I have been helping people with their farting, bloating and poop problems for a long time. Way back in 2010 and learned about a condition called small intestinal bacterial overgrowth, also known as SIBO, which is responsible for 70% of irritable bowel syndrome symptoms (IBS).

The good news is we can fix SIBO and get the IBS symptoms under control. At the time I was seeing so many patients with IBS that were not getting better with all of the tools I was taught in medical school. Probiotics often made these people feel worse. When they took an antibiotic for a sinus infection their gut symptoms got better for a few weeks.

They reacted to this weird list of foods that did not seem to make sense. I knew what I was doing was not working and I knew that my patients needed help. I started reading everything I could on SIBO and continue to stay up-to-date on this very common and very annoying condition. I have been specializing in the treatment of SIBO for 12 years and beyond treating my patients I also frequently speak on the topic.

My goal is to make SIBO a household name, put SIBO in remission and get you back to living your life. In the past, people who were diagnosed with irritable bowel syndrome (IBS) were told to, “Go home, maybe avoid dairy and avoid stress”. Very few people with irritable bowel syndrome received relief from this advice. Also, how do you avoid stress?! If anyone reading this has figured out how to avoid stress, this busy doctor wants to know!

To better understand how we would go about addressing SIBO and IBS also let me explain more about how this happens.

SIBO is caused by changes in your body’s ability to quickly move food through your small intestine as intended.

If food sits in your small intestine longer than it is supposed to, the very low level of bacteria that is supposed to exist in your small intestine begins to feed on that food and then the bacteria over grows.
These bacteria produce gas when they eat food, just like we do.

The more bacteria you have in your small intestine the more gas they produce and your body has a hard time getting rid of it during the day. Now you are on the road to bloat city!
Then you find yourself unbuttoning your pants at the dinner table and hope that no one notices.
When these excess bacteria produce hydrogen it will make our intestines move faster and we will get diarrhea and sometimes have to run to the bathroom.

When these bacteria produce methane we will be constipated and spent way too much time sitting on the toilet. When these bacteria produce hydrogen sulfide we could have either diarrhea or constipation.
And the best part is you could have a mix of all 3 gases battling it out for dominance in your intestines.

So. Much. Fun.

People that produce excess hydrogen or methane gas will commonly not respond well to a class of foods called FODMAPs. This is that weird list of foods that I mentioned on the front breakout of the article.
FODMAPs are fermentable sugars and sugar alcohols the bacteria in your small intestine love. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols.

High FODMAP foods that people with SIBO may not tolerate:

  • Wheat, garlic, onion
  • Peaches, nectarines, cherries, avocado
  • Dried fruits, honey, high fructose corn syrup, erythritol
  • Beer, wine
  • Beans, lentils
  • Cabbage family vegetables: Cauliflower, broccoli
  • Dairy products
  • Sweet potatoes
  • Mushrooms
  • And many, many more!

People with hydrogen sulfide SIBO do not tolerate high sulfur foods well. This includes garlic, onion, cabbage, broccoli, cauliflower, eggs, garlic, onion, among others. It is thought that people with hydrogen sulfide SIBO have difficulty metabolizing sulfur in their diet and their body puts more sulfur into their intestines.

Hydrogen sulfide SIBO is much more common in those with inflammatory bowel disease such as Crohn’s disease or ulcerative colitis. Before we can fix SIBO we have to know what type of SIBO you have. It is diagnosed by a take-home breath test that we have available at the office. I always mention that, “this is like no test you have ever taken”.

I will be the first to admit it is weird. You eat a weird diet with just starches and protein the day before the test, fast for 12 hours, then wake up in the morning and drink this sweet stuff mixed in water then collect your breath and tubes or bags over the next 2 to 3 hours.

Then you put that box of your breath in the mail and send it off to the lab.
Like I said, it is weird, but this is the only way to easily diagnose small intestinal bacterial overgrowth.
Once we know what types of gases these bacteria produce then we can reduce the overgrowth, restart normal motions of the intestines and identify what food triggers you may have.
Then you can get back to fitting in your pants, eating most of the foods that you love and living your life. When you are ready to give me all of the dirty details about your digestive issues I am ready to listen and get to work.

Common symptoms of small intestinal bacterial overgrowth:

  • Abdominal bloating that is worse as the day goes on, so much so that you do not fit in your pants at the end of your day.
  • Flatulence also known as farting
  • Burping and bleching
  • Diarrhea, constipation or loose stools
  • Incomplete stools or urgent stools
  • Abdominal pain
  • Multiple food intolerances, reactions to high FODMAP foods
  • Heartburn
  • Fatigue
  • Brain fog-cloudy thinking
  • You feel worse when you take probiotics or eat probiotic rich foods
  • Your digestive issues improve when you take antibiotics

Common causes of SIBO:

  • Past food poisoning 
  • Chronic untreated  constipation, especially in children. 
  • Repeated use of antibiotics 
  • Celiac disease 
  • Inflammatory bowel  disease such as Crohn’s or colitis

About the Author:
Dr. Sabrina Kimball has worked extensively with digestive conditions. If you are interested in learning more or setting up a visit, please give us a call at (425) 949-5961 or visit us at aim4healthnw.com.