SIBO-Constipation / Methane-Dominant

Small Intestine Bacterial Overgrowth (SIBO) is an under-diagnosed condition with a variety of the symptoms. Some people suffer from the loose stool/diarrhea form, and others from constipation. In this blog I am going to focus on the constipation form.

But to back up (so to speak) a bit . . .

So what exactly IS going on with SIBO?

Most of us have heard of the microbiome: the “good” bugs in our intestines that provide digestive and immune function (as well as mood regulation, but that’s a topic for a different time). Most of these organisms are in the large intestine, a smaller percent is in the small intestine.

What causes it?

Various risk factors - a past episode of food poisoning, chronic use of antibiotics as a child, chronic use of antacids as an adult, and many others - can lead to an overgrowth of normal non-pathogenic organisms  in the small intestine.

These organisms  “out-gas” hydrogen, methane and hydrogen-sulfide gases. When there is an overgrowth, the gases cause symptoms of bloating, and sometimes constipation and/or diarrhea.

Certain anaerobic organisms - called archae- outgas methane gas. Methane causes constipation (and bloating). Once constipation starts, it is easier for pockets of the archae to develop and output more methane gas. Thus the vicious cycle of what we call SIBO-C, methane-dominant SIBO, or the most technically accurate term: intestinal methanogenic overgrowth (IMO).

How is it diagnosed?

There is an at-home breath test to test for this and it can also be what’s called a “clinical diagnosis,” meaning a medical practitioner can make the diagnosis based on your signs and symptoms.

How can it be treated?

As you might guess, treatment is customized if a person has hydrogen vs. methane-dominant SIBO. No matter what type, we need to eliminate or significantly decrease the overgrowth. But after that we focus on the constipation and specifically on reducing the methane.

I don’t have space in this article to dive into more details on treatment, but I can tell you that a high percentage of my patients experience a significant decrease in bloating and an improvement in bowel function within 2-4 weeks of treatment. There are both pharmaceutical and herbal options as well as dietary changes and other supplements to heal the gut after the overgrowth has been managed.

I know that many of you will finish this article and Google SIBO, which you should. Do your research, see what people diagnosed with it are saying. I do caution against trying to treat it yourself. It is a medical condition and needs to be treated by a licensed specialist.

For more information on SIBO in general see my blog: More information about SIBO