Investigating Common Gut Health Issues: IBS, SIBO, and Lactose Intolerance

By Dr. Martin Hahn –

Gut health plays a crucial role in overall well-being, influencing everything from digestion to immune function. However, navigating gastrointestinal disorders can be complex, with symptoms often overlapping across different conditions such as irritable bowel syndrome (IBS), Small Intestinal Bacterial Overgrowth (SIBO), and lactose intolerance. Here’s a concise overview of these common gut health issues, their symptoms, causes, and modern approaches to diagnosis and management.

Irritable Bowel Syndrome (IBS)

IBS is a chronic gastrointestinal disorder characterized by symptoms including abdominal pain, bloating, and altered bowel habits like constipation and/or diarrhea. The exact cause of IBS remains unknown, but it is believed to involve problems with digestive tract motility, increased sensitivity to pain in the gut, and environmental and psychological factors. IBS affects more women than men and is often diagnosed in individuals under 50. Although there is no cure for IBS, treatments typically focus on symptom management through dietary changes, stress management, and prescribed medications. Many patients carry a diagnosis of IBS – and receive this diagnosis from their provider based on symptoms alone, or after only limited testing to rule out other problems with similar symptoms. There is no (good) available test that proves that the correct diagnosis is IBS (= diagnosis of exclusion). Many patients have not had sufficient testing to rule out other, underlying disorders that mimic the symptoms of IBS. (e.g. Lactose Intolerance, SIBO etc.) – which would then require different management than bona fide IBS.

Small Intestinal Bacterial Overgrowth (SIBO)

SIBO occurs when there is an abnormal increase in the overall bacterial population in the small intestine, particularly with types of bacteria not commonly found in that part of the digestive tract (since the small intestine generally harbors few if any bacterial flora). Symptoms of SIBO are similar to those of IBS, including bloating, gas, abdominal pain, diarrhea, and constipation. Factors such as slow gut motility, frequent use of antibiotics, or previous bowel surgeries can predispose individuals to SIBO. Diagnosis is typically made through a breath test, which can distinguish SIBO from other conditions by measuring the production of hydrogen or methane after consuming a sugar solution. Treatment often involves antibiotics and dietary adjustments.

Lactose Intolerance

Lactose intolerance stems from the body’s inability to digest lactose, a sugar found in milk and dairy products, due to a deficiency in the enzyme lactase. This condition can cause symptoms like gas, bloating, diarrhea, and abdominal pain shortly after consuming lactose-containing foods. Unlike IBS and SIBO, which may require more complex management strategies, lactose intolerance is typically managed by avoiding lactose-containing products or using lactase supplements to aid digestion.

Modern Diagnostic Tools and Self-Management

The diagnosis of gut health issues has been transformed by the availability of advanced, non-invasive tests that can be performed at home. These include breath tests for SIBO and lactose intolerance, which provide quick and reliable results. For IBS, while there is no specific test, diagnosis often involves ruling out other conditions like SIBO and lactose intolerance through a combination of symptom assessment, laboratory tests, and exclusion diets.

Home testing kits available online have made it easier for patients to take an active role in diagnosing and managing their conditions, particularly in a time when access to healthcare providers can be delayed. By providing fast, direct feedback on specific gut health issues, these tests help streamline the path to effective treatment and better quality of life.


Understanding the distinctions and similarities between IBS, SIBO, and lactose intolerance is key to effective management. With the aid of modern diagnostics and more accessible information, individuals suffering from these conditions can achieve greater control over their symptoms and lead healthier lives. The role of personalized diet modifications, informed by specific diagnostic tests, cannot be overstated in the management of gut health issues, underscoring the importance of individualized treatment plans.