More than a quarter of the population has digestive problems, with symptoms such as abdominal pain, bloating, diarrhea or constipation. Generic and non-specific indicators that, typed into Google or transferred to the field of social networks and influencers, usually 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 so-called patients to stress medical consultations and to polish up the accounts of laboratories that can carry out tests of doubtful reliability.
“SIBO is a concept that must be understood well. It is not a disease, it is a complication of some digestive process”, says Javier Santos, associate of Neurogastroenterology at Vall d'Hebron and Ciber of liver and digestive diseases. It usually affects patients with diabetes or systemic diseases such as Parkinson's, who have undergone abdominal surgery or who have other digestive diseases.
In other words, not everyone has SIBO, far from it, but "it's fashionable," says the doctor: "If you go into Google there are many websites of dubious scientific quality that mislead patients. People see that their symptoms match what they are told and they come to the consultations with the specific demand of if we can evaluate the SIBO”. According to Santos, as much as 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 an enormous demand. They are people who are not feeling well and the system is left out”. It is not surprising, according to this reasoning, that they look for answers on the net.
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 asking for SIBO detection tests are overwhelming consultations. "It is a real madness what has been happening since the pandemic in terms of a social scourge," he denounces.
He maintains that around this disease, and framed within the cult of the body and food, a lucrative business of laboratory tests and the sale of all kinds of diets and food supplements has been set up that could end up harming people and the system. “The number of people requesting tests in digestive consultations is starting to be an overload problem, and the pressure you have from patients who already come with a positive SIBO is starting to be significant. And they are not 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 at odd hours, poor chewing...
"Since the symptoms are so frequent, people believe that SIBU may be the cause," says Katja Serra, a specialist in the digestive system at the HM Nou Delfos hospital. In her opinion, all you have to do is investigate patients with severe or disabling symptoms and question a test "that has become very fashionable." “The most widely 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. There may be overdiagnosis.
Serra points out that most of the digestive problems that come to the consultations are linked to factors such as anxiety or stress, which do not intervene in the bacterial overgrowth in the small intestine.
