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SIBO / Small Intestinal Bacterial Overgrowth Questionnaire

July 10, 2015 By Trudy Scott 14 Comments

sibo-bacterial-overgrowth

During season 3 of The Anxiety Summit, I interviewed Dr. Allison Siebecker on Small Intestinal Bacterial Overgrowth and Anxiety.

I talked about the SIBO Questionnaire I use with my clients and said I’d share it (with her permission).

There is a real SIBO-anxiety connection. I wrote about this in my book the The Antianxiety Food Solution.

Studies have found that people with digestive complaints such IBS, food allergies and sensitivities, small intestinal bacterial overgrowth and ulcerative colitis frequently suffer from anxiety and, to a lesser extent, depression (Addolorato, Mirijello, D’Angelo, Leggio, Ferrulli, Abenavoli, et al. 2008).

One study (Lydiard 2001) found that 50 to 90 percent of people with IBS who visited a doctor for treatment also suffered from various anxiety disorders (panic disorder, generalized anxiety disorder, social phobia, and post-traumatic stress disorder) and major depression.

I have all my clients who have any digestive issue (which is most of them), do the SIBO questionnaire and then talk to their doctor about doing the SIBO breath test/ hydrogen breath test or SIBO test. Genova offers this or you can ask your conventional doctor to order this.

Keep in mind that this is just one questionnaire/test of many that can be used to try and figure out the root cause of your anxiety. (I write about this and other questionnaires/testing here: Nutritional testing for figuring out the root cause/s of your anxiety.)

SIBO Symptoms, Clues and Associated Conditions

The main symptoms of SIBO are those of Irritable Bowel Syndrome (IBS).  SIBO has been shown to exist in up to 84% of IBS patients and is therefore theorized to be the underlying cause.  It is associated with many other disorders as well, as an underlying cause or as an after effect of the pre-existing disease.

In particular, if the symptoms of IBS are present, or one of the associated diseases along with digestive symptoms is present, consider SIBO.

According to Bures et al, “It is mandatory to consider SIBO in all cases of complex non-specific dyspeptic complaints (bloating, abdominal discomfort, diarrhea, abdominal pain), in motility disorders, anatomical abnormalities of the small bowel and in all malassimilation syndromes (malabsorption, maldigestion).”

Check off or highlight all that apply:

IBS Symptoms
Abdominal bloating (gas)
    – belching, flatulence
Abdominal pain, cramps
Constipation, Diarrhea, both

Other symptoms
Heartburn (Reflux or GERD)
Nausea

Leaky Gut Symptoms (Leaky Small Intestine)
Food Sensitivities
Headaches
Joint Pain
Fatigue
Skin symptoms (such as eczema or rashes)
Respiratory symptoms (such as asthma)
Mood symptoms (depression/anxiety/OCD)
Brain symptoms (such as in autism)

Malabsorption Symptoms
Steatorrhea (fatty stool – stool that floats)
Anemia (Iron or B12)

Associated Conditions– see SIBO Diseases for Study links
Acne Roseacea
Acromegaly (excess growth hormone)
Age: Elderly
Alcohol Consumption (moderate intake)
Anemia
Autism
Celiac Disease
Chronic Fatigue Syndrome
CLL (Chronic Lymphocytic Leukemia)
Cystic Fibrosis
Diabetes
Diverticulitis
Erosive Esophagitis
Fibromyalgia
GERD (Gastroesophageal Reflux Disease)
H pylori Infection
Hyprochlorhydria/low HCl
Hypothyroid/ Hashimoto’s Thyroiditis
IBD (Inflammatory Bowel Disease)
    -Crohn’s
    -Ulcerative Colitis
IBS (Irritable Bowel Syndrome)
Interstitial Cystitis
Lactose Intolerance
Leaky Gut
Liver cirrhosis
Lyme
Muscular Dystrophy (myotonic Type 1)
NASH/NAFLD (non-alcoholic: steatohepatitis/fatty liver disease)
Obesity
Pancreatitis
Parasites
Parkinson’s
Prostatitis (chronic)
Restless Leg Syndrome
Rheumatoid Arthritis
Scleroderma
Surgery:  Post-Gastrectomy

The above list of SIBO symptoms has been adapted from the site of Dr Allison Siebecker and used with permission here on the blog. Please check out Dr. Siebecker’s site siboinfo.com for a wealth of information about SIBO.

