What are Irritable Bowel Syndrome (IBS), Small Intestinal Bacterial Overgrowth (SIBO), and Candida Overgrowth? May these conditions be the true cause of your digestive problems?
I'm sure you've experienced gastrointestinal issues at some point in your life. Typical examples include abdominal pain during stress or exams.
Those of you who are affected by irritable bowel syndrome know well how an irritated bowel can negatively impact daily life. Our quality of life is adversely impacted, we tend to withdraw from social events, and everything revolves around abdominal discomfort: a real roller coaster.
In the series of articles about irritable bowel syndrome, I want to explain what IBS is and how small intestinal bacterial overgrowth or fungal overgrowth can contribute to gastrointestinal issues.
I will also discuss what a low-FODMAP diet and elimination diets are, and why they can alleviate symptoms of Irritable Bowel Syndrome, Small Intestinal Bacterial Overgrowth, and fungal overgrowth. I will also guide you on how to approach the Low-FODMAP diet
What is irritable bowel syndrome (IBS)?
Irritable Bowel Syndrome (IBS) is characterized by unclear and recurrent abdominal pain and distressing bloating. After eating, nausea, pressure, fullness, and either diarrhea or constipation can occur.
According to Dr. Georgie, a classic diagnosis of irritable bowel syndrome follows the Rome IV criteria: experiencing bowel issues at least three times a week for about six months.
In Search of a Diagnosis
In the hope of ending these sufferings, many of us confidently empty pharmacy shelves. However, tablets and medications only provide a partial relief if the true causes of irritable bowel syndrome are not addressed. Finding a good specialist is also often a significant challenge.
IN the quest for an accurate diagnosis, individuals are often sent from one physician to another, encountering little empathy. Especially when numerous laboratory tests and examinations fail to provide a clear explanation for a patient's discomfort.
It was previously believed that the psyche was a primary cause of irritable bowel syndrome, as psychological influences can manifest in the gastrointestinal tract. According to Prof. Dr. Labenz, it is now understood that IBS is primarily a gastrointestinal disorder with credible symptoms.
How is the Irritable Bowel Syndrome Diagnosis Confirmed?
Often, it is a long journey before an irritable bowel syndrome diagnosis is made. Following the exclusion principle, various examinations are conducted initially to rule out organic disorders. These may include gastrointestinal endoscopy, ultrasound, or abdominal MRI.
Liver and pancreatic enzymes, potential parasite infestation, as well as allergies or food intolerances (gluten, lactose, fructose, or multiple intolerances) should also be checked.
However, if no organic findings are discovered, and intolerances have also been ruled out, a functional bowel disorder is often diagnosed. In that case, the diagnosis is irritable bowel syndrome.
Possible Causes of Irritable Bowel Syndrome
The causes of irritable bowel syndrome are often not identifiable. A disrupted gut flora, such as after taking antibiotics, a salmonella infection, or prolonged consumption of processed and sugary foods, can contribute to irritable bowel syndrome. Persistent and chronic stress, unnoticed over time, can also affect the stomach and intestines.
Small Intestinal Bacterial Overgrowth (SIBO)
According to Dr. Pimentel, 60 to 70% of IBS patients suffer from small intestinal bacterial overgrowth, known as SIBO.
SIBO is characterized by the colonization of the small intestine by bacteria that normally inhabit the colon and are not supposed to be present in the small intestine.
SIBO presents a similar clinical picture to IBS and can be diagnosed, for example, through a lactulose breath test, according to Dr. Fiedler.
Candida Overgrowth:
SIFO and LIFO
In a conversation with globally renowned SIBO specialist Dr. Jacobi, Dr. Beeson talks about common fungal infections in IBS patients.
Her clients, who mostly complain of brain fog, daily bloating, and constipation or diarrhea, are tested for fungal overgrowth.
Small Intestinal Fungal Overgrowth (SIFO) stands for fungal overgrowth in the small intestine, while Large Intestinal Fungal Overgrowth (LIFO) refers to fungal overgrowth in the colon.
In SIFO and LIFO, symptoms resemble those of irritable bowel syndrome and can occur either alone or in conjunction with small intestinal bacterial overgrowth (SIBO).
Approximately 25% of all SIBO patients suffer from either SIFO alone or a mixed form of SIFO and SIBO simultaneously.
Fungal overgrowths are hard to detect, and their treatment is more complex and time-consuming than treating mild cases of irritable bowel syndrome, which may be manageable through dietary changes alone.
See: “The Role of Gut Flora and Food & Symptoms Diary in IBS, Part II” to learn more about IBS.
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