Getting Tested for SIBO
SIBO (small intestine bacterial overgrowth) is a chronic bacterial infection of the small intestine. While we all naturally have beneficial bacteria in our intestines that help us digest food, in cases of SIBO, there is an imbalance in the bacteria. The abundance of bacteria causes problems with normal digestion and absorption of nutrients and can cause damage to the lining of the intestines, also known as leaky gut syndrome. Common symptoms of SIBO include abdominal bloating, abdominal pain, constipation, diarrhea, or both constipation and diarrhea. SIBO can also cause belching and flatulence, as the bacteria produce gas as it consumes our food. 1
The SIBO symptoms might sound awfully familiar to anyone who has irritable bowel syndrome (IBS), as these are also the most common symptoms experienced with IBS. I was originally diagnosed with IBS over ten years ago, and that was after years of experiencing symptoms. I’ve become so accustomed to the symptoms that IBS has become my normal. So when I first read about SIBO, although I recognized my symptoms in its description, I didn’t give it much thought. Until a new doctor who was asking about my health history told me that SIBO is theorized to be the underlying cause of many cases of IBS.2 She asked if I had ever had food poisoning, and I recalled that I had experienced a bad case of food poisoning that led me to the emergency room for dehydration in my mid-20’s, and shortly after that was when I started experiencing IBS symptoms.
Could it be? The idea of identifying the cause of my IBS gives me a renewed sense of hope. With this cause, there is a defined treatment, an antibiotic called Xifaxan (rifaximin).
The first step was doing a breath test. Sounds simple in name: just breathe into a tube? However, the test was a more involved than I expected. For 24 hours before the test, I had to follow a very strict diet. I could eat meat, chicken, fish, or eggs, as well as brown rice or quinoa, with a little olive oil and salt and pepper, and that’s it. No vegetables or fruit, no other condiments or seasoning, no alcohol or soda. Personally, as a foodie, it wasn’t my idea of a fun day, but I got through it.
The next morning, after fasting for at least 12 hours overnight, I had to be up and awake for an hour before drinking the solution that came with the test. It was tasteless, but it gave me a slight queasy feeling. I blew into one of the test tubes using the straw provided in the kit before drinking the liquid, and blew into another test tube directly after drinking the liquid. I repeated the breathing into test tubes every 20 minutes until all the test tubes were done, which took about 3 hours. During this testing time, I couldn’t eat anything and could only drink a little water. So I was a bit queasy from the liquid and getting extremely hungry the whole time. Mentally, I was thinking, “this test better show something.”
A week later, I got the results from my doctor: they were positive for hydrogen, a gas produced by bacteria. My doctor prescribed Xifaxan, an antibiotic that doesn’t get absorbed through the intestinal wall, which keeps it in the intestines and enables it to kill off the overgrowth of bacteria.
Unfortunately, it took another couple weeks to actually get the antibiotic. As my doctor warned me, insurance companies often deny the prescription at first, requiring the doctor to provide additional documentation and proof for the necessity. My insurance company denied the first submission, but my doctor persisted. She told me with my symptom history, the various treatments I’ve already tried, and with the breath test results, I fit the criteria.
I just received my prescription and have taken the first dose. Xifaxan has to be taken three times a day for 14 days. I’m cautiously optimistic.
Do you have a good understanding of what triggers your flares?