In studying IBS, scientists have determined a main cause of IBS to be an imbalance of bacteria in the small intestine called Small Intestinal Bacterial Overgrowth or SIBO. Normally, the small intestine has very small amounts of bacteria and these bacteria are flushed through the intestines very quickly. In SIBO cases, bacteria from the large intestine or bacteria from a gastroenteritis infection are able to move into the small intestine where they cause numerous problems. The bacteria feed on fiber called fructooligosaccharides (or FOS) and produce gas, which causes the bloating and pain commonly associated with IBS. The bacteria are also responsible for changing the motility of the gut, preventing proper digestion and absorption as well as creating inflammation in the intestinal walls, increasing susceptibility to food sensitivities.
Fortunately, recent studies have shown some success treating SIBO with antibiotic therapy, most commonly rifaximin. In several studies, a single course of rifaximin with no other interventions will treat IBS in about 50-60% of patients. In a single study this rate was as high as 92% by using a fiber supplement during treatment. These efficacy rates can be drastically increased by utilizing a combination of anti-microbials including conventional and herbal over a period of 1-3 months followed by a period of maintenance which helps to re-establish normal digestive function and motility. Rifaximin has been found to have a very low side effect profile compared to other common antibiotic drugs as it targets the bacteria that cause SIBO and is not absorbed systemically.
Many patients have been told that following a strict low FODMAPS diet can treat IBS. Unfortunately, this advice can actually cause more harm than good as the removal from FOS in the diet also starves the bacteria that resides in the large intestine and is crucial to human survival. It also is very difficult for patients to follow this diet indefinitely and when they begin to consume the foods after a period of time, often they are right back where they started. By utilizing anti-microbial treatments first, we keep the bacteria active and feeding while killing them and we can prevent the relapse rates associated with diet alone.
If you believe that you may have IBS or SIBO and would like help with navigating your treatment, please contact the clinic closest to you and ask for an assessment with Dr. Katie Coombs, ND. IBS is no longer something you have to live with!
Momentum Health Westbrook 403-454-1600
Momentum Health Creekside 403-239-6773
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