Do you have fatique, headache and stomach upset at the same time? If the answer is yes, gas and bloating can be one of the reasons. If the situation is chronic, you may need to consult a doctor. But most of these symptoms subside within a few hours and again start when you have a meal or dinner. The ‘real culprit’ behind such irritating symptoms is called “small intestinal bacterial overgrowth” or simply “SIBO”.
What is SIBO?
According to MedicineNet.com, there are about 10,000 bacterial per milliliter of fluid in the small intestine or small bowel. (This small intestine is part of the ‘macro’ digestive system that connects the stomach with the large intestine or colon.) These include both harmful and good bacteria. But patients with SIBO experience excessive amounts of unhygienic, colonic-type of bacteria in their small intestines. These unhealthy bacteria act on the lining of the small bowel and can cause some irritating symptoms.
Most of the time when the food remains in the digestive system, this condition arises. The unhealthy bacteria act on the undigested food and convert it into gas. This creates bloating. This condition is also associated in patients with gastroparesis. Since diabetic patients have ‘unhealthy’ bowel movements, SIBO can be a primary cause for headache, fatique, constipation and diarrhea in such people.
This is also known by the name small bowel bacterial overgrowth syndrome (SBBOS).
What are the Symptoms?
There can be several indications of this SIBO syndrome. But the main symptoms of SIBO include
- Excess wind
- Abdominal bloating and distension
- Diarrhea or Constipation or both
- Abdominal pain
- Partial or intermittent obstruction – Crohn’s disease or adhesion from previous surgery
- Body aches
- Weight loss
- Heartburn (Reflux or GERD)
- Food Sensitivities
- Joint Pain
- Skin symptoms (such as eczema or rashes)
- Respiratory symptoms (such as asthma)
- Mood symptoms (such as depression)
- Brain symptoms (such as Autism)
The same symptoms that are associated with some other diseases or conditions can arise in SIBO. Some of the other disorders associated with SIBO are –
- IBS – irritable bowel syndrome
- Malabsorption syndromes
- Food sensitivities – such as lactose intolerance
- Chronic Fatigue Syndrome
- Joint symptoms
- Skin symptoms – eczema, rashes, rosacea
According to this article
SIBO is very common in gastroparetics with predominance of abdominal pain and bloating, especially those with a longer duration of gastroparesis. Awareness of SIBO in the setting of gastroparesis will facilitate separation of the 2 entities and allow appropriate therapies to be instituted.
Patients with autonomic neuropathy have a significantly higher prevalence of SIBO, that is also associated with a higher daily insulin requirements.
Another study indicates that SIBO in type-2 diabetes patients may be due to delayed OCTT (orocecal transit time).
According to a ‘reputed’ body in gastroenterology, about 84% of patients suffering from IBS are more likely to suffer from SIBO. This is also like the sub-sect of IBS. So once this symptoms for IBS subside, the SIBO symptoms are tend to decrease.
What is the Test to Identify SIBO?
SIBO is usually diagnosed with a test called the ‘hydrogen breath test’ or ‘methane breath test’. This is used as a diagnostic tool for patients with IBS and common food intolerance. The test is simple, non-invasive and is performed after a short period of fasting (likely about 12 hours). In this test, any release of hydrogen or methane gas that is evolved due to the anaerobic bacteria acting on the ‘undigested’ food stuff inside the small intestine is measured. These gases are more likely to be released by the unhealthy bacteria present in the small bowel. So if you have excessive hydrogen or methane, than you are more likely to be ‘positive’ with SIBO.
But there are also some limitations with this test.
What is the Treatment?
Doctors are more likely to give you an antibiotic called ‘Rifaximin’ to treat SIBO symptoms. This will automatically reduce the amount of gas and bloating. Xifaxan is the common brand name used in USA. This is mostly used to treat patients with traveler’s diarrhea. But it’s also effective for non-constipating IBS symptoms. These are generally available in the form of tablets of 200 and 550 mg. The recommended dosage is 200 mg 3 times daily for 3 days for traveler’s diarrhea.
You can also find different brands for ‘Rifaximin’ in India. These are listed here. (http://www.drugsupdate.com/brand/showavailablebrands/1054)
There can be also some side-effects in usage of this drug. These are more likely the symptoms of SIBO, which didn’t go away still. If you are having these side-effects, immediately consult your doctor.
- Black, tarry stools
- dizziness or lightheadedness
- muscle spasm
- rapid breathing
- shortness of breath
- trouble sleeping
- unable to sleep
Dr. Mullin, an integrative gastroenterologist at Johns Hopkins Medical Center in Baltimore, prefers to use oregano oil, wild garlic and berberine (the active constituent of Oregon grape root and other plants used as GI remedies), which can help reduce the excess bacterial growth. (http://www.drweil.com/drw/u/QAA401348/Diet-to-Cure-SIBO.html)