Anyway, SIBO means bacterial overgrowth in the small intestine. Apparently, much like the bladder, the small intestine is supposed to be pretty much free of bacteria. If bacteria gets into the small intestine, maybe due to migration from the large intestine- bloating, gas and digestive issues can result. You can have either constipation or diarrhea. The test for SIBO is called a lactulose breath test. The test can show abnormally high levels of methane and hydrogen gas. Usually, with constipation, there is more methane and with diarrhea, more hydrogen. This in turn can make the problems worse- i.e., methane can slow down the bowel even more. From what I've read though the test is not always reliable. The preferred treatment is Rifaximin, sometimes also Neomycin. These antibiotics supposedly stay mostly in the GI tract and are not absorbed by the body like with most other antibiotics. Rifaximin is currently only approved for travelers' diarrhea so insurance may not cover it and I guess the cost can be quite high. Approval for its use for SIBO/IBS is still in clinical trial stage from what I've read.
One of the causes listed in the book is adhesions. The reason for this is that adhesions can interfere with what are called the 'cleansing waves'- which is a stage of digestion where the small intestine moves the contents forward into the colon, if I understand correctly. This occurs 3-5 hours after eating, which is why eating snacks or small frequent meals is not recommended because these cleansing-waves cannot occur while food is being digested.
I just thought this might explain why some of us with adhesions seem to have a permanently distended abdomen. It sounds like, in addition to eradicating the SIBO with the antibiotics, the cause for the lack of proper cleansing waves needs to be corrected. Which means, for any of us who may have this, that we'd need to address the adhesions! Otherwise, the SIBO would just return after the antibiotics.
It may be a good place to start with our next visits to our gastroenterologists if they are update and amenable to the idea of SIBO. Some of them may not believe in it because the concept is still relatively new. The book about it came out 5-6 years ago. The doctor who wrote it mentioned how long it took for the concept of H. Pylori as a cause of ulcers to be accepted- the medical community wanted to continue to think ulcers were caused by stress and psychological issues- and the same may be true for considering SIBO as a cause of GI issues.