The key to treating Irritable bowel syndrome and SIBO is an accurate diagnosis

SIBO may have similar clinical symptoms to IBS, but the conditions are very different in terms of their underlying mechanisms as well as treatment.

Irritable Bowel Syndrome is a condition that affects thousands of people with abdominal pain, bloating and gas. Standard treatments have not been able to provide complete relief. In some cases, the symptoms of IBS may be caused by a condition that is less well-known but increasingly recognized: Small Intestinal Bacterial Overgrowth.

“SIBO may share symptoms with IBS but are separate entities when it comes to their underlying mechanisms as well as their treatment,” explains Dr Gerardo Blanco, Consultant Gastroenterologist at Quirónsalud Torrevieja Hospital. “While IBS has a functional cause, based upon symptoms and clinical criteria. SIBO is caused by an abnormal growth of bacteria in small intestines that disrupts nutrition absorption and bowel motility.”

What causes these digestive disorders?

Irritable Bowel Syndrome is a common digestive condition that can cause symptoms like abdominal pain, bloating, and changes in bowel habit, but without any structural abnormalities to explain it. Its cause is complex, and it is linked to factors like altered intestinal motility and increased visceral sensitivities, as well as stress, past infections, and an imbalance in the gut microbiota.

In the case Small Intestinal Bacterial Overgrowth(SIBO), symptoms occur when excessive bacteria accumulates in a portion of the small intestine, where their presence is usually limited. It can be caused by impaired intestinal motility or previous surgery. This bacterial proliferation causes excessive fermentation, which can cause abdominal discomfort, gas and bloating.

Diagnosing SIBO

“SIBO may coexist with other digestive conditions, such as Crohn’s disease or even IBS itself, which makes identification more challenging,” explains Dr Gerardo Blanco, Consultant Gastroenterologist at Quirónsalud Torrevieja Hospital.

Due to the similarity of symptoms, it is crucial to distinguish between these conditions in order for the correct treatment. Irritable bowel syndrome (IBS), is diagnosed by clinical assessment, which includes recurrent abdominal symptoms and changes in bowel habits. Other digestive diseases are also ruled out.

By contrast, SIBO requires specific diagnostic tests, most commonly the breath test – a simple, non-invasive technique that detects abnormal bacterial fermentation in the small intestine. In some cases, more precise and complex investigations, such as an endoscopic aspiration or culture of the small intestinal fluid, may be required.

A correct diagnosis can make all the difference. It prevents patients living with uncontrolled symptoms for many years. The specialist in gastroenterology stresses that it should be done under expert supervision.

An integrated approach for improving quality of Life

Dr Blanco emphasizes that patients should avoid self-diagnosis or self-medication. This is especially common when they seek quick answers online or through social media. “Management must take into consideration the patient’s history of medical conditions, diagnostic testing, and medical care. This may include dietary changes, medication, and nutritional follow-up.”

Through accurate identification of the underlying cause of each of these digestive conditions, many patients experience significant improvements in their wellbeing and quality of life – an outcome that both specialists and patients regard very positively.

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