Small Intestinal Bacterial Overgrowth (cont.)
Is there a relationship between SIBO and irritable bowel syndrome (IBS)?
Irritable
bowel syndrome (IBS) is a common
gastrointestinal condition. Patients with irritable bowel syndrome typically complain of abdominal
pain associated with bloating, gaseousness, and alterations in their bowel habit
(diarrhea, constipation, alternating diarrhea and constipation, or a sense of
incomplete evacuation of stool). Irritable bowel syndrome is a chronic condition. Symptoms can be
continuous or vary over months, years, or even decades. While irritable bowel
syndrome is not
life-threatening, symptoms of irritable bowel syndrome can have a major impact on a person's
quality of life and can even be
debilitating. For example, a patient with diarrhea after meals may avoid eating
out. Patients who experience bloating and abdominal pain after meals may develop
a fear of eating. In its extreme, they may even lose weight. Even flatulence can
be socially limiting.
Irritable bowel syndrome has been a frustrating condition for both physicians
and patients because it is difficult to diagnose and treat. Irritable bowel
syndrome is difficult to
diagnose because there is no test that will be abnormal. The diagnosis is made
on the basis of typical symptoms and tests that exclude OTHER diseases that
might be causing the symptoms such as ulcers, infections, tissue inflammation,
cancers, and obstruction of the intestine. Tests to rule out other conditions
include CT scans, barium x-rays,
upper gastrointestinal endoscopies, and
colonoscopies. Physicians have to rely heavily on their clinical judgment to
decide when enough testing has been done and to confidently make a diagnosis of
irritable bowel syndrome. Physicians are frustrated further by the fact that the treatment for
irritable bowel syndrome is
not helpful to many patients.
There is a striking similarity between the symptoms of
irritable bowel syndrome and SIBO. It has been theorized that SIBO may be responsible for the
symptoms of at least some patients with irritable bowel syndrome. The estimates run as high as 50% of
patients with irritable bowel syndrome. Support for the SIBO theory of IBS comes from the observation
that many patients with irritable bowel syndrome are found to have an abnormal hydrogen breath
test, and some patients with irritable bowel syndrome have improvement of their symptoms after
treatment with antibiotics, the primary treatment for SIBO.
Furthermore, it has been reported that successful treatment of symptoms with
antibiotics causes the hydrogen breath
test to revert to normal, suggesting that bacteria indeed
are causing the symptoms. Although this theory is tantalizing and there is much
anecdotal information that supports it, the rigorous scientific studies that are
necessary to prove the theory have just begun. Nevertheless, many physicians
have already begun to treat patients with irritable bowel syndrome for SIBO. The intriguing issue yet
to be elucidated is the reason why individuals who appear normal develop SIBO
and IBS. The most popular theory is that patients with irritable bowel syndrome have a subtle
abnormality in the function of their intestinal muscles that allows SIBO to
occur.
Next: How is small intestinal bacterial overgrowth
treated? »
- metronidazole, Flagyl - Explains the medication metronidazole (Flagyl) an antibiotic drug used against anaerobic bacterteria and certain parasites like giardia and ameba that can infect parts of the human body. Article includes descriptions, uses, drug interactions, and side effects.
- Hydrogen Breath Test - Read about the hydrogen breath test used to assist in diagnosing lactose intolerance, bacterial overgrowth of the small bowel, celiac disease, and pancreatic insufficiency.
- Abdominal Pain - Learn about abdominal pain (pain in the stomach / abdomen) including causes, symptoms, how abdominal pain is diagnosed, and how abdominal pain is treated.
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