This article explains how to tell the difference between SIBO and Candida or SIFO (Small Intestinal Fungal Overgrowth) symptoms, as well as treatment plans and dietary considerations for SIFO.
What we’ll cover:
Interpreting SIBO and Candida Symptoms
Let me walk you through a common SIBO Amigo scenario: You’ve been diagnosed with Small Intestinal Bacterial Overgrowth and experienced small intestinal bacterial overgrowth treatment. You feel about 40% better, so you retest and find that the SIBO is gone. But your symptoms — chronic bloating, belching, nausea, diarrhea, and gas — persist, even if to a lesser degree.
It would be great if there was one issue that caused all of our IBS problems, many people pin all their hopes and dreams on SIBO. But unfortunately, many times there will be some co-infection. One of the most common overlaps is yeast or fungal overgrowth, also known as candida or SIFO.
What is SIBO vs Candida or SIFO?
SIBO, or small intestinal bacterial overgrowth, occurs when perfectly normal bacteria colonize too far in the digestive tract. Most of the good bacteria are found in the large intestine, where they play a role in an important step in the digestion process, breaking down plant fibers and aiding in their elimination.
While SIBO may be caused by an outbreak of bad bacteria, it’s really a matter of location, not type.
When that same flora of bacteria settles in the small intestine, it can cause a host of digestive problems: gas, bloating, leaky gut and food intolerances.For a full list you can check out my post SIBO test or view my book On this subject, SIBO made simple.
Just like bacteria, the presence of yeast or fungi in the body is fairly normal. In most cases, it colonizes our skin and mucous membranes. Problems arise when our immune system or microbiome are out of balance—often associated with the same risk factors for small intestinal bacterial overgrowth (SIBO), such as repeated use of antibiotics. This can cause these organisms to overgrow or lose tolerance, or both.
How to get SIFO or Candida?
There are three main conditions that cause yeast or fungal overgrowth.
The first is an infection — a condition that can be treated with over-the-counter medications. Consider a vaginal yeast infection or a fungal toenail infection. Excess estrogen is one of the potential triggers for yeast infection recurrence, especially if it is mid-cycle or pre-menstrual because of fluctuating hormone levels, yeast infections tend to be exacerbated.
The second condition is what we see most often in SIBO: intestinal overgrowth. SIFO refers to an excess of fungal organisms in the small intestine, while SIBO refers to an excess of bacterial organisms.
The term was coined by Dr. Satish Rao, one of the leading researchers of the relationship between SIBO and SIFO. Dr. Rao’s studies of collecting juice samples from the small intestine via an endoscope found that when patients had symptoms of irritable bowel syndrome (IBS), One quarter had only SIBO, another quarter had only SIFO, and about half had both.
A third yeast condition that can co-occur with an overgrowth is when your immune system turns on your fungal friends and develops an intolerance to them. This is another example of how the immune system can have problems with cross-reactivity between different proteins.
For example, someone with this Candida intolerance may also be sensitive to gluten or have full-blown celiac disease. There is also a high correlation between loss of yeast tolerance and loss of yeast tolerance. mast cell activation syndromeeczema and other skin problems, and inflammatory bowel disease (IBD).
Multiple studies have found that people with Crohn’s disease have higher rates of yeast colonization and higher levels of anti-yeast antibodies.[i] An immune response to yeast may actually trigger Crohn’s disease and related symptoms in some patients. Likewise, treating patients with colitis with antifungal drugs has been shown to improve symptoms and remission rates.[ii]
The tricky thing about distinguishing SIBO from SIFO is that they have relatively the same symptoms, as do many of the risk factors.
The testing options for determining yeast are far less reliable and easy to use than the SIBO breath test, so your best bet is a process of exclusion. If the SIBO test is negative and all signs in your health history point to the presence of yeast, the next step is easy to treat with a round of antifungal medication or dietary modifications.[iii]
How to Take a Candida or SIFO Diet Test
When the fungus overgrows, it can cause you to be sensitive to mold or yeast in your diet. This means changing your diet can both be part of your treatment plan and help you find out if you have SIFO in the first place.
The yeast challenge involves Remove foods containing yeast and mold, plus feed yeast for five days.
Components to remove from the SIFO diet include:
- sugar
- baker’s yeast
- vinegar
- dried fruit
- Fermented alcohol (wine, beer, cider)
- sauerkraut
- kombucha
- Tea
- coffee
- Old meat
- bottled juice
- bone broth
The list includes virtually all stale stuff.For a complete list see my book SIBO made simplewhich also has recipes labeled Candida or SIFO friendly.
After 5 days, reintroduce one of the foods and assess your response. For example, start with fermented vegetables and see how you feel over the next one to three days.
This dietary test is one of the most effective ways (beyond testing) to rule out SIBO with Candida.
Tips for ruling out other bowel problems
Figure out if histamine is a problem too。 If you have a reaction to fermented foods, it could also mean a histamine imbalance, which is common in both SIBO and fungal overgrowth. You may have noticed that the foods listed above are very similar to foods that contain high amounts of histamine. Test again with distilled vinegar or fresh lemon juice, both of which are rich in histamine but not yeast or mold.For more on this read or listen to my full interview Histamine Intolerance and SIBO.
Watch for cross-reactivity with other food groups. If you develop an immune resistance or allergy to Candida, these antibodies may cross-react with gluten proteins. Here are other things to avoid if you want to reduce yeast symptoms: all sweeteners, eggs, soy, and corn.
Or better yet, go on a total elimination diet to find triggers (more info How to Do an Elimination Diet here).
If you can tolerate it, keep whole grains in your diet. Many candida diets on the internet will say to eliminate all starches and starchy vegetables, but this may not be necessary for SIFO.[iv]
“White rice has less mold than eating flour products that have been ground and sat on the shelf for a while,” said Dr. Ami Kapadia, who specializes in SIFO. “There are studies that show that if you remove all the starch, the fungus starts to feed on other foods.”
You can read the full transcript of my interview with Dr. Kapadia SIBO Candida Connection here.
check for nutritional deficienciesLow levels of magnesium, B vitamins, vitamin A, zinc, essential fatty acids, iron, biotin, and folic acid have all been linked to yeast-related problems.
Check for co-infections. Tick-borne diseases such as Lyme disease and environmental toxins Can affect our immune system tolerance and overall gut health. Parasites are another big problem.
Watch out for deaths. If someone has a strong reaction to antifungal medications, such as those found in many herbal complex regimens for SIBO, it may be a sign that the immune system is no longer tolerant to these organisms.
Beware of Environmental Mold. Studies have shown that if you are colonized with Candida, you may be more likely to be allergic to environmental molds.[v] If you live in a building that has previously suffered water damage and you are vulnerable to water damage, it may trigger an immune system response. Mycotoxins in the home can also cause SIBO because it affects bile production and damages the nervous system. If you suspect a mold problem in your home, seek out a trusted environmental advisor in your area.You may also want to take a protocol Detox Your Liver Naturally.
Look for ways to reduce symptoms other than diet. My summary Best SIBO Supplements There are plenty of Candida-friendly options that can help fight bloating, gas, constipation, and more.
refer to:
[i] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163673/
[ii] https://www.medicalnewstoday.com/articles/319633.php
[iii] Dr. Garland’s Nutrition and Candidiasis.
[iv] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3667795/
[v] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5647975/
