More than a quarter of the population has digestive problems, with symptoms such as abdominal pain, bloating, diarrhea or constipation. Generic and not very specific indicators that, typed into Google or transferred to the terrain of social networks and influencers, often result in SIBO, an acronym for excessive growth of the bacterial population in the small intestine. It is the fashionable disease, the pathology that is leading its supposed patients to saturate medical consultations and to gloss over the accounts of laboratories that do tests of dubious reliability.
“SIBO is a concept that needs to be understood well. It’s not a disease, it’s a complication of some digestive process”, explains Javier Santos, neurogastroenterology assistant at Vall d’Hebron and Ciber for liver and digestive diseases. It usually affects patients with diabetes or systemic diseases such as Parkinson’s, people who have undergone abdominal surgery or who have other digestive diseases. In other words, not everyone has SIBO, not by a long shot, but “it has become fashionable”, says the doctor: “If you go to Google there are many websites of dubious scientific quality that mislead patients. People see that their symptoms match what they are being told and come to consultations with the specific demand of whether we can assess for SIBO”. According to Santos, more than the internet, the problem is the healthcare system. “ Up to 30% of the population may have digestive problems and the public system is not prepared to absorb such a huge demand. They are people who are not well and are excluded from the system”, he argues. It’s no surprise, according to this reasoning, that they look to the web for answers.
According to Pilar Nos, head of digestive medicine at La Fe hospital and president of the Valencian Society of Digestive Pathology, patients who go to health centers and ask for SIBO detection tests are collapsing the consultations. “It’s real madness what’s been happening for a couple or three years, since the pandemic, a social cycle”, complaint”. He maintains that around this disease, and framed in the cult of the body and food, a lucrative business has been set up of laboratory tests and the sale of all kinds of diets and food supplements that can end up harming people and the system. “The number of people requesting tests at digestive clinics is starting to become an overload problem, and the pressure you have from patients who are already coming in SIBO positive is starting to be significant. And they do not come indicated by the specialist, but because they have seen it on social networks. Health should not be in the hands of influencers”.
Dr. Nos warns that the obsession with SIBO can hide more important disorders. According to the specialists, the profile of the affected people corresponds to that of a young or middle-aged woman with digestive disorders attributable to lifestyle: stress, anxiety, consumption of ultra-processed foods, eating outside, bad chewing. ..
“Because the symptoms are so frequent, people think that SIBO may be the cause,” says Katja Serra, specialist in the digestive system at the HM Nou Delfos hospital. In his opinion, it is only necessary to investigate patients with serious or disabling symptoms and question a test “that has become very fashionable”. “The most used test is the aspirated hydrogen breath test, which has a problem of variability and a high rate of false positives. Many laboratories do not know how reliable they are. Some do the test and the machine itself gives you the diagnosis, without going through an expert. Indeed, there may be overdiagnosis”.
Serra points out that most of the digestive problems that come to consultations are linked to factors such as anxiety or stress, which do not play a role in the development of bacterial overgrowth in the small intestine (SIBO).
