Have you been diagnosed with IBS and SIBO? Are you wondering what it all means and how these two conditions connect? Here are the 3 most important things you need to know.


#1 What is SIBO?


SIBO stands for Small Intestinal Bacterial Overgrowth. This condition refers to a bacteria (or fungus) that has overgrown to where it doesn’t belong. This is a form of dysbiosis (imbalance of the healthy and unhealthy flora in our gut). Dysbiosis is a major issue when it comes to managing IBS!

This can be caused by healthy gut flora that’s gone rogue and is living where it doesn’t belong. It can also be caused by pathogenic bacteria and can be referred to as an infection.


#2 SIBO Diagnosis Controversy


Whenever I encounter someone looking for support with SIBO, my million-dollar question is:

How were you diagnosed?

There are two main tests discussed in the blogosphere when it comes to diagnosing SIBO: the Lactulose Breath Test (LBT) and the Glucose Breath Test (GBT).

Both of these tests have the benefit of being non-invasive. But, both of these tests have the negative of being very inaccurate. 


Lactulose Testing


The Lactulose testing shows false positives over 35% of the time. This means that if you have been diagnosed with SIBO from this test, there is more than a 1-in-3 chance that you DON’T actually have SIBO!

Another trial has shown that IBS sufferers with confirmed SIBO have had the Lactulose test and shown up negative for SIBO 100% of the time! This means that having the Lactulose test may completely miss your undiagnosed SIBO!


Glucose Testing


The Glucose Breath Test has much better accuracy with fewer issues for false positives. The problem with the glucose breath test is that it can’t tell you anything about which bacteria is causing the problem!

We need to know which direction this overgrown bacteria is coming from. Is it from the mouth, or is it from the colon? It’s important information because this alters the methods used to treat you and get the best results.


#3 Gold-Standard Diagnosis


So how do you get an accurate diagnosis? I always refer to a gastroenterologist who will do a Jejunal/Duodenal Aspirate and Culture

This form of diagnosis is more invasive than breath testing, but it’s much more accurate. It’s still not perfect, but it’s the gold standard for diagnosis.

We can assess which direction the bacteria is coming from (mouth or colon) and can assess most of the problem-causing bacteria. This means that when we treat, we know a) that you really do have SIBO and b) how to customise treatment specifically for your situation.


IBS and SIBO: Chicken or Egg?


It’s hard to know which came first: IBS or SIBO?

What we do know is that if there is a structural issue in your gut, this can absolutely lead to the development of SIBO. Likewise, SIBO can be the cause (and a major driver) of IBS.

Either way, if you have IBS and have been accurately diagnosed with SIBO, you must eradicate it if you want to heal your IBS symptoms. As long as dysbiosis is present, your symptoms will remain.


Medical Treatment for SIBO


There is an antibiotic called Refaximin that your specialist might prescribe for your overgrowth. It has definitely been shown to help kill off the offending bacteria. There is a chance of re-infection after antibiotic treatment, though. Some people can end up needing multiple courses of this drug and can suffer from much worse IBS symptoms as a result.


What I Can Do To Help


Alternatively, the naturopathic approach can work well to prevent re-infection, as well as reducing your IBS symptoms.

Treatment can also include herbs and probiotics that can target the offending bacteria if you prefer to avoid Rifaximin altogether.

Your health is your decision. I can support your journey to healing IBS with or without antibiotics as part of the picture.


The Next Step


Do you suspect you have SIBO? Have you been diagnosed via a Lactulose Breath Test instead of Gold Standard Testing?

Book your FREE 15-Minute Gut Health Assessment with me right now to discuss where you’re at now and where you’d like to be with your digestive health!


Lauren Booth

BHSc (Nat)

Nutritionist & Naturopath




Share the "Like"!

Share the "Like"!