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The Mysteries and Underdiagnosis of SIBO

0 2 years ago

In 2017, shortly after she turned 32, Phoebe Lapine had just spent the previous three years overhauling her health to make up for her ailing thyroid, the result of unchecked Hashimoto’s thyroiditis. She was following a gluten-free diet, drinking kombucha and taking prebiotics, and finally feeling her best when she noticed peculiar gut symptoms starting to rear their head: burping during meals, stomach discomfort, and a bloated belly that simply would not deflate. She turned to a functional doctor who quickly gave her a diagnosis: small intestinal bacterial overgrowth (SIBO), a gut condition not uncommon for hypothyroid patients.

Lapine, who lives in New York, had never heard of it, nor had her endocrinologist warned of the possibility of developing it. The diagnosis was a relief: “It’s not all in my head; the bloating is just sticking to my body like an inner tube,” Lapine, now 36, remembers thinking. But treatment proved to be an odyssey in and of itself. It would take six weeks of antimicrobial medicines and another six months of a restricted diet for her digestion to feel normal again, and for the bloat to finally go away. Lapine, a food and health writer and chef, chronicled her SIBO journey and shared SIBO-appropriate recipes on her blog and podcast in early 2018. That’s when she learned how lucky she’d been

“I’ve gotten many, many messages and emails from really sick, desperate people. They reach out from all over the world and are like, ‘No one here where I live knows what this is,’” Lapine says. She answered the first few notes, but when the avalanche didn’t let up, she set up an automatic response with links to online resources.

SIBO is a notoriously underdiagnosed condition, despite research suggesting it may be a chief cause of irritable bowel syndrome (IBS). Approximately 11% of people worldwide suffer from IBS, a “wastebasket diagnosis” many patients with an array of digestive issues are given when doctors can’t pinpoint a more precise cause. Their symptoms can be managed through diet and a handful of supplements and medications, but for a long time, a cure was considered to be out of the question. “People were relegated to ‘learn to live with it.’ When SIBO came along, it really offered some cures and solutions,” says Dr. Nirala Jacobi, a naturopathic doctor whose online platform “The SIBO Doctor” offers courses on the disorder for both practitioners and patients. But although Jacobi and others have led an awareness crusade, many practices fall short when it comes to SIBO diagnosis and treatment. “I still hear from patients every day that they go to the gastroenterologist and it’s still not being recognized,” says Jacobi.


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