Stool and SIBO: Everything You Need to Know

May 12, 2024

Small Intestinal Bacterial Overgrowth (SIBO) is a complex gastrointestinal disorder where an abnormal increase in the population of bacteria occurs in the small intestine. This condition can cause various symptoms, one of the most telling being changes in stool characteristics. In this article, we will explore everything you need to know about SIBO and its impact on stool, including changes in color, consistency, and the presence of mucus or blood.

Understanding SIBO

SIBO occurs when bacteria that typically grow in other parts of the gut start growing in the small intestine. This can cause pain, diarrhea, bloating, and indigestion. While the cause of SIBO can vary, it often results from a slow transit time in the small intestine, anatomical abnormalities, or the malfunctioning of the muscular activity of the small bowel that normally sweeps bacteria out of the region. (1)

SIBO and Stool Characteristics

Below, we will discuss some of the most common characteristics of SIBO stool:

1. SIBO Stool Color

One of the most noticeable changes SIBO can cause is in the color of the stool. Typically, stool color can range from light brown to dark brown. However, individuals suffering from SIBO may notice that their stool may become yellow or green. This color change is often due to the presence of undigested fat in the stool, a condition known as steatorrhea, which can occur due to the bacteria interfering with fat absorption. (2)

2. SIBO Die-Off Stool

During treatment for SIBO, patients may experience what is known as "die-off," a reaction that occurs when large quantities of bacteria are killed off quickly. The die-off can lead to increased gas production, and this may change the stool's consistency and frequency. The stool may become more watery and more frequent during die-off periods.

3. SIBO Stool Test

Diagnosing SIBO often involves a stool test, which can indicate the presence of inflammation, fat malabsorption, or increased levels of certain types of bacteria. However, breath tests are more commonly used to diagnose SIBO directly by measuring the production of hydrogen or methane after consuming a sugar solution. (3) Stool tests are more about understanding the consequences of the overgrowth rather than detecting SIBO itself.

4. SIBO Stool Pictures

For clinical assessment, sometimes patients are asked to keep a record of their stool's appearance. Pictures can help healthcare providers identify any visible abnormalities in stool, such as mucus, excessive fat, or unusual color, which can be indicative of SIBO or other digestive issues.

5. SIBO Mucus in Stool

The presence of mucus in stool is a common symptom in many gastrointestinal disorders, including SIBO. Mucus may appear as white or clear strings or a slimy substance mixed within the stool. This occurs as the intestinal lining produces mucus to protect itself against irritation and inflammation caused by bacterial overgrowth. (4)

6. SIBO Yellow Stool

Yellow stool in SIBO patients can be a sign of fat malabsorption. It is essential for individuals noticing such symptoms to seek medical advice, as ongoing malabsorption can lead to nutritional deficiencies and further complications.

What Does SIBO Look Like in Stool?

SIBO can manifest as a range of symptoms in stool appearance. Apart from changes in color, the stool may appear more loose and watery if diarrhea is a symptom. In some cases, the stool may also float due to increased fat content, which is not absorbed properly.

Can SIBO Cause Blood in Stool?

While SIBO is not typically associated with blood in the stool, severe cases involving extensive inflammation might lead to occasional bleeding. However, visible blood in the stool is not a common symptom of SIBO and should be evaluated by a healthcare provider to rule out other conditions like inflammatory bowel disease or infections.

How to Get Rid of SIBO

Treating Small Intestinal Bacterial Overgrowth (SIBO) involves a multifaceted approach that addresses the underlying causes, reduces bacterial overgrowth, and manages symptoms. Here's how to effectively tackle SIBO:

1. Antibiotic and Natural Antibacterial Remedies

To effectively combat SIBO, a combination of antibiotic therapy and natural antibacterial remedies can be utilized. Traditional antibiotics, such as Rifaximin for hydrogen-dominant SIBO and a combination of Rifaximin and Neomycin or Metronidazole for methane-dominant SIBO, are commonly prescribed to reduce the bacterial overgrowth directly in the small intestine. These antibiotics are chosen for their minimal absorption and targeted action in the gut, which helps minimize side effects and maximize efficacy against SIBO. (5, 6)

Alongside or as an alternative to conventional antibiotics, natural antibacterial remedies can also play a crucial role in treating SIBO. These include herbal extracts with antimicrobial properties, such as oregano oil, berberine extract from plants like goldenseal and Oregon grape, allicin-rich garlic, and thyme. These natural agents work by inhibiting bacterial growth and can be especially beneficial for those looking for a holistic approach or those who may not tolerate traditional antibiotics well.

Our SIBO Cleanse Tonic is a natural antibacterial remedy that supports the elimination of bacterial overgrowth and helps restore gut health, especially when used as a part of our Complete SIBO Cleanse Protocol.

If you have SIBO, it's important to work with a healthcare professional to do proper testing and treatment methods for your particular case.

2. Dietary Modifications

Diet plays a crucial role in managing SIBO. The goal is to reduce foods that feed the bacteria in the small intestine. A low FODMAP diet is commonly recommended, as it restricts foods that are high in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which can exacerbate bacterial growth and symptoms. (7) Other diets that may be considered include the Specific Carbohydrate Diet (SCD) or the Gut and Psychology Syndrome (GAPS) diet, both of which limit sugar and complex carbohydrates that can ferment in the gut.

To learn more, read our article "Best Nutrients for Fighting SIBO"

3. Prokinetics

Prokinetics are drugs or supplements that help increase the muscular activity of the small intestine, thus preventing bacteria from settling and proliferating again. (8) They are especially useful after antibiotic treatment to keep the small intestine moving and reduce the risk of recurrence. Common prokinetics include low-dose naltrexone and erythromycin. Herbal options like ginger and Iberogast may also be effective and have fewer side effects.

4. Lifestyle Changes

Managing stress and improving lifestyle factors such as sleep and exercise can also help manage SIBO symptoms. Stress reduction techniques like meditation, yoga, and regular physical activity can improve gut motility and overall gut health. (9)

5. Addressing Underlying Conditions

Finally, it's crucial to address any underlying conditions that may contribute to SIBO, such as poor gut motility, previous surgeries that alter the anatomy of the gut, or diseases like Crohn's that affect gut health. Managing these conditions can prevent the recurrence of SIBO and improve overall gastrointestinal function.

Getting rid of SIBO usually requires a combination of treatments tailored to the individual's specific symptoms and causes. Antibiotics or antibacterial remedies, diet adjustments, prokinetics, and lifestyle changes are all viable options that can be used alone or in combination. Due to the complexity of SIBO and the potential for recurrence, working with a healthcare provider who specializes in gastrointestinal health is crucial for effective management and recovery.

Summary

SIBO is a significant health condition that affects the small intestine and can significantly alter stool characteristics, such as color, consistency, and the presence of mucus or blood. These changes can be important indicators of SIBO and other gastrointestinal issues. For those experiencing these symptoms, consulting healthcare providers for a proper diagnosis and appropriate treatment is essential.

Managing SIBO may involve a combination of antibiotic therapy and natural antibacterial remedies, dietary modifications, and lifestyle adjustments. Understanding the link between SIBO and stool changes, along with effective treatment options, can provide critical insights into managing and treating this complex condition effectively.