Have you felt confused while you look up symptoms online to address an aching stomach and rashes? You’re likely to find a sizable list of diseases and infections as possible causes, including Small Intestinal Bacterial Overgrowth (SIBO) and Candida overgrowth.
Both SIBO and Candida typically lead to stomach pain, bloating, and in some cases, diarrhea and constipation. IBS and leaky gut syndrome have also been linked to these infections, which may cause bowel irregularities as well as additional discomfort.
This begs the question: Despite all the overlap in symptoms for both SIBO and Candidiasis, are they essentially the same?
Although the discomfort associated with both health conditions may seem similar, there are key differences in the tests and treatments prescribed for both. But here’s the most rudimentary difference between SIBO and Candida: Candida is a fungal infection and SIBO, as it indicates in the name, relates to bacteria.
With this essential distinction out of the way, here’s a deep dive into both the diseases and how you might be able to discern the difference between both before you visit a health practitioner’s office.
What is Candida Overgrowth?
Candida is a form of fungal yeast that resides in our mouths and small intestines in minuscule quantities. It is also part of the vaginal tract and skin. Its presence is not always unfavourable, and it is not there in your system only when you are sick. On the contrary, when present in the right amounts, this yeast is helpful insofar as assisting in nutrient absorption and digestive processes.
Things go awry when the balance of the various kinds of bacteria, yeast, viruses, and other microorganisms that inhabit our gut is skewed.
Candida albicans, which is the yeast that lives in our system, can multiply, and when it does, it is referred to as Candida Overgrowth. The presence of excessive candida in the gut often means depletion of the beneficial bacteria, which can disrupt the overall balance of the gut microbiome.
Why is it so easy for Candida albicans to enter the intestine?
Candida is known to change shapes. It usually exists in a round cell structure. It can transform into pointy thread filaments that can pierce the intestinal lining of the gut wall. When the gut lining is compromised, it makes it easy for Candida to enter the intestine. Once the non-filtered harmful substances enter your bloodstream, it can result in a leaky gut, along with other symptoms of Candida.
Candida Overgrowth is quite common and has a laundry list of symptoms, which we deal with in another section, but here is a quick checklist:
- Bloating or constipation
- Fatigue, brain fog, or mood swings
What Are the Causes of Candida
Candida Overgrowth may begin with the entrance of a foreign chemical into your body, which
disrupts the balance of the bacteria in the gut microbiome or microbiota.
There’s a lot to say about how our microbiota keeps us healthy, but the general idea is that it plays a crucial role in our immune system and its imbalance can lead to a higher risk of infections. Both the imbalance of gut microbiome and Candida infections have also been closely associated with long-term use of antibiotics, birth control, and a diet high in refined sugars. As a healthy microbiome plays a key role in protecting us from infections, its imbalance may also lead to Candida.
Candida Overgrowth causes include:
- Birth control pills
- Estrogen replacement therapy
- Acute and chronic stress
- Poor diet
- Recreational drugs
- A lack of physical activity or exercise
As some of the causes are poor lifestyle choices, they can be fixed with a conscious effort towards correctly nourishing our body, not including harmful substances in our diet, and moving our bodies now and then to stay active and fit.
A naturopathic consultation that focuses on addressing these key parts of your lifestyle with a focus on holistic treatment can also be beneficial in managing Candida.
What is SIBO?
Small Intestinal Bacterial Overgrowth, as its name suggests, refers to the overgrowth of bacteria in the small intestine, resulting in a skewed balance of bacteria in the GI tract. When you are an individual free of SIBO, the bacteria contributes to bone health and is present in the large intestine and colon.
When these bacteria permeate into the small intestine, that’s when SIBO becomes apparent.
When you eat something, and there are bacteria in your small intestine, they feast on this food before it gets digested. The carbohydrates ferment and produce hydrogen. Tiny organisms in the small bowel feed on this hydrogen and produce methane.
SIBO occurs due to the presence of hydrogen and the breeding ground of small organisms that produce methane.
This excess bacteria sets off symptoms like diarrhea and might also cause extreme weight loss.
Suppose your digestive tracts are normal, but you are still displaying symptoms that are common to SIBO. Then, there is a third potential culprit that might be at work: SIFO, i.e., Small Intestinal Fungal Growth.
SIFO is a relatively newly discovered disease, with its causes and symptoms being published only in 2015.
A throwback to middle school science class will remind you of the differences between bacteria and a fungus. That’s the main difference between SIBO and SIFO. The former is an overgrowth of bacteria, and the latter is an overgrowth of fungus.
