Symptoms of SIBO vs. IBS

When it comes to digestive health, the terms Small Intestinal Bacterial Overgrowth (SIBO) and Irritable Bowel Syndrome (IBS) are often discussed, sometimes interchangeably. However, these are distinct conditions with different underlying causes, symptoms, and treatment approaches. Both can significantly impact quality of life, but understanding their differences is crucial for effective management. In this post, we’ll explore the symptoms of SIBO vs. IBS and discuss holistic, functional medicine approaches to treatment.

What is SIBO?

SIBO occurs when there is an overgrowth of bacteria in the small intestine, where bacterial levels are typically low compared to the large intestine. This overgrowth interferes with normal digestion and nutrient absorption, leading to a range of gastrointestinal and systemic symptoms.

Common Symptoms of SIBO Include:

Bloating and Abdominal Distension: Especially after meals due to bacterial fermentation.
Diarrhea and/or Constipation: Alternating patterns may occur.
Excessive Gas: Includes flatulence and burping.
Abdominal Pain or Discomfort: Often cramping in nature.
Nutritional Deficiencies: Particularly vitamin B12, iron, and fat-soluble vitamins.
Fatigue and Weakness: Due to nutrient malabsorption.
Unintentional Weight Loss: In more severe cases.
Food Intolerances: Especially to fermentable carbohydrates (FODMAPs).
Brain Fog: Occurs due to the gut-brain axis dysfunction, where bacterial toxins like lipopolysaccharides (LPS) and D-lactate, systemic inflammation, and nutrient deficiencies (e.g., B12, iron) impact cognitive function. These factors can lead to mental fatigue, difficulty concentrating, and memory issues.

What is IBS?

IBS, on the other hand, is a functional gastrointestinal disorder. While the exact cause of IBS is not fully understood, it’s thought to involve a combination of altered gut motility, visceral hypersensitivity, and gut-brain axis dysregulation.

Common Symptoms of IBS Include:

Abdominal Pain or Cramping: Often relieved by a bowel movement.
Altered Bowel Habits: This can manifest as diarrhea (IBS-D), constipation (IBS-C), or a mix of both (IBS-M).
Bloating and Gas: Often accompanied by a feeling of fullness.
Mucus in Stool: Particularly common in IBS-D.
Urgency to Defecate: Frequently seen in diarrhea-predominant IBS.
Feeling of Incomplete Evacuation: Common in constipation-predominant IBS.
No Significant Nutritional Deficiencies: Unlike SIBO, IBS does not typically cause malabsorption.

Symptoms of SIBO vs. IBS: How to Tell the Difference

Both SIBO and IBS share symptoms like bloating, gas, and changes in bowel habits, which can make differentiation challenging. However, there are some key distinctions:

Nutritional Deficiencies: More common in SIBO due to malabsorption of vitamins and minerals.
Weight Loss: May occur in SIBO but is rare in IBS.
Systemic Symptoms: Fatigue and nutrient-related deficiencies are often signs of SIBO rather than IBS.

Diagnostic testing plays an essential role in distinguishing these conditions. A breath test (lactulose or glucose) is often used to diagnose SIBO, while IBS is typically diagnosed based on clinical criteria (Rome IV) after ruling out other conditions.

Holistic, Functional Medicine Approaches to Treatment

Functional medicine focuses on identifying and addressing the root causes of illness rather than merely managing symptoms. This approach is particularly effective for conditions like SIBO and IBS, which often stem from multiple underlying factors.

Treatment for SIBO

Addressing the Overgrowth:

1. Antimicrobial Therapy: Herbal antimicrobials (e.g., oregano oil, berberine) can effectively reduce bacterial overgrowth.

2. Antibiotics: Rifaximin is a commonly prescribed antibiotic for SIBO, but functional medicine often prioritizes natural treatments.

Dietary Modifications:

1. Low-FODMAP Diet: Reduces fermentable carbohydrates that feed bacteria.

2. Elemental Diet: A liquid diet that starves bacteria while providing essential nutrients.

3. Support Digestive Function:

4. Digestive Enzymes and Betaine HCl: Improve stomach acid levels and digestion.

5. Prokinetics: Help regulate gut motility to prevent recurrence.

Replenish Nutrients:

1. Address deficiencies in B12, iron, and fat-soluble vitamins through supplementation.

2. Supplements: Supplements can be highly individualized depending on each patient's presentation. Supplements can vary from L. Glutamine, to Iberogast, to S. Boulardii, to name a few.

Treatment for IBS

Dietary Strategies:

1. Low-FODMAP Diet: Beneficial for reducing bloating and gas.

2. High-Fiber Diet: Helpful for IBS-C, but should be introduced gradually.

Stress Management:

1. Mind-Body Techniques: Meditation, yoga, and deep breathing can reduce stress, a common trigger for IBS.

2. Cognitive Behavioral Therapy (CBT): Effective for managing gut-brain axis dysregulation.

Gut Microbiome Support:

1. Probiotics: Specific strains (e.g., Bifidobacterium and Lactobacillus) can improve symptoms.

2. Prebiotics: Support healthy gut bacteria, but should be used cautiously to avoid bloating.

Supplements:

1. Peppermint Oil: Can reduce abdominal pain and cramping.

2. Magnesium: Helps alleviate constipation in IBS-C.

Functional Medicine: A Personalized Approach

A hallmark of functional medicine is its emphasis on personalized care. Since the symptoms of SIBO vs. IBS can overlap and vary in severity, treatment plans are tailored to the individual. This includes comprehensive testing to uncover root causes, such as food sensitivities, gut dysbiosis, or chronic stress.

Functional medicine practitioners often employ:

Advanced Nutrigenomic Testing: To identify genetic predispositions affecting digestion.
Lactulose and/or Glucose Breath Testing: To assess small intestinal bacterial overgrowth.
Comprehensive Stool Analysis: To assess gut microbiota and inflammation levels.
Hormone and Adrenal Testing: To address stress-related contributors.

Lifestyle and Long-Term Management

For both SIBO and IBS, long-term success involves lifestyle adjustments:

Regular Exercise: Promotes healthy gut motility.
Adequate Sleep: Supports overall health and reduces stress.
Hydration: Essential for digestion and bowel health.

Conclusion

Understanding the symptoms of SIBO vs. IBS is the first step toward effective treatment. While these conditions may share similarities, their underlying causes and treatments differ. A functional medicine approach offers a comprehensive, holistic path to healing by addressing root causes and supporting the body’s natural ability to restore balance.

If you’re struggling with digestive issues, give us a call or email us so that we can assist you in personalized solutions for lasting relief.