Risk factors/other possible clues*: (* all the following added by Trudy Scott, based on what I see with clients)
C-section birth (yours)
Not breast-fed
Probiotics cause digestive distress
Prebiotics (such as inulin) cause digestive distress
Have seen some symptom relief after a course of antibiotics
Symptoms appeared after a bad bout of gastroenteritis
Low triglycerides
Digestive enzymes help
Markers of poor enzyme status on a stool test
Pyroluria (see the Pyroluria Questionnaire here)
Low niacinamide
Low ferritin
Low vitamin D
Carb intolerance
Fat intolerance
Markers of fat malabsorption on a stool test
Low fatty acid levels on a fatty acid test
Have done well on gluten-free diet
Have done well on GAPs/Paleo diets (no grains, no starchy vegetables, no legumes)
Carb/sugar craving/addiction
Other addictions
Low zinc
Low GABA
Low serotonin
Low endorphins
Low catecholamines
Blood sugar issues (for low GABA/serotonin/endorphins/catecholamines and low blood sugar see Amino Acid Questionnaire here)
Stressed
Eat on the run i.e. not sitting down
Low secretary IgA (stool or saliva)
Adrenal fatigue
Heavy metals/environmental toxins
Appendix has been removed (it stores bacteria needed for motility motor complex)

Other possible causal factors **:  (** added June 2017 after the MINDD 2017 practitioner conference, courtesy of the SIBO presentation by Dr. Nirala Jacobi ND) 

Medications:  Proton Pump Inhibitors, Opiates/pain meds, possibly calcium channel blockers
Endometrial surgeries, C-section, and/or gallbladder removal (cholecystectomy) and other pelvic surgeries (such as a hip replacement)

Testing: 

Positive SIBO breath test (methane, hydrogen and a 3rd gas that can’t yet be measured)

Positive anti-Cdtb and anti-vinculin antibodies indicating post-infectious cause (details here)

Also, here is a more recent blog post on this topic: MINDD 2017 practitioner conference, courtesy of the SIBO presentation by Dr. Nirala Jacobi ND 

 

Additional Anxiety Resources
Click on each image to learn more

Filed Under: Anxiety and panic, SIBO Tagged With: Allison Siebecker, anti-Cdtb, anti-vinculin, Dr. Nirala Jacobi, SIBO, small intestinal bacterial overgrowth

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About Trudy Scott

Food Mood Expert Trudy Scott is a certified nutritionist on a mission to educate and empower anxious individuals worldwide about natural solutions for anxiety, stress and emotional eating.

Trudy is the author of The Antianxiety Food Solution: How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood and End Cravings and host of The Anxiety Summit now in its 4th season and called a “bouquet of hope.”

Trudy is passionate about sharing the powerful food mood connection because she experienced the results first-hand, finding complete resolution of her anxiety and panic attacks.

Reader Interactions

Comments

  1. AvatarPauline says

    July 10, 2015 at 3:28 pm

    Hi Trudy. Well, I am amazed. I read about SIBO and that the removal of one’s appendix can cause motility problems. I had my appendix removed when I was quite young and have had motility problems ever since. Never connected it to the removal of my appendix. Even in my ‘old age’ I learn something new every day!! Thank you for teaching us so much. I hope that you and your mother are recovering from the awful accident. My thoughts and prayers are with you.

    Reply
    • AvatarTrudy Scott says

      July 11, 2015 at 6:20 am

      Pauline – thanks for sharing and it’s good to hear that you noticed that connection.

      We are both doing much better – thanks for asking! Please keep the motor biker rider’s family in your thoughts

      Reply
  2. AvatarJodie says

    February 26, 2016 at 1:56 pm

    Hi Trudy, this is me 100% what’s my first step to reduce digestion distress? And feel better again?