Both occur when the acid in the stomach is not doing its job of killing harmful bacteria and fungi before the small intestine absorbs them.
Candida is a subset of SIFO, with the latter being an umbrella term of fungal overgrowths.
What Are the Causes of SIBO
The causes of SIBO are a combination of lifestyle choices and injury to the gut. When the digestive enzymes break down the food you eat, and the gut is either damaged or blocked, or the gut flora is not optimal, SIBO can occur.
While the injuries can be due to a host of pre-existing diseases or scarring that might not be in your control, your diet choices are.
A healthy diet of protein, fibre, non-processes carbohydrates such as eggs, fish, leafy vegetables, potatoes, and nuts can help keep SIBO at bay. If you are wondering how to maintain a healthy vegan diet while also managing SIBO symptoms, don’t worry, there are plenty of vegan alternatives out there which won’t require you to sacrifice veganism.
When diets are dominated by high-fructose items, processed meats, highly processed cereal, etc., it can wreak havoc to your intestines and lead to SIBO.
SIBO and SIFO cannot be differentiated much based on symptoms, but there is merit in differentiating them based on causes.
Causes of SIBO include:
- Damaged nerves in the gut allow bacteria to enter the small intestine
- Gut blockage
- Medication that modifies levels of bacteria in the gut microbiome
- Diet high in sugar, processed carbs, or alcohol
In contrast, SIFO can be caused by the overuse of immunosuppressant drugs, proton pump inhibitors, and antibiotics. Underlying syndromes and diseases such as diabetes and motility disorders can cause SIFO as well.
SIBO vs. Candida Overgrowth
The main difference between SIBO and Candida Overgrowth is that SIBO is a bacterial overgrowth and Candida is a yeast or fungal overgrowth. While SIBO only has symptoms related to digestive and gut issues, Candida Overgrowth has symptoms related to digestion but also other infections related to nails, skin, mouth and also energy, mood and memory.
Here’s a quick reference guide outlining the differences between both these diseases. Knowing these fundamental differences will put you at ease as you go down the rabbit hole that is the internet. You will transition from thinking SIBO causes Candida or the other way round (both are false) to understanding their vastly distinct origins.
Refers to bacterial overgrowth
Refers to yeast (fungal) overgrowth
Bacteria that usually inhabits in the large intestine and colon now multiplies in the small intestine
Occurs in the intestines but is also found in other parts of the body like the skin, mouth, and vaginal tract
Symptoms are largely related to digestive processes and gut issues
Symptoms include issues with digestion and also, other infections related to nails, skin, the urinary tract, mouth, and also energy, mood, and memory
SIBO vs. Candida Symptoms
Intersecting symptoms of SIBO and Candida
- Exhaustion due to Fibromyalgia or chronic fatigue syndrome
- Gas, bloating, diarrhea (also symptoms of SIFO)
- Autoimmune diseases
- Abdominal pain or cramping
- Constipation, in a few cases
- Skin rashes
- Diagnosis of Irritable Bowel Syndrome (IBS) or Inflammatory Bowel Disease (IBD)
- Food intolerances (Lactose, fructose, gluten, histamine intolerance)
- Chronic illnesses like diabetes, neuromuscular disorders
- Vitamin and mineral deficiencies (Vitamins A, B12, D, and E)
- Troubled absorption of fat, which can be observed through pale, bulky, or malodorous stools
- Leaky Gut
- Skin and nail fungal infections (including but not limited to athlete’s foot, ringworm, and toenail fungus)
- Foggy memory, lack of focus and concentration, ADD, ADHD
- Skin issues such as psoriasis, eczema, and hives
- Mood swings, anxiety, depression
- Seasonal allergies
- Sugar cravings
- Sinus infections
- Blood sugar issues
In general, Candida’s symptoms largely depend on the location of the overgrowth and the yeast in the body. When the yeast is present in the mouth, it can cause white patches, inflamed tissue, or cracked corners in the mouth.
When the yeast is found in the esophagus, you may experience pain when swallowing.
The yeast, if found in the vaginal area, might cause itchiness in the vulva, thick discharge, pain during sexual intercourse, or a UTI. Naturopathic solutions for vaginal yeast infections exist, which might help alleviate some of these symptoms. These include probiotics (more on this later!), vitamin C and some essential oils like coconut oil.
Testing for Candida and SIBO
Given the similarities between Candida and SIBO, the next step would be to get the relevant tests done to zero in on which one is causing the symptoms. There are two standard tests for both, which are the Dysbiosis Test and the Comprehensive Functional Medicine Stool Test.
