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My name is Todd Mansfield and I’m a clinical herbalist dedicated to digestive health. Every week I treat Australian and New Zealand patients with IBS, IBD, SIBO, reflux, indigestion, bloating, loose bowel movements and constipation.

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When we're talking about small intestinal bacterial overgrowth (aka SIBO), understanding the symptoms is important for effective intervention. The two primary subtypes, methane and hydrogen dominance, present in very obvious and different ways.

Bowel movements serve as a key differentiator. Hydrogen dominance manifests as loose, urgent, or reactive bowel movements, resembling diarrhoea. In contrast, methane dominance paints a picture of constipation, with a sluggish gut as its hallmark. Understanding these differences provides a valuable window into the digestive tract.

Bloating and distention, another important symptom, shows less obvious variations between the two subtypes. Hydrogen-dominant SIBO patients experience rapid bloating quickly after meals. Most methane-dominant individuals, on the other hand, exhibit a more persistent, visible distention that gradually worsens throughout the day.

Transit time, the duration from mouth to toilet bowl, serves as the third crucial difference. Hydrogen dominance tends to accelerate transit, with bowel movements occurring relatively quickly. Methane dominance, conversely, results in slow transit, with severely impacted patients experiencing constipation lasting up to weeks.

Recognising these differences in symptoms aids in navigating the complexities of SIBO treatment. While individual experiences may vary, these fundamental insights provide a starting point for intervention strategies. Seeking professional guidance and considering SIBO breath testing can offer a clearer understanding of one's specific subtype and inform targeted treatment approaches.

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