I Tested Positive for SIBO, So What’s Next?

I Tested Positive for SIBO, So What’s Next?

I knew it. I just knew it.

I am positive for the methane and hydrogen types of small intestine bacterial overgrowth, or SIBO.

Measured in parts per million (ppm), my gas levels are in the moderate range. The amount of gas indicates the severity of SIBO, as gas is a result of fermentation caused by bacteria. Tests can’t actually measure the amount of bacteria in the small intestine, but they can measure the amount of gas given off by it, which then indicates how much SIBO is present.

Given the success I’ve had in managing my gut health in the past couple years, I believe I’ve reduced some of my SIBO from severe to moderate. I suspect it’s from trying different supplements, which surprisingly worked at some level as a type of SIBO treatment. For example, antimicrobial herbs are one of three main options for managing or eradicating SIBO.

If you’ve followed my column for some time, you’ll know I’ve struggled with constant bloating and severe irritable bowel syndrome, with nausea, gas, and diarrhea all my life. My symptoms have become more manageable lately, and I suspect that had I tested for SIBO several years ago, my results would have been higher.

This is encouraging news, because the amount of SIBO dictates the amount of treatment. Antibiotics and herbal antibiotics reduce gas levels by an average of 30 ppm per treatment round, so if you had severe SIBO at 100 ppm, you’d be looking at a few months of treatment.

The third treatment option, the elemental diet, reduces SIBO by 70 ppm on average, so it’s often more appealing for those with higher levels. However, this two- or three-week liquid diet is not for the fainthearted.

My next course of action is deciding which treatment I want. The question I need to deliberate first, however, is which type of SIBO I will treat — is it hydrogen and methane, or is it hydrogen, methane, and hydrogen sulfide?

There isn’t a specific test for the hydrogen sulfide type of SIBO, though one is being developed. In some cases, if hydrogen sulfide is present alone, one can determine its presence by a specific pattern in the other two gases, hydrogen and methane. Essentially, the level of these two gases would be zero, creating what we call a “flat line” on a graph of test results, which provides a visual representation of gas levels.

That flat-line result would be coupled with the symptoms and history of the person testing, and if the flat line was present along with hydrogen sulfide symptoms, one could reasonably assume the patient had hydrogen sulfide SIBO.

However, if all three types are present together, it would be harder, if not impossible, to tell from a breath test whether hydrogen sulfide was there, too. Just the symptoms would need to be examined.

I have about 90% of the symptoms associated with hydrogen sulfide SIBO, so I’ll likely lean into treating all three types of SIBO. My other option would be to treat for hydrogen and methane, retest to see if there’s a flat line pattern in the gas levels, then analyze my symptoms for any remaining hydrogen sulfide.

The prospect is both exciting and daunting.

Two-thirds of SIBO patients have chronic SIBO. This doesn’t mean they can’t feel well, but that they may have relapses throughout their lives.

Sometimes, these cases can be resolved if the root cause of the SIBO is found. For example, with endometriosis patients, a common cause of SIBO is adhesions around the gut, creating pockets and blockages in the intestine, resulting in a buildup of bacteria where it shouldn’t be. With careful surgery and visceral manipulation, a client might fall into the third of cases that aren’t chronic, but the chance still exists that new adhesions might form.

In some cases, the root cause can’t be found or entirely fixed. I suspect my SIBO isn’t caused by adhesions, as I’ve never had severe endometriosis growths, and my SIBO symptoms have been present since I was a child.

At age 2 or 3, I was hospitalized with severe food poisoning, which led to dehydration. Food poisoning is the No. 1 cause of SIBO, because it damages the cells in the small intestine that are responsible for the migrating motor complex (MMC), a motion that cleans the small intestine and helps to clear out bacteria into the large intestine. Damage means a slower MMC, causing stagnation, which is the perfect environment for developing bacteria.

If this is the cause of my SIBO, while I can help the MMC along, it might not be something I can fully resolve.

Whichever category I fall into, after 30 years of suffering with these symptoms, I’m ready to commit to the new healing path that awaits me.


Note: Endometriosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Endometriosis News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to endometriosis.