VERIFIED CONTENTAuthor: Dominika Wilk

Abdominal bloating, a feeling of overflow in the intestines, an excessive amount of gas are characteristic symptoms of SIBO (bacterial overgrowth in the small intestine). However, they also occur with the overgrowth of Candida albicans in the abdominal cavity. Therefore, before we start diagnosing and treating SIBO, let's conduct research on Candida, as it may be the main cause of our he alth problems.

What is SIBO?

SIBO is an abbreviation of small intestinal bacterial overgroth, meaning the overgrowth of bacteria in the small intestine. These bacteria overgrow for a variety of reasons. One of them may be:

  • low stomach acid secretion;
  • not enough digestive enzymes;
  • anatomical defects of the intestines, e.g. malfunctioning ileocecal tab;
  • disturbing myoelectric complex (MMC).

When this happens and there are too many bacteria, they can destroy the intestinal villi, leading to the malabsorption of various nutrients. The bacteria also produce gases that cause gas, gas and gurgling. They also adversely affect the functioning of the intestines leading to either chronic diarrhea or constipation.

What is Candida overgrowth?

Candida is a yeast that naturally lives in the human digestive tract. However, some external factors, such as chronic antibiotic therapy, may lead to their hyperplasia. The excessive amount of Candida albicans yeast disrupts the functioning of the intestines and causes the overproduction of gas, bloating or an unpleasant stinging sensation in the abdomen.

Very often, yeast overgrowth in the gastrointestinal tract gives symptoms similar to intestinal dysbiosis, therefore, prior to treatment, appropriate tests for Candida should be performed to confirm or exclude Candida as a potential factor of gastrointestinal disorders.

What to test first: Candida overgrowth or SIBO?

The rule is that if our research shows an overgrowth of Candida, as well as SIBO, we first treat Candida. If we had done the opposite, the treatment would have been pointless.

Very often, after curing Candida, the patient feelsa definite improvement, and the unpleasant abdominal symptoms disappear. Treating later with SIBO is just a dot on the "i" that allows the intestines to be eubiosis.

How does it research Candida overgrowth in the gut?

There are currently two tests available in Poland with which we can diagnose Candida overgrowth. They are:

  • urine d-arabinitol test
  • and Organix Gastro panel.

In addition, you can test Candida in your stool, but this test rarely shows an overgrowth. Usually we receive information about the presence of Candida, which is a natural fungus that lives in our digestive tract, but we have no information about the amount of yeast.

D-arabinitol is a metabolic product of yeasts, so if it is detected in the urine, it may indicate their presence and overgrowth (depending on the amount detected).

The test substance is urine. However, we do not urinate into an ordinary container. It must be collected in a test tube containing a special stabilizing substance. We will receive such a test tube for free at the collection point where this test is performed.

It is important to collect a test sample from your morning urine. Before the test, you should wash yourself, and then transfer the middle stream of urine to the test tube.

Do you need to prepare for the d-arabinitol test? Yes. On the day preceding the test, you should not consume fruit, sweet drinks, aspartame or alcohol, because they may affect the test result. In addition, remember not to drink too much before going to bed, not to be forced to urinate at night, because the urine for testing must be concentrated.

Organix Gastro test

Organix Gastro is another test that will help us detect Candida overgrowth, and also indicate whether we have intestinal dysbiosis. It consists in detecting 12 metabolites in the urine, excreted by bacteria, which may be found in the digestive tract.

Thanks to it we can check:

  • D-arabinitol, which will show us yeast overgrowth.
  • Tartaric acid - which is a yeast or mushroom growth maker. Its too high level may also be caused by improper preparation for the test, e.g. eating fruit the day before or other fermenting products.
  • p-cresol sulfate - an indicator of clostridium infection.
  • p-hydroxybenzoic acid to show if we have an E. coli infection.
  • Hippuric acid, which can tell us about the putrefactive process in the gut.
  • Indykan - it can be one of the SIBO indicators, but not only because it is highlevels may also indicate celiac disease or a bile problem.
  • p-hydroxyphenylacetic acid - a result outside the norm may indicate an infection by Gardia lamblia or an anaerobic bacterial infection.
  • m-hydroxyphenylacetic acid, which shows if we have an excessive overgrowth of the bacterial flora.
  • Tricarbalylic acid, which is produced by bacteria and can lead to a deficiency of important nutrients such as magnesium, calcium and zinc.
  • Benzoic acid produced by many bacteria, which leads to a deficiency of vitamin B6 or glycine.
  • Dihydroxyphenylpropionic acid, which may indicate infection with Clostridial bacteria, which is the cause of severe inflammation.
  • Creatinine level, which will show how well our kidneys are.

How to prepare for the Organix Gastro test?

