Understanding the Connection Between SIBO, IBS, and Hormonal Changes in Midlife

Do you get bloating? Diarrhoea? Constipated? Or alternating bowel movements? You’ve tried many diets and supplements, you can’t work out what is going on, and you start feeling frustrated that conventional medicine does not have much to offer for your digestive issues….

Many digestive conditions share symptoms, which makes it challenging to pinpoint specific issues within the digestive tract. Two of these conditions are SIBO (small intestinal bacterial overgrowth) and IBS. In this blog I explore these 2 conditions. highlighting their differences, connections, and considerations from a hormonal standpoint. Why do midlife women often experience a worsening of their digestive issues?

Firstly, let’s look at SIBO.

What is SIBO?

Small Intestinal Bacterial Overgrowth, refers to an excess of bacteria in the small intestine. SIBO for short.

Under normal circumstances, the small intestine hosts a small, beneficial bacterial population crucial for well-being. This bacteria plays a role digesting our food, regulating our immune system, protecting against other bacteria that cause disease, and producing vitamins.

If the bacteria in the small intestine becomes excessively high, it leads to bacterial overgrowth. This condition can manifest as SIBO. The bacteria use undigested and fermented foods to survive, creating gases. The 3 main gases are hydrogen, methane and hydrogen sulphide.

All three types of SIBO can pose significant challenges. Primarily by hindering the absorption of nutrients from food. This not only results in a feeling of unwellness but also increases the risk of nutrient deficiencies, food intolerances, leaky gut, malabsorption, and/or malnutrition. Plus lots of bloating!

Symptoms of SIBO:

Symptoms of SIBO can vary slightly from person to person. Bloating is one of the most common symptoms. Others symptoms include:

·     Bloating

·     Burping

·     Flatulence

·     Reflux or heartburn

·     Diarrhea (common in Hydrogen Dominant SIBO and Hydrogen Sulfide SIBO)

 ·      Constipation (common in Methane Dominant SIBO)

·     Nausea

·     Abdominal pain

·     Loss of appetite

·     Food intolerances

·     Gluten sensitivity

·     Iron or B12 deficiency

·     Burning or painful bladder

·     Joint pain

·     Nerve pain or tingling in feet or hands

·     Headaches

·     Chronic fatigue syndrome

·     Rashes

·     Insomnia

·     Anxiety

·     Hives

·     Facial flushing

·     Sinus congestion and mucous

·       Unexplained weight loss.

The presentation of the symptoms and the severity may vary for each individual. A classic symptom of SIBO is that symptoms often get worse after eating.

What is IBS?

Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder characterized by a group of symptoms that affect the large intestine (colon). It's a chronic condition that can cause a range of digestive symptoms.

There are many root causes of IBS. Sometimes they can occur on their own, yet more often than not, there is a combination of these drivers going on at the same time. This is one of the reasons why it’s so important to treat holistically so that all of these can be identified and addressed.

Let’s take a closer look at them:

Small Intestinal Bacterial Overgrowth (SIBO):

SIBO, as mentioned above is characterized by an excess of bacteria in the small intestine. It can be Diarrhea-dominant, constipation-dominant, or alternating variations may occur, with up to 85% of IBS cases potentially having an association with SIBO.

Microbiome disruption:

Disruption of the gut microbiome, often caused by antibiotics, can lead to a lack of beneficial bacteria diversity, contributing to the onset of IBS symptoms. Studies show that a majority of IBS patients exhibit abnormal fecal biomarkers and intestinal dysbiosis.

Intestinal Hyperpermeability (Leaky Gut):

Leaky gut occurs when the intestinal lining allows the passage of larger particles into the bloodstream, triggering an inflammatory immune response. This dysfunction is linked to inflammatory bowel disease and functional bowel disorders like IBS.

Gastric Infections:

Infections by parasites, bacteria, or fungi/yeast can cause IBS symptoms. Pathogens like Blastocystis hominis, Helicobacter pylori, and Candida albicans can result in cyclical diarrhea, constipation, gas, bloating, reflux, and other symptoms.

