Testing for SIBO
There are a few different and controversial methods of diagnosing SIBO. None are 100% accurate or conclusive. Even if you have a severe chronic case of SIBO, it’s not guaranteed a test will unveil the infection(6). Accurate sampling is a challenge as the bacterial populations are anaerobic, hard to reach, protected by a biofilm barrier and methods can be contaminated, influencing the results.
The breath test is the most common test for diagnosing SIBO as its simple, safe and non invasive. The breath test works because bacteria produce hydrogen and methane when they break down carbohydrates (such as lactulose, glucose, sucrose, or xylose) in the gut. These hydrogen and methane molecules enter the bloodstream, travel to the lungs, and leave the body in the breath. Thus, in theory the presence of overgrowth can be better identified through this method of testing. However, there is no consensus regarding a gold standard for diagnosing SIBO(1). This sugary solution can also make the SIBO worse so in chronic cases where a secondary AID has developed - such as our cases - this often inconclusive test isn’t worthwhile.
Thus, diagnosing SIBO usually requires a series of tests and is more a process of elimination, ruling out other possible gut conditions. Malnutrition and vitamin deficiencies may also help direct testing to find the diagnosis. Other tests to determine the presence of SIBO include - jejunal aspiration (the most accurate but invasive), stool tests, blood tests or a fresh urine broth test. It's a good idea to have multiple digestive organs checked via your GP/doctor also, including liver, pancreas and gallbladder health, as SIBO can affect the whole GI digestive anatomy and functions.
Gut dysbiosis and SIBO share many similar symptoms, see our Home page or the Gut Dysbiosis/SIBO In Depth page. There are at least 400 species of bacteria found in the gut microbiome and they are all essential for our health and wellness. They aid digestion, fight off pathogenic microorganisms, and synthesise and help us absorb vitamins and minerals. When these bacteria become imbalanced, and there is an overgrowth of pathogenic (bad) bacteria, they can override the beneficial bacteria and cause illness(2).
See here for a few testing methods. Not mentioned on this site however, is stool testing, which is how we both got our SIBO/dysbiosis diagnosed. There are reasonably priced stool tests you can buy online and if you go through a Nutritionist or holistic/functional medicine practitioner, they can sometimes offer discounts with companies they have deals with.
“The single biggest problem in communication is the illusion that it has taken place.” - George Bernard Shaw
When it comes to both preparing for a consultation with a GP/specialist or functional practitioner, and the face to face meeting itself, organisation and communication are everything! Think of the meeting as an interview - you only have a short amount of time to communicate a large amount of specific data in order to receive a positive outcome (hopefully in the form of tests, specialist referrals, solutions or a diagnosis). Presenting your case clearly, calmly, methodically and without being overly emotional is important vital. Because emotions warp our sense of perspective and judgements, the more calmly and clearly you come across, the more sincerity the MD/practitioner will weigh on your words. We learned this the hard way! But this doesn’t mean that you should be a robot, but you should be aware that crying - as hard as it can be to hold it in - uses up precious time when you could be discussing the riddle of your health condition. Don’t get me wrong - we have both cried many times in doctor’s surgeries and when seeing consultants. Take deep breaths and remember that you’re there to get some practical help from someone willing and who is able to give you that help, or refer you to someone who can.
Preparing for a health appointment -
All of the above it useful for your own records too and will help you keep track of changes.
The Right Attitude + Expectations
The importance of having the right attitude when entering any surgery/clinic cannot be understated. It’s best to go in with an open mind and ready to listen. Going in with guns blazing, an arrogant attitude and fixed ideas means that neither you nor the doctor will get the most out of your brief time together. You know your body better than they can, but at the end of the day they do have years of medical training and may be able to suggest possible diagnoses and have ideas that you hadn’t thought of, or didn’t know about previously. Once you have listened to their ideas, then you can tell them your ideas about what you believe may be going on in your body and the next steps you’d like to take - testing etc. UK-based peeps - be warned - you will have to go through the long-winded NHS system and certain tests which are just standard procedure. It may take time but having any kind of results, even negative ones, will make the wait worth it. And it’s free!
Also - make sure your expectations aren’t too high. Try to keep them realistic and grounded.
