EP.392/ Which Type of SIBO Gases Are Endo Patients Most Likely to Have, and What Are the Symptoms?

Podcast

17 May

Today I want to talk very briefly on endo belly and IBS symptoms, and the three SIBO type gases and the specific symptoms they can cause, so that you can look for clues as to whether SIBO is behind your gut issues.

So, first up, let’s just do a quick recap.

SIBO stands for small intestine bacterial overgrowth and is an overgrowth of bacteria in the small intestine, and a leading cause of IBS.(1)

There are three gases released by the different bacteria: hydrogen, methane and hydrogen sulphide.

The methane and hydrogen sulphide types have been renamed to Intestinal Methanogen Overgrowth and Intestinal Sulphide Overgrowth, as these two can occur in the large intestine.

Now, the latest research shows correlations with types of gas and symptoms. We’ve always had an idea of this from the studies, but we have more data now(2):

Hydrogen: Mild diarrhoea
Methane: Constipation, discomfort, bloating
Hydrogen sulphide: Severe diarrhoea, pain, urgency

‘Mixed type’ is the presence of both hydrogen and methane, causing both diarrhoea and constipation.

Dr Pimentel’s research reveals if H2S is present(3), diarrhoea will dominate, though Dr Siebecker reports that she often sees constipation too(4).

Additionally, both in the research and clinically, we see hydrogen sulphide patients feeling much sicker with systemic symptoms, as hydrogen sulphide is toxic at high levels and has far reaching effects on the body.(3)

Finally, I would say that whatever the gas, I almost always see bloating in any SIBO-endo client.

So, if you have endo which type are you more likely to have?

A recent 2025, case-control study found that 91.9% of endo participants were positive for either SIBO or IMO.(5) They found that patients had -

Both gases: 49.4%
Hydrogen alone: 34.8%
Methane alone: 15.8%

So, based on this research alone, there’s about a 50% chance of having both gases, and I would say in my experience, it’s rare I see one or the other, they normally occur together, but not always. Sometimes I do see one gas alone, but it’s not frequent.

Unfortunately, this test didn’t test for hydrogen sulphide, so I am looking forward to the day they start bringing this into the endo research as I tend to see it fairly often.

So, how do you test for SIBO? In the show notes, I have linked to my articles and episodes on testing, but if you’d rather not figure it out alone, you can always reach out to me for a single SIBO session and we can get that set up.

References:

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