the symptoms I have seen here parallel mine, the bloating, the gas and the brain fog (searching for words and not finding them).
These comments and Phoebe’s article make so much sense. I really can’t believe that so many doctors refuse to look for the real cause a person has a disorder.
Autoimmune diseases do not “just happen.”
Thank you Phoebe and everyone here who have shared their intimate experiences and details. I am so grateful!
I would like to do a SIBO test, so do I need to find a SIBO doctor, or my GI doctor can prescribe me the test? Thanks!
Thanks for the detailed information. I have some of these symptoms and I think I will raise these with my doctor next time I see him and suggest I get the “synthetic sugar” test that you describe above and see what he says.
I just ordered your book. I’m going on 3 years of recurrent SIBO. Back then, I tested high in both methane and hydrogen SIBO. We are a mold sick family. We left mold in 2014 and have been great since. So I know that’s no longer a factor. I’ve never had food poisoning that I recall and no endoscopies/colonoscopies showed abnormal anything. I also do not take antibiotics and we generally eat low sugar. I just can’t figure out WHY this keeps happening. It doesn’t take much-just 2 weeks of not eating perfectly (too much grains and sugar) and bam. And by 2 weeks of eating bad I mean I had ice cream twice and more wheat than normal. And overeating. I’m a good healthy weight, but I ate too much. Any guidance? Also, it’s been 3 years, but I got violently sick from the glucose test and I never ever want to be that sick again. Do I really need to retest or do you think I just trust my experiences to know what I’m dealing with?