Why Am I Bloated Every Day? What a SIBO Breath Test and a Stool Panel Show

Dr. Rose says bloating is a symptom with many possible causes, so the real question is what is causing it. She runs through constipation, SIBO, yeast or fungal overgrowth, IBS, food intolerance, celiac disease, low stomach acid, enzyme insufficiency and bile problems, along with stress, how fast you eat, and hormonal shifts that change gut motility. Colin Renaud adds that a label like irritable bowel is the point where he starts asking harder questions about what is driving it.

Colin Renaud says he has had other providers dismiss it as functional medicine speak, and he disagrees. Leaky gut is increased intestinal permeability, where the lining of the small intestine, which is one cell layer thick, becomes porous enough to let substances pass into the bloodstream that should have stayed inside the digestive tract. When those gaps form, the body responds with immune activation and inflammation. He notes it shows up as a real feature in conditions like celiac disease and Crohn's disease, and it can also stand on its own.

SIBO is small intestinal bacterial overgrowth, meaning too much bacteria has built up in a part of the digestive tract that is supposed to stay relatively clean. Colin Renaud compares the fermentation to a beer factory, where bacteria feed on certain foods and produce the gas behind the bloating. He is direct that not every microbiome imbalance is SIBO and not every bloated patient needs SIBO treatment. Dysbiosis is the broader term for an imbalanced gut microbiome, and it can sit short of full SIBO.

You ingest a sugar solution, typically lactulose, which feeds the bacteria in the gut. Colin Renaud explains that the bacteria produce gas as they eat it, and you then breathe into small balloons, like birthday balloons, so the lab can measure what you are giving off. You are expected to produce a certain amount, and a result that crosses the threshold is what produces a positive SIBO diagnosis. Some research now supports running the test over three hours at 20 minute intervals, instead of the 15 minute intervals over two hours that most standard labs use, because everyone's gut moves at a different speed.

The test measures three gases, and which one is elevated points at a different picture. Plenty of people do not fall neatly into these categories, but in general elevated hydrogen goes with the diarrhea type of SIBO, methane goes with slowed motility and constipation, and hydrogen sulfide is the least common of the three, with an odorous sulfur smell as its hallmark. The organisms producing the gas belong in the small intestine, so the question the test answers is whether there are too many of them. The type matters because treatment differs, and methane SIBO takes multiple antibiotics where the other types may not.

Dr. Rose describes IBS as a diagnosis of exclusion, given once celiac disease, cancer and inflammatory bowel disease have been ruled out and you are still symptomatic. She sees patients who were handed that label along with a medication or an antidepressant and are still no better. Colin Renaud says the functional medicine job is to keep asking questions. Is this a food reaction, a motility problem, inflammation, a bacterial or yeast overgrowth, a parasite, or stress. The label is a starting point for that work.

Colin Renaud states at the top of the episode that it is educational and not personal medical advice, and lists the symptoms that call for medical care instead: severe abdominal pain, blood in your stool, unexplained weight loss, persistent vomiting, fever, dehydration, or rapidly worsening symptoms. The rest of the episode is about the daily chronic pattern, bloating after meals, constipation, diarrhea and reflux, and what testing can explain about it.