“Why do (behavioural) patterns translate into illness? ...because as traditional medicine has always understood and as Western science has now confirmed, mind and body are inseparable…the emotional sections in the brain are connected with the immune system, hormonal apparatus and the nervous system.”(7) - Dr Gabor Maté
In our body-conscious society, we often focus far more on fitness and diet than mental wellbeing. But we neglect our mental health to the detriment of our physical and emotional health. Traditional medicine has long-since been treating patients holistically, believing mental, physical, emotional and even spiritual health to be entwined. Scientific studies are now revealing that our mental and physical states are indeed linked and that one profoundly affects the other - as those who have suffered from a mental disorder such as anxiety of depression will know intimately after having experienced first-hand the physiological symptoms.
Stress manifests itself physically in the body, wreaking havoc with our internal systems(3), (4), (5) and we now know that there is a fundamental link between our thoughts and the stress levels we experience(6), (7). Our thoughts can have a profound influence our physical wellbeing(8), (9).
“The greatest discovery of my generation is that human beings can change the quality of their lives by changing the attitudes of their minds.”(22) – William James
As mental health is so paramount to our overall health, we’ve dedicated 4 pages on this site to the subject - Mental Wellbeing, Meditation, Happiness and Creativity + Art as Therapy. But in many cases there is more than one cause and assessing the full picture - your holistic health - is essential to understanding where you are now and what’s going on in your body.
“Inflammation appears connected to almost every known chronic disease — from heart disease to cancer, diabetes to obesity, autism to dementia, and even depression.”(3)
“Autoimmune conditions are connected by one central biochemical process: A runaway immune response also known as systemic inflammation that results in your body attacking its own tissues.”(3)
Detecting Chronic Inflammation
Inflammation is not easy to detect - it can hide in specific tissues and systems and can be present on a microscopic level. There are accessible blood tests that are quite sensitive to various signs of inflammation, but because biology is messy they are not super reliable, and even people with serious inflammatory diseases do not always get a positive result(5).
Nevertheless, ask your doctor to get your “CRP” (C-reactive protein) levels checked. This is a common and easy test to get done, and you might discover that you have not-so-low-grade inflammation which is potentially chronic!
Testing For Autoimmunity
There is no single test which can diagnose most autoimmune diseases. Your doctor will use a combination of tests (a process of elimination) and a review of your symptoms and physical examination to diagnose you. The antinuclear antibody test (ANA) is often one of the first tests that doctors use when symptoms suggest an autoimmune disease(4). There are now 80+ recognised autoimmune conditions, each with their own specific symptoms. However, there are a few uniting symptoms which they seem to share.
The early symptoms of many autoimmune diseases are very similar, and include the below(4) -
Addressing the Root Causes Of AI
It has been recognised that there are a few underlying and significant factors which seem to be playing a major role in causing autoimmunity. Dr Jockers has highlighted 12 areas to address for autoimmune disease(5), many of which we discuss the in depth elsewhere on our site -
It is common to have more than one factor as the cause. Explore SIBO + Autoimmunity to read more.
This chronic, complex health condition can cause many more potentially serious health issues. Be vigilant, stay informed and get tested regularly. We list some of the major common health complications which can arise as a direct consequence of SIBO and gut dysbiosis below. Some tests can be bought cheaply online but most can be done via the NHS and a quick trip to your local GP.
“...forgetfulness about little things such as names or grocery lists could indicate hypothyroidism, or low levels of thyroid hormone.”(10) - just one of many symptoms of hypothyroidism to watch out for.
“If there’s not enough cortisol there is development of gut inflammation. And that’s a problem because from gut inflammation we can lose our protective mucus lining, we can start changing our microbiome, we can start breaking away the IGG immunity there and start reacting to what would necessarily shouldn’t react to and so forth.”(9)
“An absent or disordered migrating motor complex pattern is almost always invariably associated with SIBO.”(11)
We are all unique as our fingerprints and microbiome profiles, and at the end of the day, we know our bodies better than any medical professional can. But learning to read the signs that your body is giving you can take time and some signs can be misleading. We read many signals incorrectly because of cultural conditioning/myths and below we bust a few mainstream beliefs -