SIBO (Small Intestinal Bacterial Overgrowth)
What is SIBO?
SIBO is an increase in the number of bacteria and / or an alteration in the type of bacteria in the small intestine. Imbalances in the small intestine can be due to too many pathogenic bacteria producing gases, too many probiotic species which become detrimental to digestion and peristalsis or bacteria species traveling up from the large bowel into the small intestine due to a poorly functioning ileocecal valve which separates the small intestine from the colon.
Symptoms Commonly Associate with SIBO:
- Abdominal bloating
- Abdominal distension
- Abdominal pain
- Reflux / heartburn
- Brain fog
- Joint pain
- Weight gain or weight loss
- Multiple food intolerances ‘food is not my friend!’
- Nutrient deficiencies (mainly iron and B12)
- Bile salt malabsorption / fatty food aggravation
- Autoimmune conditions
- Mood symptoms
- Skin disorders
- Breathing difficulties and more . . . .
Bacteria in the gut ferment fibre and carbohydrates as food and depending on the species produce hydrogen gas (usually no smell during flatus and a tendency toward diarrhoea) or methane gases (usually a sulphur smell and are more likely to suffer from constipation). In the small intestine these gases can cause abdominal distension, bloating, gas and pain etc. These gases are absorbed into the blood stream along with other various toxic agents that the bacteria produce resulting in a varied array of other symptoms.
SIBO has been shown to significantly interfere with the digestion of food and the absorption of nutrients due to the damage to the cells lining the small intestine and the brush border enzymes. The bacteria can also rob us of certain B vitamins (especially vitamin B12), iron, amino acids and also decrease fat metabolism leading to deficiencies in the fat soluble vitamins such as vitamin A and D. The damage to the small intestine lining (mucosa) negatively affects the structure and function of the small intestine leading to impaired gut permeability otherwise known as a “leaky gut”. A leaky gut can lead to food sensitivities, allergies, inflammation, immune reactions and autoimmune diseases may develop.
What Causes SIBO?
Possible causes / associations of SIBO include:
- Inheritance (bacterial exposure in the uterus)
- Structural changes of the small intestine
- Motility dysfunction (intestinal peristalsis)
- Overuse of antibiotics
- Medications / Analgesics
- A poor diet consisting of commercial meat, farm-raised fish and dairy products containing antibiotics
- Overconsumption of refined carbohydrates
- Low HCL (hydrochloric acid) in the stomach and gastric acid suppression via medications
- Digestive enzyme deficiency
- Constant snacking and not allowing the natural sweeping of the MMC (migrating motor complex) which sweeps the GI tract clean between meals when the stomach is empty
- Infectious Gastroenteritis, Clostridium, Giardia, Lyme-disease
- Diabetes or hypo- thyroid conditions
- Overuse of probiotic supplements
- High alcohol intake
- Genetically modified foods and more . . .
One of the most common causes /associations as described above is any abnormalities in gut motility (your migrating motor complex or MMC) resulting in delayed transit time of the small intestine. These waves of electrical, contractile activity originate in the stomach and terminate in the distal ileum.
Gut motility moves the contents of the gut forward clearing undigested food particles and microbes sweeping them toward the colon. The stomach must be empty for these waves to occur and so constant snacking without giving your digestive system a rest interferes with this process. It takes 3-4 hours to digest a meal in the stomach and so allowing 4 hours between meals is beneficial to allow the bodies MMC to do its job effectively and aid in the treatment of SIBO.
Many of the causes listed above can impair gastric peristalsis including infections of the gut, medications (opiates, antibiotics), scleroderma, diabetes, hypothyroid conditions, stress and frequent snacking. A weak Ileocecal valve may contribute towards SIBO by allowing reverse entry of microbes from the cecum into the ileum (large intestine back up into the small intestine). Weakness of the Ileocecal valve may be due to straining during evacuation during constipation.
Bacteria (also parasites and yeast) secrete a protective mucous called biofilm which makes eradication difficult. Biofilms have the potential to contribute to cause of a wide array of infections, diseases and most chronic autoimmune and inflammatory diseases. The biofilm helps the bacteria to adhere to surfaces and protects the bacteria from human immune cells, antibiotics and herbal antimicrobials.
Testing For SIBO:
Examining the small intestine is not really an option with Endoscopy only reaching the top portion and Colonoscopy reaches only into the lower portion. Stool testing only really gives insight into the health of the large intestine. No test is 100% accurate but the test for SIBO most commonly used is the Hydrogen Breath Test. This test is also commonly used to test for H pylori infection and carbohydrate malabsorption.
Testing for SIBO can be performed at home and takes a 3 hour period to complete after a 12 hour period of fasting the night before and a specific diet the day before the test. The test is then sent away to the lab and your results are usually ready within 1-2 weeks. The cost for the SIBO breath test is $215.00.
Treatment For SIBO:
The treatment for SIBO is a long process and requires determination and perseverance to eradicate the bacteria and prevent its return. It involves a restricted diet, digestive and liver support (if needed), herbal antimicrobials, biofilm disruptors, motility enhancement, gut healing and restoration of the gut microbiome.
What should I do if I think I may have SIBO?
Treating SIBO is no easy task, take it from someone who has been there! You will need support!
I have a three step program available designed specifically for SIBO which is tailor made to each individual depending on their health and circumstances. I have successfully helped many people with SIBO and my own personal experience has taught me many valuable lessons and tips which I will pass on to you for a more successful treatment. You will also have my full support throughout this process. BUT the first step is to determine if there is a high chance you may have SIBO and then get tested!
If you think you may be a candidate for SIBO, please don't hesitate to contact me for assistance.
For more information about SIBO please visit: www.siboinfo.com