Should All Endometriosis Patients Be Tested for SIBO?

After 30 years, I have an answer. I am positive for hydrogen and methane type SIBO. My suspicions were correct and the diagnosis has left me with feelings of relief and excitement, yet grief too.

What is SIBO?

Before I dive in and explain my complicated response to the news, let me give you a quick overview of what SIBO actually is. In future columns, I’m going to really dig deep into this subject, but for now, I’ll start at the top. SIBO is when large amounts of bacteria which should be in the large intestine accumulate in the small intestine. This results in symptoms such as bloating, gas, nausea, constipation, diarrhea, and many others. It can also cause issues such as malabsorption and nutrient deficiencies.

SIBO is very common in the endometriosis community, but unfortunately, just like endometriosis, no one is connecting the dots. That’s exactly why I have such complicated feelings about my diagnosis. As a newly trained SIBO health professional, I’m fully equipped to treat myself and manage any relapses.

My symptoms started as a kid

But it’s my younger self I mourn for. I believe I’ve had SIBO since a child – perhaps two or three. I was hospitalized with serious food poisoning (the number one cause of SIBO), after which I was continuously plagued with a bloated stomach, with multiple IBS issues. In fact, my stomach was so distended I had family members telling me to hold it in. It was then that I became aware of the size of my ballooned stomach in comparison to other children, and the stage was set for an eating disorder, which would haunt my entire youth.

By the time I was 11, I had decided that the problem was fat and that if I could get skinny enough, my problem would be solved. I got skinny, I did more sit-ups than Britney Spears in the nineties, and I sucked my stomach in constantly. But alone, in the mirror, I analyzed my ballooned belly – swollen and tight, and making me look several months pregnant.

Over time, I worked out that in the mornings my stomach was incredibly flat, and the swelling would happen as I ate over the day. My reasoning therefore, was to eat less and less – and it worked. People admired me for my toned stomach muscles, and I began to fear what they’d think if they saw what happened when I ate. Once I reached 17, I had stopped eating from Wednesdays to Fridays to achieve a stomach flat enough to warrant a crop top on the Friday night. Sometimes, I allowed myself a few glasses of milk or orange juice if I was feeling particularly shaky.

SIBO was the root cause of my suffering

It’s not just the impact of what it did to my body that breaks me; it’s the internal suffering I put myself through. Absolutely crippling low self-esteem, depression, suicidal ideations and so much more. On top of that, I was suffering with some of the trademark symptoms of SIBO – brain fog, fatigue and acute anxiety. Anxiety that controlled my life for as long as I can remember.

And I have continued to suffer with these symptoms right until this very moment, believing for the last eight years that it was just down to endometriosis. Yet always wondering why, despite getting on top of my other endo symptoms, I couldn’t get on top of these.

Why aren't all endo warriors tested?

So my question is, why aren’t we screening endometriosis patients for SIBO as soon as they’re diagnosed with endo? We know that a classic, yet mysterious, symptom of endo is the bloated belly, and we know that endo is a risk factor for SIBO development. How many others have to suffer as I have, before we begin looking at the whole picture of endometriosis – and all the conditions that come with it?