I often encounter patients who have read online that SIBO (small intestinal bacterial overgrowth) is a chronic condition that never fully goes away. In my clinical experience, this is not true. However, it can feel like a chronic issue when it’s either misdiagnosed or not treated thoroughly.

Why Accurate SIBO Diagnosis Matters

Let’s start with diagnosis. The most accurate, readily available, way to diagnose SIBO, is with a breath test. Sometimes patients tell me they were diagnosed using a specialty stool test. While certain stool markers might suggest the possibility of SIBO, they are not definitive or diagnostic. 

I typically order at-home breath tests, which I have found to be very reliable. These tests are often easier for patients to complete than in-office ones, especially since I usually order the 3-hour tests, to make sure to catch cases in people who have slower digestive motility. These breath tests measure hydrogen and methane gas levels in the breath. (When methane is elevated, it is technically considered Intestinal Methanogen Overgrowth, or IMO.)

Why does this matter? Because an accurate diagnosis is the first step to an effective, complete treatment plan. Which gases are present, and how elevated the levels become, are key to guiding treatment strategies. 

SIBO Treatment Plans Based on Breath Test Results

Knowing your gas levels helps tailor the treatment approach. As a naturopathic doctor, I offer an integrative treatment plan. This may include:

• Prescription antibiotics
• Herbal antimicrobials
• Or a combination of both 

I generally don’t recommend antibiotics without a confirmed diagnosis. But with a positive test, the treatment recommendations change depending on the type and amount of gases present. 

Some patients choose to go the herbal route only, which is totally fine. While it may take longer to fully eradicate with herbals alone, it is definitely possible. 

Preventing Chronic SIBO with Complete Treatment

So, how do we prevent SIBO from becoming chronic? We treat it until it has fully resolved. One of the most common mistakes I see is under-treatment. The only reliable way to confirm eradication is by repeating the breath test. 

What to Do When SIBO Symptoms Don’t Improve

Sometimes, gas patterns change in ways that give clues about how to shift treatment strategies, and this is where repeat testing can be helpful. Adjustments made based on the results can make your treatment plan more precise and more effective.

The key is working with a provider who has the clinical insight and experience to guide you through the process until the SIBO is truly resolved. 

Personalized SIBO Support in Seattle

If you’re tired of feeling adrift, and looking for this kind of specialized support, I’d love to help. 

You may call to schedule an appointment at 206-643-2239, or book online at www.pnwintegrativemed.com 

The post Is SIBO Chronic? Not Necessarily. first appeared on Pacific Northwest Integrative Medicine.

The terms diverticulosis and diverticulitis sound similar, but what’s the difference?

And is one more serious than the other?

These are common questions I get when discussing the topic of diverticulosis and diverticulitis, so, let’s discuss. They are different, but related. The short version: Diverticulosis is an out-pouching of the wall of the intestine, and diverticulitis refers to the process of one or more of these pouches becoming infected and inflamed.

So, what exactly is diverticulosis (the longer version)? Diverticulosis occurs when part of the wall of the colon (usually, but can also form in the small intestine) forms a pouch, like a pothole. According to the American College of Gastroenterology 2023 guidelines, it is not clearly understood what the actual cause of this is, but there is a genetic link, and it is not uncommon in people who have connective tissue disorders, such as Ehlers Danlos syndrome (EDS).

Additionally, some experts believe that straining to have a bowel movement may weaken the colon wall and cause the outpouching. It does not occur commonly among people under 30, has about a 20% occurrence rate in people 40-60 years of age, and up to 60% occurrence in those over 60 years of age. Some of the risk factors associated with developing diverticulosis include a low fiber diet, elevated BMI, smoking, increased consumption of alcohol, and regular use of NSAIDS.

As such, some of the recommendations to prevent diverticulosis from progressing or developing into diverticulitis include maintaining a healthy weight, regular physical activity (some studies report the more vigorous the activity the better), consuming sufficient dietary fiber (in the form of fresh fruits, vegetables, whole grains, and legumes), limiting red meat, reducing sweets in the diet, smoking cessation (if applicable), moderation of alcohol consumption, and avoidance of NSAIDs.

According to the American College of Gastroenterology, diverticulosis is thought to be mostly asymptomatic, although some sources indicate people can have some abdominal discomfort, changes in bowel function (such as diarrhea or constipation), gas, and bloating with diverticulosis. Diverticulosis can be found with the use of barium enema, colonoscopy, or CT scan.

