Do You Have SIBO?

Are you chronically bloated? Fatigued and foggy? Do you have a host of gut-related symptoms that don’t seem to improve no matter how much you clean up your diet?

There is a chance you are suffering from SIBO (Small Intestinal Bacterial Overgrowth.) SIBO can be very stubborn to overcome if you are trying to go at it by diet alone but it is highly treatable when using a targeted integrative approach that I’ll share with you today.

What is SIBO?

SIBO occurs when some of the gut bacteria in the colon migrates into the small intestine. Unlike the colon which functions best with a thriving and diverse microbiome, the small intestine is intended to have a very low quantity of bacteria with its primary functions being digestion and absorption, not fermentation. When the small intestine is invaded with unwanted bacteria that begins to multiply, it becomes an environment where carbohydrates are rapidly fermented before they are properly broken down. This results in the release of large quantities of fermentation gases that leads to bloating, GERD, and/or a change in the frequency and consistency of the bowels.

 If SIBO is left untreated it can lead to other conditions such as IBS, leaky gut, obesity, acne, anemia, fatigue and an increase of symptoms in gut-brain disorders such as anxiety, depression and autism.

Underlying causes of SIBO

● Low stomach acid

● Poor motility (a term used to describe the intestinal contractions that move food through the gastrointestinal tract)

● An imbalance of gut bacteria

● A misshapen small intestine (usually resulting from a surgical procedure or a medical condition)

A vicious cycle can occur when a disease creates the conditions for SIBO and then the symptoms of SIBO exacerbate the disease. For instance, diabetes can be associated with poor motility that can lead to SIBO. In turn, nutrient deficiencies associated with SIBO can aggravate diabetes.

Do you have the symptoms?

Gas and bloating (oftentimes chronic and very painful) is one of the most noticeable symptoms of SIBO. In some cases it can cause the abdomen to swell and even resemble pregnancy. Other symptoms may include:

● GERD (gastroesophageal reflux disease)

● Diarrhea or loose stools

● Constipation

● Nutrient deficiencies (including fat soluble vitamins, b12, iron and red blood cell folate²)

● Food intolerances

● FODMAP sensitivity (You can find a list of high and low FODMAP foods here. )

It’s important to note that a large percentage of those diagnosed with Irritable Bowel Syndrome (IBS) have SIBO (possibly up to 65% and higher³). If SIBO is the cause of IBS symptoms, the condition improves or disappears once the bacterial overgrowth in the small intestine is eradicated.

Who is more at risk?

● Those with a high-starch and/or high-sugar diet

● Heavy drinkers

● Those with a history of opioid abuse

● Diabetics

● Those with Celiac or Crohn’s

● Long-term antacid users (which lowers the stomach’s pH)

My Treatment Approach

I often suspect that a patient has SIBO based on their history and symptoms. I will then test for it with a comprehensive stool analysis. Two other common ways to test for SIBO are a breath test (which measures fermentation gases released via the lungs) and testing for organic acids in the urine (a marker of SIBO).

Antibiotics: I usually recommend that my SIBO patients take antibiotics to clear the bacteria. This is a highly effective way to treat SIBO. Treating SIBO through diet alone can be a very long and tedious process that leaves little room for error. However, once the bacteria is eradicated, eating a healthy diet is an important part of preventing recurrence.

Complimentary Therapies: Depending on the patient, I usually recommend a combination of the following:  Immunoglobulin G (IgG) which is found in colostrum (such as this product), probiotics & prebiotics, digestive enzymes and bone broth soups.

Practical tips to prevent recurrence

● Learn to manage your stress with techniques such as yoga, massage and meditation. Even a long walk or a warm bath, regularly scheduled, can work wonders.

● Start your morning with a couple of teaspoons of apple cider vinegar diluted in a glass of water to raise stomach pH levels

● Eat a reduced-carbohydrate diet and avoid sugars and starches

● Take probiotics and prebiotics

● Clear the stomach between meals and don’t eat late at night