The Link Between Rosacea and IBS/SIBO

An estimated 16 million Americans suffer from rosacea. Lately, there has been a trending link that when we clear up a patient’s digestive issues their rosacea clears up as well. The patients are usually ecstatic and want to know how this has happened. It happens because of the link between Small Intestine Bacterial Overgrowth (SIBO) and rosacea.

Rosacea is a dermatologic issue, whereas IBS is related to the bowel system. However, studies have found a link between disturbed gut flora and rosacea skin manifestations. This hypothesis is not confirmed as yet and is only supported on a theoretical basis.

Woman scratching wrist
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What Is Rosacea?

Rosacea is a disorder of the skin, primarily the facial skin, characterized by flare-ups and remissions. It is characterized by the formation of pustules, papules, persistent redness, flushing, visible blood vessels and swelling of the facial skin. This skin ailment can affect any age group but usually occurs over the age of 30.

The main cause of rosacea is still a mystery. The main contributing factor is an abnormality in our immune system, which leads to an inflammatory reaction. Some researchers feel this can be due to microorganisms on our skin, exposure to UV light, and anything that causes intestinal inflammation.

What About IBS/SIBO?

The human intestine contains a certain amount of bacterial flora which forms a natural component of the system. Small intestinal bacterial overgrowth (SIBO) is a condition where large amounts of bacteria are present in the small bowel. These bacteria are the types that are typically found in the colon. The small bowel is meant to be a sterile environment, so these bacteria can be very destructive to your digestive health and well-being.

Irritable bowel syndrome (IBS) is a spectrum of symptoms which mainly involves abdominal pain that is chronic in nature, frequent bloating, shifting bowel habits and stomach discomfort. Until now, there has not been a clear cause of mechanism of action for IBS. Now, new research has shown that these symptoms, formerly called IBS, are actually due to the overgrowth of bacteria in the small intestine.

The Connection

There is a famous saying which states, “A happy and clean gut leads toward a healthy life.” The human gut is the storehouse of human health and any pathology of the digestive tract can lead to great metabolic disturbances. On a long-term basis, this can start affecting each system of the body one after another. The blood gets filtered through the gut in order to pick up food molecules, which have to be transported to every body organ, tissue and cell.

A research study was done about 40 years ago at the Royal Victoria Infirmary at Newcastle on Tyne in England by a team of pathologists. The study looked at the intestines of cadavers who had rosacea. They found that the gut lining, in the small intestine, consisted of tiny pouches where gut bacteria were colonized. Overall, the results showed that about 35 percent of the patients who had rosacea were found to contain profound alternations in the lining of their guts.

Another research study, done in 2008, also found a connection between SIBO and rosacea. Subjects were tested for their intestinal bacterial growth via a breath test, and those diagnosed with SIBO were provided antibiotics. In about 70 percent of the study subjects, individuals having rosacea and SIBO were cleared of both ailments after following a course of antibiotics. This finding supported the hypothesis that an overgrowth of gut flora can, in many cases, lead toward development of rosacea as well.

Rosacea, IBS, and You

If you have IBS symptoms and have struggled with rosacea, it might not be a bad idea to make an appointment with your gastroenterologist. There are many treatments out there for eradicating the bacteria in the small intestine. Some are prescriptions such as antibiotics and others are all-natural options. Whatever route you take, returning the small bowel to a sterile environment is essential for overall health.

4 Sources
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  2. Yamasaki K, Gallo RL. Rosacea as a disease of cathelicidins and skin innate immunity. J Investig Dermatol Symp Proc. 2011;15(1):12-5. doi:10.1038/jidsymp.2011.4

  3. Pyleris, E., Giamarellos-Bourboulis, E.J., Tzivras, D. et al. The Prevalence of Overgrowth by Aerobic Bacteria in the Small Intestine by Small Bowel Culture: Relationship with Irritable Bowel Syndrome. Dig Dis Sci 57, 1321–1329 (2012) doi:10.1007/s10620-012-2033-7

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By Kenneth Brown, MD
Kenneth Brown, MD, is a board-certified gastroenterologist specializing in digestive health, including irritable bowel syndrome, colon cancer screening, and GERD.