  • You must not eat fish or seafood for 48 hours before the test.
  • 24 hours before the test, you must not eat: fruit, especially: plums, apples, bananas, kiwi, rhubarb, cherries, avocado, raisins, blueberries. In addition, you must not reach for nuts (walnuts, pecans, etc.), and also for pumpkin seeds. We also do not eat tomatoes, butternut squash, or any product that contains aspartame or benzoic acid. We also avoid wine, lemonade and fruit, carbonated drinks.
  • The last meal should be eaten at least 8 hours before urinating into the test tube.
  • In the day before the examination, we do not drink too much fluids at night.
  • Collect urine in the morning (you must not urinate at night), on an empty stomach.

Hydrogen-methane test towards SIBO

The test that detects bacterial overgrowth in the small intestine is the hydrogen-methane test. It allows you to discover whether the patient's ailments are caused by an overgrowth of bacteria, i.e. SIBO, or an overgrowth of archaea, i.e. IMO (methane SIBO).

In the first case, we will see a large jump in the hydrogen indicating line in the test graph, in the second case - methane. Of course, this is ambiguous, because sometimes we deal with a simultaneous overgrowth of hydrogen and methanogens or with sulfur-hydrogen SIBO, which is difficult to detect using this type of test (a special test for this type of SIBO is currently available in the United States).

A specialist from Sibo (gastrologist or dietitian) is able to find out what kind of ailments we are dealing with, as long as he puts the test results together with the patient's symptoms. In the case of IMO, patients more often complain about e.g. constipation, and in SIBO - about diarrhea.

How is SIBO recognized?

According to the North American Consensus guidelines of 2022, if the hydrogen-methane test with glucose (75g) or lactulose (10g) has increased the concentration of hydrogen by ≥ 20 ppm by the 90 minute of the test, we can talk about hydrogen SIBO.

SIBO is also recognized when, at any time of the test, there was an increase in methane of ≥ 10 ppm (then usually methane SIBO is recognized).

How to prepare for the SIBO test?

For the test result to be credible, it is necessary to properly prepare for the hydrogen-methane test. We start the preparations 4 weeks before the test, when we should stop all types of prokinetics (including herbal ones) and we must keep a 4-week interval between antibiotic therapy and the SIBO examination. In addition, 4 weeks before the test, we cannot perform such procedures as: colonoscopy, hydrocolonotherapy, fluoroscopy, ileoscopy, enteroclysis.

Two weeks before the test, we also give up probiotic therapy, enemas and laxatives that affect what happens in the intestines. We also pay attention to whether there was an episode of infectious diarrhea 2 weeks before the examination, which disturbs the intestinal microflora.

In turn, a week before we put it aside:

  • proton pump inhibitors,
  • all kinds of bactericidal herbs, such as oregano or berberine,
  • we avoid very intense physical exertion,
  • do not take large doses of vitamin C and magnesium citrate 4 days before.

1 day before the test, we do not use:

  • dietary supplements with fiber,
  • dietary supplements in general,
  • apple cider vinegar, betaine HCL, baking soda or digestive enzymes.

Diet before the SIBO hydrogen-methane test

Depending on whether we suffer from diarrhea or constipation, we follow a diet for a shorter or longer period. In the case of diarrhea, one day of a special diet is enough. When we have a constipation problem, the restrictive menu must be followed for 2 days.

The diet before the test is very restrictive. We can then eat only:

  • meat (each type),
  • fish,
  • seafood,
  • fats of all kinds,
  • eggs,
  • only s alt and pepper from spices.

It's best to limit the number of meals to 3 a day, and in the meantime only drink water (no sweetened drinks). For example, for breakfast we can eat scrambled eggs fried in olive oil, for lunch we can eat fish seasoned with s alt and pepper, and for dinnerfried chicken.

People who have a problem with hypoglycemia can afford to eat a handful of rice with one of their meals. As it was mentioned: people struggling with diarrhea eat this way for only 1 day, people suffering from constipation - 2 days.

How does the SIBO test work?

The hydrogen-methane test involves exhaling air into special samples. We exhale this air every 20 minutes, and describe each sample in detail - we provide the exact time in which we exhaled and describe the tube with a number. The test begins after 12 hours of fasting. Then, on an empty stomach and without brushing our teeth, we exhale into a special test tube.

Then we drink the lactulose solution and exhale again into the test tube. Fill the next test tubes with air every 20 minutes. The total duration of the study is 3 hours. The test can be performed at a special point, where the samples are collected by a nurse, doctor or other person authorized to perform the test.

We can also make it ourselves at home, by ordering a special set of test tubes. Each of these options gives a reliable result, as long as we adhered to a special diet beforehand and exhale the samples at appropriate intervals.

You cannot lie down, sleep or walk during the examination. A sitting position is the best, so it is worth taking an interesting book with you to the test to shorten the waiting time for the end of the test.

Category:

Gastrology