Although we medically recognize an overgrowth of candida on the skin, vulvovaginal tissues, oral cavity, and numerous other locations as an indication for treatment, medical guidelines state that the presence of Candida spp. Many of the factors that contribute to SIBO are also well-documented to contribute to candida colonization. In this population, it is imperative that we consider other factors that may coexist leading to the symptomology that we often ascribe to SIBO. However, in some patients, SIBO is seemingly resistant to treatment, even after many cycles of otherwise effective therapies.
, įortunately, for many diagnosed with SIBO, symptoms do improve with a combination of dietary modification, digestive support (supplemental hydrochloric acid, enzymes, and/or ox bile), and antibiotics and/or herbal antimicrobials-and, in those with constipation, support for normal motility. SIBO has a lot of hype-and how can it not, with so many conferences, practitioners, and clinics focused on its treatment? Given that the lactulose breath test (LBT), commonly used for the diagnosis of SIBO, has a low sensitivity and frequently gives false-positive results (although sensitivity can be improved via three-hour methane and hydrogen testing), it can be overused for the ease of diagnosing, well, something. Nowadays, with any mention of digestive symptoms of constipation, diarrhoea, gas, or bloating, and a history of antibiotic or proton-pump inhibitor use, one of the first things most integrative healthcare practitioners will consider in the differential diagnosis list is gastrointestinal dysbiosis with testing for small intestinal bacterial overgrowth (SIBO).
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