Dysbiosis refers to the imbalance of fungi, bacteria, and other microorganisms in the gut. The test helps determine the presence of IBS or IBD and other underlying gut-related symptoms of both Candida and SIBO due to D-Arabitol, a waste product generated by Candida. These will determine whether you have Candida in your gut or SIBO.
With a stool test, a definitive overview of whether there is an overgrowth of a species of bacteria and/or yeast (if applicable) might give you some answers. This will dictate the appropriate treatment options.
Stool that is white, yellow, or some other unusual colour may be an indication of Candida. This can be accompanied by frothing or foaming or general looseness. It is challenging to diagnose Candida or SIBO just by looking at the stool since multiple other infections and diseases have stool-related symptoms as well.
SIBO stool might not be of a different colour but is likely to be of a different texture. This could include stool that has a strong odour, has a floating consistency, and is possibly difficult to flush.
Testing for Candida Overgrowth
Other than the above tests, you can also test for gut yeast overgrowth through regular blood tests. Candida also requires a complete blood count and an antibodies test. When these tests reflect a high amount of Candida antibodies (IgG, IgA, and IgM) in the blood, it means you probably have Candida Overgrowth.
A low white blood cell count (WBC) also signifies the possibility of Candida.
Testing for SIBO Overgrowth
Besides the Dysbiosis Test and the Comprehensive Functional Medicine Stool Test, the breath test is crucial for detecting SIBO. We spoke about how SIBO is caused due to the presence of hydrogen and methane, and this test helps determine their presence.
The process is straightforward and non-invasive. You will be asked to drink a solution, and then your breath will be examined after a few hours. It will help identify whether the SIBO is due to high methane levels or high hydrogen levels. A breath test cannot be used as a standalone method of detecting SIBO. It needs to be complemented with some of the other tests.
According to this journal, Small Intestinal Bacterial Overgrowth can also be tested clinically through small intestine aspirate and fluid culture. This test is invasive since an intestinal sample needs to be extracted. A long tube is inserted down the throat, all the way to the small intestine.
Your healthcare practitioner will be able to advise on the tests required to diagnose SIBO, so this should just serve as an overview.
Treatment for Candida and SIBO
Both SIBO and Candida relate to the overgrowth of bacteria and fungi, respectively. The goal of the treatment being employed is three-pronged. The first is to stop the growth, and the second is to enhance the presence of the “good” bacteria and restore the balance of the microorganisms in our GI tract. The third step is to seal off the gut and repair it.
Treatment for Candida Overgrowth
Cutting down on refined sugars, complex carbs, and high-lactose dairy products and food items are the first line of attack to stop the growth.
Going alcohol-free and removing sugar from your diet while also limiting carbs will stunt the growth of Candida and lessen the intensity of the symptoms. Remember, Candida thrives on sugar and yeast, so we need to remove food containing these to help prevent Candida.
It is not required to completely ditch carbs, since a prolonged low-carb diet can lead to other health complications.
Some aspects of Candida Overgrowth can be addressed naturally. It is a good idea to add ingredients to your diet that help fight yeast overgrowth. This “yeast-detox diet” could include garlic, ginger (the health benefits of ginger are comfortingly diverse), turmeric, olive oil, cinnamon, and apple cider vinegar, along with broccoli and other cruciferous vegetables.
You could supplement these with curcumin, which though found in turmeric in small quantities, is also available on its own. The health benefits of curcumin, such as its anti-inflammatory properties, lend themselves to treating Candida.
Since Candida is a kind of fungus, antifungal medication can also be prescribed to reduce the yeast level, along with dietary consultations. These can be topical if the Candida Overgrowth is on your skin or even in tablet form. For Candida infections that are not on the skin, invasive application of antifungal medication will need to be done.
Antifungal medicines can also be used to treat SIFO. Since they are both fungal infections, their treatment will have similarities. Specially formulated supplements might help kill Candida by entering the intestine, revitalizing the gut and intestinal environment, and catalyzing the effect of probiotics. Usage of these supplements is dependent on the intensity of the overgrowth and the test evaluations.
Lastly, another important tool for dealing with Candida may be Probiotics. Probiotics, and why they are important for health have been studied for a long time. They are known to improve gut health, so they might help restore the balance of yeast in the system. They are also known to inhibit the growth of harmful bacteria and yeast and prevent them from piercing the gut cells or the vaginal tract, thereby proving crucial in the prevention of leaky gut too.
Don’t probiotics also add harmful bacteria to the gut?
No, high-quality probiotics will not make your Candida worse. On the contrary, they are likely to promote tissue repair and help in boosting your immune system.
