By Naturopath Mickayla Hosking, from Rosemary Naturopathy.

Have these been popping up in conversation for you? Has someone you know recently been diagnosed and you're confused as to what it is? Let's talk about IBS and SIBO and what the main differences are.

Both dysbiosis and small intestinal bacterial overgrowth (SIBO) cause IBS symptoms. In fact, between 4 and 78% of IBS patients have SIBO. IBS is commonly diagnosed by symptomatic picture and ruling out other causes, where SIBO can be confirmed with a hydrogen breath test or the more reputable quantitative jejunal aspirate culture.

IBS will present as abdominal pain/ discomfort, irregular stool form and transit time (constipation/ diarrhoea), bloating, and flatulence.

SIBO presents similarly with abdominal pain/ discomfort, bloating, flatulence, nausea, feeling of fullness and diarrhoea. There may be many other 'odd' symptoms experienced with SIBO, as it can and does interact with many body systems.

The differences between the two are that IBS bouts can be triggered by certain food sensitivities, increased or acute stress, and hormonal fluctuations and SIBO can be continuous symptoms beginning after a trauma/ associated condition or drug use, such as protein pump inhibitors, antibiotics or major stressful events. There are a number of risk factors and complications for each, which is why it’s important to correctly diagnose each condition.

S. boulardii (a specific probiotic strain) has shown symptomatic improvement for SIBO patients when combined with traditional antibiotic treatments, though updated research on probiotic use alone is very limited. Standard dietary increase in soluble and insoluble fibre (to 25 grams per day from vegetables mainly), as well as complex carbohydrates (from veggies and grains) were also protective in rat studies. One study concluded herbal therapy to be at least as effective as tradition Rifaximin in the treatment of SIBO, they combined 4 naturopathic blends (3x day) into two separate treatments (see image below) and compared those to rifaximin (3x day).

A review of treatment for IBS found Artichoke, St John’s Wort, Peppermint, Psyllium (a bulking fibre) and Lemon balm to be effective in reducing symptoms - the actions of which include antispasmodic, bulking, carminative, thymoleptic, and antibacterial. If you are starting to increase fibre - START SLOW. I mean less than a teaspoon at a time, too much fibre increased at once will cause more distress than intended. Take the time to less your stomach and microbiome get used to a small dose before increasing, at least a week.

If you see yourself in any of these symptom pictures, make sure to book an appointment and get it checked out! Health is wealth.

You may find a lemon balm tea to be soothing on your tummy if you want to try it out! Always consults your naturopath or doctor before self-prescribing.

*This is not meant to diagnose or treat. Please seek professional treatment before attempting to self diagnose or treat.