Some of the most common symptoms of SIBO include burping, belching, and upper abdominal pain although symptoms of SIBO can vary in severity and gastrointestinal symptoms. With such varied symptoms, knowing what is causing your SIBO symptoms is confusing.
SIBO also known as small intestinal bacterial overgrowth is a condition where there is an overgrowth of bacteria in the small intestine.
Common symptoms of SIBO include:
- Abdominal pain
- Acid Reflux
- Bad Breath
Bloating From SIBO – The Annoying SIBO Symptom
One of the primary complaints and symptoms of SIBO is bloating. When you have an overgrowth of bacteria in the small intestine, the bacteria will start fermenting the undigested starches and fiber. Gas is produced as a by-product of fermentation.
The excessive fermentation and production of gas in the small intestine can cause mild to severe bloating. Even a skinny person can look as though they are pregnant.
It can feel as though you are walking around with a bloated stomach full of air. Not fun. I used to be constantly bloated. I remember looking in the mirror one day thinking, all I ate was a salad? Why I am so bloated?
I would feel less bloated in the morning, but as the day progressed, I would slowly watch my stomach blow up like a balloon. I had a whole lot of upper abdominal bloating and gas production with a noisy, growling stomach that was always talking to me. A gurgling stomach was another one of my SIBO symptoms that I used to experience.
One of the underlying causes of SIBO and bloating is a lack of digestive enzymes thus taking a comprehensive digestive enzyme is one of the first steps to reducing bloating. Lactose intolerance is also common among people is IBS and SIBO which can be improved by taking a lactase enzyme with foods that contain the fodmap lactose.
SIBO and Burping
Burping and belching can also be symptoms of SIBO. When bacteria ferment upon fibres in the large intestine the gas is released through lower flatulence.
But when bacteria produce gas in the small bowel, the gas builds up pressure in the upper abdomen leading to burping and excessive belching. What are you burping up? A whole lot of gas, produced by bacteria in the small intestine.
People with SIBO often experience constant burping or belching due to the excess gas production in the small intestine. In this study, patients with dysbiosis were more likely to experience bloating and belching. The accumulation of gas in the small intestine is released via burping or belching.
Acid Reflux and SIBO
Acid reflux is another SIBO symptom that can be caused by the excessive overgrowth of bacteria in the small intestine. Often stomach acid levels are low when acid reflux occurs. The gas produced by bacteria in the small intestine can put pressure on the stomach causing acid to reflux up into the esophagus.
Low stomach acid levels induced by the use of proton pump inhibitors have been shown to cause changes in the intestinal microbiota leading to dysbiosis and SIBO. In one study, the use of proton pump inhibitors caused symptoms of SIBO, including bloating, flatulence, abdominal pain and diarrhea.
Abdominal Pain From SIBO
Abdominal pain or cramping frequently occurs as a symptom of SIBO. The severity of abdominal pain caused by SIBO can range from mild to severe. The pain can be constant or come and go.
I noticed abdominal tenderness when palpating my upper mid-abdomen. I have also heard the pain described as a constant gnawing sensation.
Abdominal pain can be associated with too many histamine producing bacteria located in the small intestine. Often high histamine foods such as fermented foods, citrus, tomatoes, and alcohol will trigger abdominal pain or cramping.
I always like to ask the question, do you notice any trigger foods that aggravate your pain, such as onion and garlic? High fodmap foods will frequently trigger abdominal pain in people with SIBO. Dietary changes such as the low fodmap diet is frequently used to reduce symptoms of small intestinal bacterial overgrowth, such as abdominal pain.
Keeping a food journal with foods eaten and notes on any SIBO symptoms can help you connect the dots to determine which foods aggravate your SIBO symptoms the most.
Constipation and Diarrhea
Constipation and diarrhea are common symptoms of SIBO. I know confusing, both diarrhea and constipation?!
Chronic constipation is more common in people with methane-producing bacteria, which results in high methane levels. Diarrhea is more common in people with hydrogen-producing bacteria. The type of SIBO present often determines whether someone is more likely to experience constipation or diarrhea.
For example intestinal methanogen overgrowth is frequently associated with constipation but there is another underlying root cause that must be addressed in a SIBO treatment plan to relieve digestive symptoms of both constipation, loose stools and diarrhea.
A sluggish gallbladder and poor bile flow can be the root cause of constipation, diarrhea, and SIBO as well.
One of the most crucial properties of bile is that bile is antimicrobial and helps to prevent small intestinal bacterial overgrowth and kill bad bacteria. Bile also stimulates peristalsis to keep food moving along the intestinal tract for healthy bowel movements.
The other function of bile is to emulsify and break down fats. Fat malabsorption can cause loose, floating stools, and diarrhea.
Anytime someone is experiencing constipation or diarrhea, I am always thinking about a sluggish gallbladder as the root cause. If anyone has trouble digesting fats and symptoms of poor fat digestion, the gallbladder is most likely in need of support.
Bad Breath and SIBO
Bad breath is another embarrassing symptom of SIBO that no one wants to admit too. Yet no one wants bad breath. When bacteria ferment upon foods gas is produced.
Some of the gases produced can include hydrogen sulfide, which is a stinky smelling gas. When there is an overgrowth of bacteria in the small intestine, those gases can come out through the breath causing bad breath. I have seen stinky breath alongside SIBO that got worse with the use of antimicrobials before getting better. Often the exact symptoms of SIBO can flare during the healing process before getting better.
Symptoms of SIBO can vary in presentation and severity. Anyone who has excessive burping, belching and abdominal pain should consider SIBO as the cause. The best way to determine if SIBO is causing your symptoms is by doing a breath test.
If you are struggling with SIBO Dr Nirala Jacobi from the SIBO Doctor has a very informative patient SIBO success course to beat small intestine bacterial overgrowth for good. This course covers
- underlying causes of SIBO
- testing for SIBO
- Symptoms of SIBO
- types of SIBO
- biphasic SIBO diet
- herbal antimicrobials for SIBO
and much more!
Dr Nirala Jacobi has been my go-to resource for information on SIBO. There is so much to know about SIBO and the SIBO success plan covers all the essentials that you need to know about SIBO so you can beat SIBO for good.