SIBO definition: Small intestinal bacterial overgrowth. Simplified version, too much bacteria in the wrong place in the gut, namely in the small intestine. SIBO symptoms are associated with bloating, abdominal pain, poor digestion, and increased risk of development of food sensitivities associated with intestinal permeability.
Fibromyalgia and SIBO
Fibromyalgia sufferers experience an array of chronic bodily symptoms, commonly associated with pain that also is usually combined with mental health challenges. Fibromyalgia’s main cause is still not well elucidated by medical science yet a lot of research continues to be done to understand it.
It is believed that a common aspect of fibromyalgia is a chronic alteration of the central nervous system limiting the body’s natural ability to send inhibitory signals to decrease pain centers.
In addition, more research is finding a connection between fibromyalgia and the gut microbiome. In one study comparing fibromyalgia patients to patients with IBS and or the regular population. 100% of fibromyalgia patients tested positive with SIBO testing.
SIBO testing is commonly assessed using breath testing by giving a poorly absorbable sugar, like lactulose, that bacteria in the gut will act on, releasing hydrogen during this metabolic process.
Those patients with positive tests will have a particularly high amount of hydrogen production in the early stages of this breath test due to the excessive amount of unhealthy bacteria living in the small intestine.
It was also noted that if higher amounts (higher areas under curve) of hydrogen were produced it correlated with higher pain scores reported by the fibromyalgia patients themselves.
How do you approach determining if you have SIBO, starting with a hydrogen breath test if suspicion is high after evaluation with a physician along with commonly associated symptoms.
Treatment of SIBO is a multi-layered approach. Nutritional changes such as the FODMAPs diet, gut microbiome improvement, intestinal lining repair, and even at times with antibiotics.