Who cares if some people have bacteria growing in their small intestines, if that doesn’t necessarily correlate with symptoms? Why do experts keep recommending breath testing then? Oh, you mean the experts at the conference supported by a breath-testing company, most of whom had personally received funds from SIBO testing or antibiotic companies? And even if we could properly diagnose it, does it even matter? In those with digestive symptoms, there is a range of positivity for SIBO from approximately 4 percent to 84 percent-all over the map-and “there be no difference in… =symptom scores between those testing positive those testing negative,” so testing positive could mean anything. So, “patients…incorrectly labeled with SIBO may multiple courses of antibiotics…” for a problem they don’t even have. They labeled the glucose dose with a tracer and found that almost half of the positive results from glucose breath tests were false positives, because they were just fermenting it down in their colon where your bacteria are supposed to be. It turns out glucose can make it down to your colon after all.
The bacterial load in the small intestine was similar for those testing positive or negative, so that’s not a useful test either.
But when glucose was finally put to the test, it didn’t work either. Previously, a sugar called lactulose was used, but “lactulose breath tests reliably detect the overgrowth of bacteria,” so researchers switched to glucose. And so, if there is bacterial fermentation of that sugar, that suggests you have bacteria up in your small intestine and can detect that fermentation, because the bacteria produce specific gases that get absorbed in your blood stream and then are breathed out from your lungs, which can then be detected with a breathalyzer-type machine. See, normally, a sugar called glucose is almost entirely absorbed in the small intestine, so it never makes it down to the colon. But this method has been almost entirely replaced with breath testing. The traditional method for a diagnosis was a small bowel aspiration, an invasive test where a long tube is snaked down your throat to take a sample and count the bugs down there. “The ‘monster‘ that we now perceive SIBO to be may be no more than a phantom.” This is simply not true for most, and is an example of the damage done by overzealousness.
Patients can be indoctrinated into thinking SIBO is a chronic condition that cannot be cleared, and will require lifelong management. Diagnoses are often handed out quickly and without adequate substantiation. SIBO testing is overused and overly relied upon. diff, all for a condition that may not even be real.Įven alternative medicine journals admit that SIBO is being overdiagnosed, creating confusion and fear. But “dispensing antibiotics to patients with nonspecific, common symptoms…is not without risks”-you could be fostering antibiotic resistance, there could be side effects, and wiping out your good bacteria could set you up for an invasion of bad bugs like C. One of the conditions that may be considered for such a nonspecific presentation of symptoms is SIBO, small intestinal bacterial overgrowth, a concept that “has gained popularity on the internet in addition to certain clinical and research circles.” “SIBO is broadly defined as excessive bacteria in the small intestine,” and it’s typically treated with antibiotics. Gastrointestinal symptoms like abdominal pain and bloating account for millions of doctor visits every year. I’ll be answering the following questions: Is SIBO real? How reliable are the diagnostic tests? Does a low FODMAP diet help? And if you have SIBO or IBS symptoms, what should you do about it? Let’s go find out. Intro : SIBO is one of the topics I’m asked about the most and I’m glad I’ve now had the chance to dig into the research for this two-part series. Greger may be referring, watch the above video. To see any graphs, charts, graphics, images, and quotes to which Dr. Below is an approximation of this video’s audio content.
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