When do you start to wonder if there is something more going on in your gut than just a little post meal indigestion?
After all that’s normal. Right?
Actually, we put up with a lot of symptoms we shouldn’t really put up with because we assume they are normal.
Irritable bowel syndrome (IBS), small intestine bowel overgrowth (SIBO) and the symptoms that come with them are prime examples that aren’t normal, and we shouldn’t put up with.
What is IBS?
The definition of IBS, or irritable bowel syndrome, includes:
• abdominal bloating associated with eating
• either constipation or diarrhea
• abdominal cramping and discomfort
For the longest time, IBS was considered a condition of “nervousness”. While IBS does indeed involve the nervous system, the idea that it is an affliction of “nervous people” has been debunked.
In fact, IBS affects up to about 15% of the population.
Many cases of irritable bowel syndrome actually involve an imbalance of bacteria in the gut. This can occur anywhere in the large intestine or the small intestine.
What is SIBO?
SIBO, or small intestine bacterial overgrowth is a subset of IBS. Up to 78% of people who have IBS have overgrowth of bacteria specifically in the small intestine.
Obviously, the small bowel is difficult to get to for sampling. For the large bowel you can always do a poop test. That’s not possible for the small bowel, which is quite long, and sandwiched between the stomach and the large bowel.
But there is indeed testing for this. With new methods coming along to test more for more bacterial types.
The Big 4 Symptoms of IBS and SIBO
Abdominal bloating is the most common symptom with IBS and SIBO. There is nothing unusual about occasional bloating, for instance, if you eat an unusual food or an unusual amount. But daily bloating, especially after you start eating for the day, is a big tip-off.
2) Constipation or Diarrhea
The normal state of the bowel is to have one to two bowel movements per day. They should be nicely formed, fairly substantial, and not involve straining. Anything less than daily is not normal. Three to four times per week is definitely not normal.
Diarrhea, either too many stools in a day or unformed stools, are not normal either. These episodes can often involve great urgency to get to the bathroom in time.
Many people with IBS or SIBO can alternate between constipation and diarrhea. In both cases, having a bowel movement can relieve symptoms temporarily.
3) Cramping and Abdominal Discomfort
The cramping and abdominal discomfort that can come with IBS and SIBO may occur right after eating, delayed after eating, or seemingly for no reason.
Often times people will get some relief from having a bowel movement. Many resort to trying to not eat foods that seem to bother them, which leads to the fourth symptom.
4) Food Sensitivities
Foods that cause increased bloating or any other symptoms, including skin symptoms, hives, or brain fog, are common with SIBO especially.
This can happen particularly with foods that are very fermentable, called the FODMAPs foods. Unfortunately, many of these foods are actually excellent foods, such as artichoke, onion and garlic, but they can feed bad bacteria along with the good bacteria.
Food sensitivities can also happen with wheat, gluten, and any starchy or sugary foods that encourage bacterial growth, or in some cases, Candida overgrowth.
Controlling the symptoms alone will not heal IBS and SIBO
It is more clear by the day that IBS and SIBO involve a combination of gut bacterial communities, the immune system and the nervous system.
There are tests to look at the bacteria in the gut and the gas byproducts they make, which are becoming more sophisticated. In most cases, the routine stool test to look for a handful of bacteria that cause acute gastroenteritis is not useful in IBS and SIBO.
Do not accept that your gut issue symptoms are just normal. Do not be one of the people who never seek help for IBS. There is help.
You can see more about diagnosing and treating IBS, SIBO and Candida in this post.