This comes with a caveat. Fermented foods contain probiotics too, but they should be avoided since they also contain bacteria that feed Candida. They also contain prebiotics, which nourishes unhealthy bacteria. As a result, prebiotics and food that contain them can make your Candida worse.
In most cases, a healthcare practitioner will ask you to avoid both fermented and non-fermented probiotics as much as possible, including pickles and sauerkraut. You may be able to incorporate them after your Candida has stabilized.
Treatment for SIBO
The primary treatment for SIBO includes surgical repairs (if required) to a postoperative loop, stricture, or fistula (remember that one of the causes of SIBO is nerve damage that can be a result of a previous medical procedure).
When surgical repair is not an option, SIBO treatment may focus on any of the following:
- As per your medical history and symptoms, you might be put on a brief course of antibiotics or different courses of antibiotics, depending on the probability of resistance to these antibiotics.
- It might be helpful to note that some of these antibiotics might cause side effects that match the symptoms of SIBO. Depending on your doctor’s evaluation, this might be a necessary inconvenience in the process of restoring the intestinal bacteria.
- In conjunction with synthetic antibiotics such as Rifaximin and Neomycin, anecdotal evidence has shown the success of natural antibiotics such as Allicin, Berberine, Lemon Balm, Oregano, Cinnamon, and Wormwood.
- Nutritional Changes
- Just like with Candida, SIBO might require you to make some transformational changes to your diet. What to include in a SIBO diet can vary from person to person. Depending on whether you have lost weight or gained weight (both are possible due to SIBO), whether you have any vitamin deficiencies (that can be assessed from the tests under SIBO), you might have to take supplements or adopt a lactose-free diet. These might also include vitamin B-12 supplements. The facts on vitamin b12 deficiency establish that it can cause diarrhea or constipation. Other supplements may consist of calcium and iron or oral vitamins.
- Weight gain can occur due to sluggish metabolism, while weight loss can occur due to malabsorption of fats. Your weight will fluctuate depending on whether your SIBO is methane-dominant or hydrogen dominant, and you will need to make nutritional changes accordingly.
- Poor gut/digestive health may be treated using naturopathic solutions to detoxify the body. Many common digestive health disorders have links with naturopathic treatments, and SIBO is no different.
“Do I have SIBO or Candida?” can be a difficult question to answer for a layperson. This guide is your starting point to help you ask the right questions when you visit the medical professional and also give you a head start on what signs to look out for and what treatments options might be available to you.
You get no points for guessing, and since the symptoms overlap so much, it is better to get the tests and treatments done so that you can move on to rebuilding your gut health.
Q. What if you have both SIBO and Candida?
Having both SIBO and Candida at the same time can be confusing and painful. Observe all your symptoms and get all the relevant tests done, depending on which the health professional may put you on a combination of antifungals and antimicrobials.
Q. Does SIBO go away on its own?
SIBO needs to be treated, either via medication, medical procedures or through dietary changes.
Q. Who treats SIBO and Candida?
SIBO is treated by doctors who specialize in digestive orders (gastroenterologists). Naturopathic doctors that work with digestive health can also help manage the symptoms of Candida in the gut. Because Candida is treated depending on where the yeast infection has occurred, your primary healthcare practitioner may also recommend a visit to a dermatologist if you have rashes.
Q. Are SIBO and leaky gut the same?
A leaky gut is a probable symptom of SIBO. Not all leaky gut cases are a result of SIBO. Leaky Gut Syndrome refers to hyperpermeability, i.e., reduced efficacy of intestine layers that prevent foreign substances from entering the bloodstream. This hyperpermeability can cause toxins to enter the bloodstream. Although the common symptoms for leaky gut syndrome intersect with some symptoms of SIBO, they are two different kinds of health conditions.
Q. Can SIBO cause headaches?
The increase in inflammation due to SIBO can cause other peripheral problems such as joint pain, nausea, and headache.
Q. Can Candida or SIBO cause ear infections or itchiness in the ear?
Fungal ear infection (Otomycosis) has a chance of being caused by Candida, although the predominant yeast that causes it is Aspergillus. SIBO does not usually affect the ears.
Q. Is there a link between SIBO/Candida and hair loss?
Gut health and hair loss are closely linked. Poor gut health can lead to hair thinning and hair loss. Since both SIBO and Candida relate to gut health, there is a chance that they might affect your hair.
Q. Can Candida cause acne?
Fungal acne occurs when there is an overgrowth of yeast in the hair follicles. This yeast is called Malassezia, which is also found naturally in our skin and differs from Candida.