Sometimes, the pouches, or diverticula, can become infected and inflamed, and then it becomes diverticulitis. This is considered a relatively rare complication of diverticulosis, occurring in about 5% of people who develop diverticulosis. Symptoms of diverticulitis can include fever, fatigue, abdominal pain, either constipation (if a blockage occurs) or diarrhea, nausea, and poor appetite. Some of the complications that can develop, leading to blockage are abscess, stricture, or fistula. Diverticulitis is often treated with an antibiotic, as well as bowel rest. This refers to consuming only liquids for several days to enable the inflamed bowel to heal up. Surgery may be required if one of the mentioned complications occurs.

Are you wondering if you might have diverticulosis? Or already of a history of the condition? As a specialist in integrative gastroenterology, I can work with you to determine the correct diagnosis and develop a comprehensive treatment plan to not only manage symptoms, but to help heal your GI tract, and improve function long term.

Natural medicine can work very well to improve GI health. Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for any gastrointestinal issues you may have. If you live in Washington state and would like to learn more about Dr. Buckle’s naturopathic approach to your wellness, please call (206) 643-2239 or CLICK HERE to schedule a consultation.

The post WHAT’S THE DIFFERENCE BETWEEN DIVERTICULOSIS AND DIVERTICULITIS? first appeared on Pacific Northwest Integrative Medicine.

I’m not one for New Year’s resolutions, they are hard to stick to. Instead, setting life goals and intentions that can actually be obtained are more helpful. Especially after the health scape of the last few years, it’s important to take care of the issues that we’ve put on the back burner.

In the new year, consider getting in touch with your body and revisiting the health needs you have been ignoring. For instance, I have patients who have had diarrhea for years. Years. We have spent so much time in survival mode, it’s time to thrive.

If you are someone who has been experiencing chronic GI issues it is long past time to get it checked out. Ask yourself the following questions:

• Have I had intermittent GI pain?
• Alternating diarrhea/ constipation?
• Acid reflux?
• Bloating or gas?
• Unexplained, ongoing nausea?

Rather than pushing past the pain and guessing why you continue to have these symptoms, take the time to look into it deeper. I can help decipher what’s going on with your body through testing and by offering dietary modifications that will alleviate discomfort.

The big goal should be restoring normal function to your GI tract, your body and your everyday life. Don’t set a resolution this year; instead follow through on your intention to take care of yourself and to be well.

Natural medicine can work very well to improve bowel function. Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for any gastrointestinal issues you may have. If you live in Washington state and would like to learn more about Dr. Buckle’s naturopathic approach to your wellness, please call (206) 643-2239 or CLICK HERE to schedule a consultation.

The post STARTING THE NEW YEAR WITH INTENTION first appeared on Pacific Northwest Integrative Medicine.

Often times rather than narrowing down information to achieve diagnosis, independent investigation adds a level of complexity to the issues at hand. It can be hard deciphering the nuances of the symptoms on your own.

Commonly, people who have diarrhea, gas, or bloating start by googling their symptoms and begin to modify nutrition based on perceived food sensitivities. They might suffer through discomfort, pain, or worse – long term damage – by merely managing symptoms. Not understanding the root of the problem, the symptoms of IBS and IBD may appear similar but in reality, the treatments are very different.

IBS is a functional issue; chronic symptoms that develop into a syndrome affecting the body’s systems. As the symptoms of IBS are alleviated, the function of the body can be restored and maintained.

IBD, on the other hand, is a pathological issue causing inflammation of tissues in the GI tract. It is a disease rather than a syndrome, often manifesting as Chron’s Disease or Ulcerative Colitis. As such, there’s more of an algorithm to the treatment of IBD than IBS.

If you have IBD and treat the symptoms, they might alleviate to some degree but won’t go away. There are three red flags that we look at when differentiating IBD from IBS:

• Blood in the stool (usually diarrhea)
• Weight Loss
• Fatigue

It’s important to get a definitive diagnosis if you suspect IBD and better to rule out the other (IBS). Rather than gathering and deciphering the information on your own, it’s useful to have someone help you narrow down what you’re dealing with.

As a naturopathic doctor with a specialty in gastroenterology, I will recommend specific labs that make the distinction between an IBS or IBD diagnosis definitive. For instance, I can perform basic blood work and stool studies, but if IBD is suspected I will refer you to a GI doctor for endoscopy and/ or colonoscopy to rule it out. The definitive diagnosis is achieved through tissue biopsy. I will partner with you by offering a more educated distinction between IBS and IBD than you would be able to correlate independently.

Natural medicine can work very well to improve bowel function. Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for any gastrointestinal issues you may have. If you live in Washington state and would like to learn more about Dr. Buckle’s naturopathic approach to your wellness, please call (206) 643-2239 or CLICK HERE to schedule a consultation.

The post THE DISTINCTION BETWEEN IBS AND IBD first appeared on Pacific Northwest Integrative Medicine.