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Finding SIBO

Some common GI symptoms may signal a more serious issue.

Drs. Sidorenko, Meister (standing), and Mitchell, carefully review patients’ test results to determine the best treatment plan.

Drs. Sidorenko, Meister (standing), and Mitchell, carefully review patients’ test results to determine the best treatment plan.

We’ve all experienced the occasional discomfort of gastrointestinal (GI) distress: stomach pain, gas, bloating, diarrhea. Often these issues go away after over-the-counter treatment or simply with time. However, when these things recur or increase in frequency or combination, it may be time to see a doctor. Dr. Thomas Meister of Gastroenterology Associates of Colorado Springs (GACS) says, “Largely, whether or not to see a doctor is not so much based on symptoms; it’s based on how much those symptoms bother this person.”

When those symptoms reach the point of a doctor visit, your primary care physician might begin to suspect a somewhat mysterious affliction known as small intestinal bacterial overgrowth or SIBO.

It’s true that our guts are filled with good bacteria that regulate the digestive process; however, as the name implies, SIBO involves the wrong types in the wrong place. “You might consider them overgrowth of too many bacteria and then bad bacteria that shouldn’t be there,” says GACS’s Dr. Sue Mitchell.

Causes are difficult to pinpoint. “Conventionally, it was thought to relate to some sort of stasis,” says Dr. Meister. “Whether it was an abnormal contraction pattern of the small bowel or whether there were anatomic abnormalities.” However, he adds that in recent years, they are seeing more patients presenting with no structural anomalies, with symptoms potentially occasioned by a recent round of unrelated antibiotics or illness, although, again, causes are not always so straightforward.

SIBO can sometimes present in conjunction with irritable bowel syndrome (IBS)—or not. “We are learning to recognize it as a condition on its own,” says Dr. Elena Sidorenko, a new addition to the GACS team. “We do find people with bacterial overgrowth with no other adverse GI conditions, and it’s part of the mystery.” Yet she also cites a recent study showing about a 40% overlap of SIBO with IBS.

By the time a patient is seen at GACS, they have usually been through several tests and treatments with their primary doctor with no results. Being a specialized clinic, Dr. Sidorenko says, “we ask specific questions, such as about fatigue or possible vitamin deficiencies related to SIBO. We’re a little bit more tuned in to this condition, and we have the strength here to recognize it. If we feel that a patient may benefit from the test, they get tested.”

Your doctor can refer you to a testing center, and you can even order a SIBO test online and send away for your answer, but a big advantage of being treated at GACS is that they have the testing equipment onsite, and Drs. Meister and Sidorenko bring all of their expertise and particular knowledge of SIBO to reading the results, which involves examining the levels of hydrogen and methane in your breath as these gasses are produced by the bacteria. “It makes us unique because we can actually see patients, run the test right in our office, and get results immediately,” says Dr. Mitchell, which means beginning treatment sooner.

Dr. Mitchell says the cornerstone of therapy is antibiotics, which can be curative, and yes, we did just say that antibiotics can sometimes jump-start the disease. “The antibiotics necessary for effective treatment of SIBO are more targeted,” adds Dr. Meister. “It’s not the same antibiotics you’re taking for your upper respiratory infection. They are necessary and a good first step. And, for many patients, the only necessary step, but we’re trying to figure out the root cause, so we don’t have to give antibiotics three times a year.”

“We started approaching SIBO not only with prescriptions but also in a more holistic way as well,” Dr. Mitchell says. “We’re combining diet changes, lifestyle, and sometimes probiotic supplements to help with the journey to heal any leaky gut, intestinal permeability issues that can go along with SIBO. People really want to understand the root cause of their symptoms.”

This gets at the reasons why GACS is a top practice in this area. “We’re combining functional medicine that deals with the gut along with traditional GI medicine,” Dr. Mitchell says. “not just antibiotics, but approaches and nutritional guidance to help them in trying to live a healthier lifestyle.”