    Reply
    • AvatarJanet says

      May 1, 2016 at 10:20 pm

      Since no one has replied to you yet, I’ll just share that I juiced 3 carrots, 2 celery stalks, and a small apple last night and again this morning and feel much better. I’m still figuring out my issues, but have had a food sensitivity test done, but also have throat reflux so have to avoid acidic foods as well. There are other great bloggers out there living with ibs who have ideas on what foods to eat first and afterwards. I hope you have found some relief by now.

      Reply
    • AvatarTrudy Scott says

      May 2, 2016 at 11:43 am

      Sorry Jodie – I must have missed this one! If we suspect SIBO I have my client stop all grains, all starchy veggies and legumes for a week and see if they notice an improvement. If yes then it’s a matter doing SIBO breath testing to confirm and fine-tuning the diet (SCD, GAPs, FODMaps and possibly elemental) and using herbs and/or medications to eradicate the SIBO. The Siebecker’s site is a wealth of information

      Reply
  3. AvatarCheryl says

    February 17, 2017 at 4:22 am

    Hi Trudy, do you know what causes SIBO?

    Reply
  4. AvatarCheryl says

    February 17, 2017 at 4:49 am

    Please ignore my previous question. What i would like to know is what is the physical mechanism of it? So bad bacteria gets up into small intestine, and some how makes the body react to certain foods eg: fobmap foods? How does this all happen? I need to visualise it. Thanks

    Reply
    • AvatarTrudy Scott says

      February 19, 2017 at 6:41 pm

      Cheryl
      It can be due to stress or a bacterial infection or candida, often affecting the ileo-cecal value

      Reply
  5. AvatarChris says

    April 29, 2017 at 11:48 am

    A doctor removed my appendix during abdominal surgery as a routine procedure. I have had fatigue issues since and was diagnoses with SIBO about 4 years ago. I’ve had no success in getting rid of it. I wondered if there is a supplement that I should be on that might support what the appendix’s function is.

    Reply
    • AvatarTrudy Scott says

      May 2, 2017 at 11:19 pm

      Chris
      I’m horrified they removed your appendix during abdominal surgery as a routine procedure! As you can see from this new research “the appendix may serve an important purpose. In particular, it may serve as a reservoir for beneficial gut bacteria” and “the appendix may play an important role as a secondary immune organ” https://www.sciencedaily.com/releases/2017/01/170109162333.htm

      I would find a functional medicine practitioner well versed in SIBO and gut health to help you figure this all out.

      Reply
      • AvatarChris says

        May 3, 2017 at 5:59 pm

        Thank you Trudy. I have a great functional doc but no one has ever put these pieces together for me. I am trying to figure out the best strategy for replacing what my appendix should have been doing as I have SIBO and candida and apparently am lacking lactobacilus in my gut per last test.

  6. AvatarSteve says

    November 29, 2019 at 2:52 pm

    Hi trudy,
    Im 38 you, I had appendectomy surgery last week and ever since I have bloating that doesn’t go away, anxiety as well as fatigue and inability to fall asleep .
    I’m scared to death to the idea of having to live like this for the rest of my life as I went through a lot of anxiety in the past coming of antidepressants and benzodiazepines. I finally stabilized my anxiety following the pyroluria protocol and a gluten free dairy free low sugar diet.
    Today I took a big hit to my psychology and happiness following this emergency procedure that I feel might have irreversible consequences on my health.
    Please help, please advice, how can I bounce back from this? Am I destined to a life of digestive issues and therefore psychiatric symptoms and deteriorating health because of this operation?
    What can I do?
    Thank you

    Reply
  7. AvatarSteve says

    December 4, 2019 at 6:30 am

    Hi trudy,
    Is it possible that high zinc could cause low copper and thus higher risk for infections and eventually appendicitis. I’m 38 yo I never had any gastrointestinal issues before. I’ve been taking 30mg zinc bisglycinate daily and appendicitis just happened a few months later.
    Please let me what you think about this

    Reply
  8. AvatarSteve says

    December 8, 2019 at 1:37 am

    Hi trudy,
    Please what are the best supplements for anxiety after appendix surgery?
    What is the cause of this anxiety I’m feeling since I had this operation?
    Please help!

    Reply

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