Is it really IBS? This lesser-known stomach issue is often misdiagnosed and can cause nausea and toilet problems
You shouldn’t have to stomach a constantly upset stomach.
Bloating, gas and discomfort are often dismissed as harmless digestive issues, but they can sometimes signal more serious health problems.
“Normalizing chronic symptoms like bloating, discomfort or irregular bowel habits can delay diagnosis of underlying conditions such as SIBO, IBS, celiac disease or even inflammatory bowel disease and colon cancer,” Dr. Ali Rezaie, gastroenterologist and international SIBO expert, told The Post.
If you’re wondering what Rezaie means when he says “SIBO,” you’re not alone.
A recent survey revealed that three out of four Americans have never heard of SIBO, and — of those diagnosed with irritable bowel syndrome (IBS) — 41% said their healthcare provider never mentioned SIBO as a possible cause of their symptoms.
The gut disorder is often misdiagnosed as IBS.
“SIBO stands for small intestinal bacterial overgrowth, a condition where excess or misplaced bacteria in the small intestine lead to GI symptoms including post-prandial bloating, distention, gas, abdominal pain, diarrhea and/or constipation,” Rezaie explained.
“People with IBS, diabetes, prior abdominal surgery or conditions that slow gut motility — like scleroderma — are at higher risk” of SIBO.
SIBO has been historically underrecognized, Rezaie said, due to limitations in medical training and diagnostic tools.
“Until recently, symptoms like bloating were often lumped into general IBS without exploring microbial causes. As research grows, awareness is increasing — but gaps still persist,” he said.
A similar condition, intestinal methanogen overgrowth (IMO), involves methane-producing bugs and causes many of the same miserable symptoms.
For those diagnosed with SIBO, one promising treatment option is the elemental diet — a bland but scientifically-backed protocol that nourishes you while starving the unruly bacteria to reduce overgrowth.
“It’s a liquid nutrition plan with pre-digested nutrients that are absorbed in the upper small intestine,” Rezaie said.
You may be tempted to pop some popular probiotics, but he cautions they may do more harm than good.
Probiotics can worsen SIBO or IMO symptoms by adding more bacteria to an already overpopulated intestine, Rezaie said.
“Some experience more bloating or brain fog,” he continued. “Probiotics should be personalized — not assumed safe for everyone.”
So, why are gut issues blooming in the first place?
Blame the 21st-century lifestyle.
“Highly processed diets, food additives, sedentary lifestyles and increased gut infections contribute to reduced microbial diversity and gut dysfunction,” Rezaie said.
“Our modern habits have outpaced what the microbiome evolved to handle.”
His prescription for prevention is refreshingly old-school.
“Eat a diverse, whole-foods diet, minimize processed foods, stay active, sleep well and don’t ignore chronic symptoms — early care can make a big difference,” he advised.
Unfortunately, the new survey found that 27% of patients feel dismissed when they raise concerns about chronic gut issues to their doctor.
“Providers need to listen more carefully and avoid labeling symptoms as ‘just stress’ or ‘normal,'” Rezaie said.
“Validating patient concerns, asking detailed questions and staying updated on research is key,” he added. “When patients feel heard, they’re more likely to engage in effective treatment.”
