Small Intestine Bacterial Overgrowth

Small Intestine Bacterial Overgrowth: Cause of IBS found!

Small Intestine Bacterial Overgrowth: Cause of IBS found!

Olivia Franks, ND

It is estimated that IBS affects between 25-45 million people in the US.  A recent study in the prestigious Journal of The American Medical Association (JAMA) has found that overgrowth of normal bacteria was at the root of 84% of irritable bowel syndrome (IBS) cases[i].  This overgrowth that happens in the small intestines (not the stomach or the colon) has been labeled small intestine bacterial overgrowth or SIBO.  It will not show up on endoscopy, colonoscopy or even stool tests.  It is also implicated as the cause of fibromyalgia, and is associated with rosacea, lactose intolerance, thyroid disease and even Celiac disease.[ii][iii][iv][v]

Symptoms of SIBO include bloating, abdominal pain, diarrhea, constipation, heartburn and nausea.  And can also include global symptoms like joint pain, headache, skin, brain or mood symptoms.  Malabsorption of fats and iron – leading to mild anemia is common.

Diagnosis can be done by at home breath tests or biopsies of the small intestine. It will not show up on endoscopy, colonoscopy or even stool tests.

Treatment for this usually involves either antibiotic herbs or pharmaceutical antibiotics along with probiotics (healthy flora), prebiotics (food for the healthy flora) and a specific carbohydrate diet.  The specific carbohydrate diet involves avoiding grains, starchy vegetables, dairy, sweeteners (except honey) and in the beginning beans.  This diet is very similar to a Paleo diet – a diet many feel much better with.  Optimizing stomach and pancreatic function is often key to preventing re-infection.

In my practice, I have found that identifying and treating this in my patients has produced remarkable results!  Can you imagine have severe bloating every day?  Having seen specialists and MD’s, and is some cases other ND’s without any relief? In most cases relief comes within a few days of starting treatment. Nothing is more rewarding than finding the solution to someone’s health problems!

If you or someone you know has been suffering with IBS for too long please call the clinic to schedule your appointment today.  Relief and return to wellness may be just around the corner.


[i] Lin HC, Small intestine bacterial overgrowth: a framework for understanding irritable bowel syndrome. JAMA, 2004;292(7):852-858.

[ii] Goebel A, Buhner S, Schedel R, Lochs H, Sprotte G. Altered intestinal permeability in patients with primary fibromyalgia and in patients with complex regional pain syndrome. Rheumatology (Oxford). 2008;47(8):1223-1227.

[iii] Lauritano EC, Bilotta AL, Gabrielli M, et al. Association between hypothyroidism and small intestinal bacterial overgrowth. J Clin Endocrinol Metab. 2007;92(11):4180-4184

[iv] Almeida JA, Kim R, Stoita A, McIver CJ, Kurtovic J, Riordan SM. Lactose malabsorption in the elderly: role of small intestinal bacterial overgrowth. Scand J Gastroenterol. 2008;43(2):146-154

[v] Rubio-Tapia A, Barton SH, Rosenblatt JE, Murray JA. Prevalence of small intestine bacterial overgrowth diagnosed by quantitative culture of intestinal aspirate in celiac disease. J Clin Gastroenterol. 2009;43(2):157-161