Food Sensitivities/fodmap intolerance:

Food allergies or intolerances, such as reactions to gluten, dairy, eggs, and nuts, are common triggers for IBS symptoms. These sensitivities may involve immune responses (IgE or IgG) or enzyme deficiencies, and they are often connected to conditions like leaky gut. Fodmap foods may trigger adverse symptoms in those with IBS.

Psychological factors:

There is also a psychological factor where those with IBS are more likely to report greater lifetime and daily stressful events compared to healthy controls. Risk of developing IBS is higher in individuals with preexisting conditions like depression and anxiety (which may also relate back to the connect between the gut and brain).

The symptoms of IBS can vary from person to person. They may include:

·     Abdominal pain or discomfort.

·     Changes in bowel habits. Including diarrhoea, constipation, or a combination of both.

·     Bloating and gas.

·     Mucus in the stool: Some people with IBS may notice mucus in their stool.

·     The symptoms of IBS can be triggered or exacerbated by certain factors.

How are SIBO & IBS connected?

The primary difference between IBS and SIBO lies in the clinical verification process. SIBO can be confirmed through clinical tests. Whereas IBS lacks a definitive diagnostic test and is diagnosed more by exclusion. Frustratingly, many women with an IBS diagnosis receive very little help in the conventional medical system.

The challenge in distinguishing between SIBO and IBS is understandable.

As mentioned above, there can be an overlay of symptoms with both sibo and IBS, making it challenging to distinguish what is going on.

SIBO is commonly observed in individuals who suffer from IBS. Research suggests that there is a significant association between the two conditions, with estimates indicating that a large percentage (up to 70-80%) of IBS cases may be linked to SIBO. SIBO can be one of the “root causes” or contributing factors to your IBS, and therefore it can be a good idea to get tested with a simple at home breath test. 

IBS getting worse with age?

Have you ever wondered why your IBS appears to be getting worse as you age? Could your hormone fluctuations be the contributing factor?

Yes, they sure can!

Menopause, on its own, does not cause Irritable Bowel Syndrome (IBS). Yet, the fluctuations in your ovarian hormones associated with menopause can contribute to gastrointestinal symptoms. Numerous studies indicate that hormonal changes may play a role in the onset or exacerbation of abdominal pain and discomfort during menopause. Even in individuals who haven't been diagnosed with IBS before.

In Western societies, Irritable Bowel Syndrome (IBS) is 4 times more prevalent in women as they enter mid-life. It's crucial to recognize that IBS significantly influences various menopausal symptoms, including depression, anxiety, fluctuations in weight, cognitive fog, joint discomfort, hot flashes, and, notably, insomnia during menopause. The alterations in gut health play a key role in exacerbating these symptoms. So if you want to feel better in midlife, it is key to address your gut.

Are you starting to see how the digestives symptoms can be connected and the importance of working with a practitioner who understands these complexities?

Although menopause is a natural phase in a woman's life, it is also distinctly known to be part of the “inflammaging” process, meaning that as our organs age and recalibrate with the hormonal fluctuations and changes, we experience inflammation and are at more risk for a range of issues, which includes gut issues.

This emergence of IBS, or SIBO symptoms too during this time can come as a surprise for many. The decline in sex hormones, a hallmark of menopause resulting in symptoms like hot flashes, mood swings, and fatigue, can also contribute to the onset or exacerbation of gut-related symptoms such as constipation, diarrhea, and cramps. The good news is that there are testing & strategies to manage these gut symptoms, whether they stem from SIBO or IBS and reduce overall inflammation to help you transition with better health into your next phase of life (post menopause).

My 90 day Nourished Gut and Hormones Program takes midlife women through a proven process to heal their digestion, reduce inflammation and feel their best during Perimenopause and Menopause. If you are serious about taking control of your long-term health, you can book a free strategy call to hear more about how I can help you.

https://thewellnesswitches.com.au/book-better-health