IBS & SIBO Differential Diagnosis
Irritable Bowel Syndrome and Small Intestine Bacterial Overgrowth have the
same symptoms (constipation, diarrhea or both, abdominal bloating and
pain). These symptoms are not specific to IBS and SIBO - many conditions, from benign to serious, can
create these symptoms. The differential diagnosis is a list of conditions that could be causing these
symptoms instead of IBS or SIBO (or in addition to them). If it’s not SIBO, it could be one of these.
• Post-Infectious IBS (a type of SIBO) • Pancreatic Enzyme Insufficiency
• Yeast Overgrowth • Insufficient Chewing
• Small Intestine Fungal Overgrowth • Hypothyroid
• Candida • Hashimoto’s Disease
• Parasitic Infection • Hyperthyroid
• Large Intestine Bacterial Overgrowth (Dysbiosis) • Diabetes
• Large Intestine Bacterial Infection • Gastroparesis
• H pylori Infection • Bile Acid Malabsorption/Diarrhea
• Celiac Disease • Verner–Morrison Syndrome (VIPoma)
• Non-Celiac Gluten Intolerance • Zollinger Ellison Syndrome
• Inflammatory Bowel Disease • Systemic Sclerosis
• Crohn’s Disease • Ehlers Danlos Syndrome
• Ulcerative Colitis • other Connective Tissue Disease
• Microscopic or Lymphocytic Colitis • Mast Cell Activation Syndrome (MCAS)
• Carbohydrate Malabsorption/ Disaccharidase • Postural Orthostatic Tachycardia Syndrome (POTS)
Deficiency • Lyme Disease
• Lactose • Immune Deficiency Diseases
• Fructose • Abdomino-Phrenic Dyssynergia
• Polyol • Outlet constipation
• Sucrose-Isomaltase • Slow transit constipation
• Genetic reduced activity (common) • Medication-induced symptoms
• Congenital deficiency (rare) • i.e. metformin=diarrhea, opioids=constipation
• Other Food Intolerance • Chronic Abdominal Wall Pain
• Protein (standard food sensitivity/allergy) • Ischemic Colitis
• Histamine • Cancer - Abdominal, Pelvic
• Salicylates • Endometriosis
• Nickel Allergic Contact Mucositis • Small Intestine Obstruction or Pseudo-Obstruction
• Hypochlorhydria • Stress
April 2020