The symptoms of h. pylori and SIBO are very similar. Which is why self diagnosing based on symptoms can lead you down the wrong path. I see these conditions most often in my clients, with symptoms diagnosed and dismissed as IBS by doctors.
Self diagnosis may be tempting, but it can be a waste of time, money and energy, and leave you discouraged before getting down to the real root cause.
The list of symptoms below are not meant for self diagnosis. Just to show how symptoms can frequently overlap.
Symptoms are simply messages from your body that something is wrong everyone displays them differently, because we all have unique bodies. Two people with h. pylori can have very different symptoms.
What you’ll learn here is what drives symptoms of h. pylori and SIBO, how to test for them and how to tell them apart.
SIBO is typically caused by a combination of low stomach acid and poor motility in the small intestine. There could also be poor bile flow.
Low stomach acid could be caused by either h. pylori (most commonly), old age, stress, medication or a combination of these factors.
Getting rid of h. pylori, if present, is the best way to bounce back stomach acid. And because h. pylori can actually increase stress due to its effect on the biome and neurotransmitters, addressing h.pylori improve stomach acid AND stress.
How to test for h. pylori and SIBO
The best test for h. pylori is the GI Map because it’s least likely to produce a false negative. Many tests miss h. pylori because it’s hard to test for (it is protected by biofilm and often goes undetected even when present).
The best and only test for SIBO is the SIBO breath test. The choices are the trio smart (which also tests for sulphide gas) the lactulose breath test and the glucose breath test. Anyone who says you have SIBO based on a stool test, does not understand SIBO.
If you are interested in ordering these test you can find out more here.
Symptoms of h. pylori and SIBO
Both SIBO and h. pylori can cause upper GI symptoms.
Belching, reflux/GERD/heartburn is caused by low stomach acid which results from h. pylori bacteria neutralizing stomach ph so it can survive better. Low stomach acid loosens the tight seal of the LES (lower oesophageal sphincter) and lets acid escape into the esophagus.
It can also be caused by upward pressure from gas, a byproduct of fermentation produced when bacteria feed on undigested food in the small intestine. The upward pressure from gas in the small intestine push the LES up, letting acid and gas escape.
Gastritis is caused by inflammation of the stomach lining, which can be a result of h. pylori bacteria burrowing into the lining and inflaming it or gases from the small intestine causing irritation to the stomach lining.
Food sensitivities are cause by undigested food particles (from low stomach acid) moving into the small intestine, where they become food for the bacteria or yeast that live there. There is an inflammatory response to the microbial activity caused by food, as the immune system gets confused and attacks. When the immune system is inflamed, it can tag a harmless food as an invader and defend against it.
SIBO causes an overgrowth of bacteria in the lining of the small intestine, which leads to leaky gut. As undigested food particles leaks into the bloodstream through the holes in the gut, the immune system attacks and tags the food particles as invaders/pathogens. Every time it encounters that food again, it causes an inflammatory reaction. This immune response causes food sensitivities.
Bloating and gas is caused either by low stomach acid as food is emptied undigested into the small intestines where it’s eaten by microbes instead of being absorbed. Or by the endotoxins released by bacteria after they eat. This endotoxic off-gassing causes bloat and gas. The more bacterial overgrowth you have, the bigger the bloat (and you belly). That is why you can look pregnant after a meal or two. That gas/bloat can also cause belching, reflux or farting as the pressure is expelled.
Nutrient deficiencies happen when food that’s supposed to be digested into chyme (a liquid that’s easily absorbed and assimilated into the small intestine) is emptied into the small intestine in undigested chunks. Food that’s not properly digested and absorbed becomes food for bacteria instead of you. This leads to nutrient deficiencies as you don’t get nutrients from your food. The biggest deficiencies I see with both are b12, iron and thiamine.
Weight changes can happen when we don’t absorb calories from food (for the same reason nutrients are not absorbed). This leads to weight loss and is more common with h. pylori. Weight loss can also happen with hydrogen SIBO, which causes diarrhea. Methane SIBO, on the other hand can cause constipation and weight gain because methane extracts more calories from food.
Constipation or diarrhea are common symptoms of both h. pylori or SIBO. The intestines react to the inflammatory environment caused by these conditions by either getting rid of toxins with diarrhea or slowing down and holding on to waste with constipation.
One of the most common symptoms I see is anxiety or depression with both conditions. With low stomach acid you are not breaking down protein into amino acids, which are the building blocks of neurotransmitters like serotonin, dopamine and GABA. These are the neurotransmitters that regulate mood.
Loss of appetite is more common with h. pylori but can also be caused by SIBO and lack of motility. When stomach acid is low it causes food to sit in the stomach for too long instead of emptying into the small intestine. It can start to ferment there. Because your body intuitively knows it can’t handle too much food without sufficient acid, it lowers appetite. And you may feel full after very little food.
SIBO can cause loss of appetite due to poor motility. Lack of healthy motility (cleansing waves in the small intestine that pushes everything down), can create a feeling of fullness and bloat that dampens appetite.
Nausea is caused by food fermenting in the stomach because it sits there too long or from endotoxins produced by bacterial off gassing in the small intestine. This additional toxic load to the system could also stress the liver and increase nausea as it tries to detox.
Fatigue can be caused by nutrient deficiencies (iron and B12), leaky gut or inflammation in the stomach or intestines. Both h. pylori (through down stream affects on the biome) or SIBO can cause all of these issues.
Rosacea is a skin condition that is common with both SIBO and h. pylori. It is caused by the immune system’s reaction to both conditions as it produces a large amount of inflammatory mediators that show up as an inflamed skin manifestations like rosacea.
Clues that distinguish the two
There are a few clues and timing of symptoms that can distinguish if the problem is h. pylori or SIBO. Testing is still the best way to confirm your hunch.
With h. pylori you can get a burning or gnawing feeling in your stomach that gets much worse when your stomach is empty.
With SIBO your bloating gets progressively worse as the day progresses, and is at its worst at night.
How much time it takes for the onset of symptoms is also a clue.
With h. pylori, symptoms start within 30 minutes of eating.
With SIBO it takes 60 to 120 minutes to experience symptoms, depending on the person, with an average of 90 minutes.
People who have both SIBO and h. pylori can experience a mix of times it takes symptom to occur. And it is not uncommon to have both h. pylori and SIBO.
H. pylori can increase the likelihood of developing SIBO because it lowers stomach acid. You need low stomach acid and poor motility to develop SIBO.
You don’t automatically have SIBO when you have h. pylori but it can raise your chances. H. Pylori can lead to overgrowth of bacteria, parasites or yeast in the small or large intestines. H. pylori can also decrease digestive enzyme production, to further compromise digestion.
That is why if both SIBO and h. pylori are present, we always deal with h. pylori (the root cause) first.
If you already know or suspect you have SIBO or h. Pylori you can learn about how to deal with both naturally by downloading the guides below.
If you want to order testing (GI Map or SIBO test) you can do it here.
Angela Privin is proof that IBS is NOT an incurable disease, but a cry for help from a gut out of balance. When the body AND mind are complaining, it’s an opportunity to examine what’s not working and change it. After solving her own IBS mystery almost two decades ago, Angela became as a health coach to help others. Angela uses root cause medicine protocols personalized to the individual to solve each IBS mystery. Her tools are lab testing, dietary changes, supplementation, subconscious mind work and nervous system rebalancing . Learn more here.