sibo

Causes, Symptoms, Diagnosis, and Effective Treatment Strategies for SIBO

Are you grappling with persistent digestive issues, but the cause remains a mystery?

It’s possible that you’re unknowingly dealing with Small Intestinal Bacterial Overgrowth (SIBO).

We get it. Dealing with SIBO can feel like an uphill battle with constant bloating, pain, and unpredictable digestion. The worst part is SIBO doesn’t just mess with your gut. It can cast its shadow on other aspects of your life, leaving you feeling fatigued, achy and even dealing with unexpected skin issues you never thought could be connected.

But here’s the thing, you’re not alone in this fight. There’s a whole community out there who have experienced the same horrible symptoms and craved answers just like you.

So, why not join us on this journey? Together, we’ll unravel the mystery of SIBO and equip you with the knowledge and tools to navigate its complexities. This comprehensive guide is here to empower you toward improved digestive wellness.

Let’s conquer SIBO and take back control of your health!

What is SIBO?

Small Intestinal Bacterial Overgrowth, or SIBO for short, is a condition that occurs when an excessive number of bacteria from other parts of the digestive system migrate to the small intestine.[1] Typically, the small intestine contains a relatively small number of bacteria compared to the large intestine. However, in SIBO, there is an abnormal increase in the population of bacteria in the small intestine, disrupting the balance of the gut microbiota.

The Small Intestine’s Role in Digestion

The small intestine is a vital organ in the digestive system, responsible for breaking down food and absorbing nutrients. Through the action of digestive enzymes and bile, it breaks down complex carbohydrates, proteins, and fats into smaller molecules.[2] The small intestine’s inner lining, with its finger-like projections called villi, absorbs these nutrients, including sugars, amino acids, fatty acids, vitamins, and minerals, allowing them to enter the bloodstream for energy production and nourishment throughout the body. Additionally, the small intestine’s rhythmic contractions propel food forward, aiding digestion and ensuring efficient nutrient absorption.

When there is an overgrowth of bacteria in the small intestine, it can interfere with normal digestive processes. These bacteria can ferment carbohydrates and produce gasses like hydrogen and methane, leading to symptoms like bloating, abdominal pain, excessive gas, diarrhea, or constipation.

Symptoms of SIBO

What are common SIBO symptoms – and how common is it?

Common symptoms of SIBO can vary from person to person, but some typical symptoms include: [3]

The exact prevalence of SIBO in the general population is not well established, although it is a relatively common condition. Research suggests that up to 84% of people diagnosed with IBS have SIBO as the underlying factor contributing to their symptoms.[4]

Causes of SIBO

Causes and Risk Factors of SIBO Explained

SIBO can occur due to various causes and risk factors. Here are some common factors that contribute to the development of SIBO: [5]

The exact cause of SIBO can vary from person to person, and sometimes multiple factors may contribute to its development. If you suspect SIBO or have persistent digestive symptoms, we recommend you talk with your healthcare provider for evaluation.

How is SIBO diagnosed?

Breath tests are the gold standard for diagnosing SIBO. This non-invasive test involves drinking a solution containing either lactulose or glucose. These substances are not well absorbed in the small intestine but are fermented by bacteria, producing hydrogen or methane gases. After drinking the solution, breath samples are collected and analyzed for hydrogen and methane gasses.

The type and amount of gas produced can provide insights into the specific types of bacteria present in SIBO and guide appropriate treatment options.

SIBO Treatment Options

SIBO Treatment Options

The treatment approach for SIBO usually involves using a combination of herbal antimicrobials and pharmaceutical antibiotics that focus on reducing gas production by eliminating the gas-producing bugs responsible for its formation.

The treatment approach for SIBO varies based on the severity of the condition. We recommend a comprehensive four-step treatment plan tailored to the severity of the case:

  1. Eliminating inflammatory foods: In the first phase, the primary focus is on identifying and eliminating inflammatory foods that can worsen SIBO symptoms and contribute to gut inflammation. Inflammatory foods can vary among individuals, but some common culprits include gluten, dairy, processed sugars, and certain high-FODMAP foods. Instead, we focus on increasing nutrient-dense foods, including meat and organ meat, fiber from fruits and veggies, and healthy fats.
  2. Focus on motility: This second phase, lasting upwards of three months, focuses on enhancing gut motility. Supplements can support proper intestinal movement and keep the gas-producing bacteria in check. Additionally, we recommend a spore-based probiotic to specifically target SIBO in the small intestines.[6] This probiotic bypasses stomach acid, ensuring the delivery of beneficial bacteria to the intended location.
  3. Herbal antimicrobials: The third phase incorporates herbal antimicrobial supplements. We recommend Berberine and oregano oil for hydrogen gas, while allicin is used for methane gas.[7] These natural ingredients, known for their antimicrobial properties, are an integral part of the treatment plan and are typically taken for approximately one month.

Although this three-step process may seem straightforward, it’s important to note that treating SIBO can be complex and individualized. Alongside the specific treatment approach, addressing underlying diseases, providing nutritional support, and implementing cyclical gastrointestinal selective antibiotics are essential components of a comprehensive treatment plan.

Nutritional Support in SIBO Treatment

A specific diet known as the low FODMAP diet is often recommended for individuals with SIBO. FODMAPs refer to fermentable oligo–, di–, mono-saccharides, and polyols – types of carbohydrates poorly absorbed by the body. These carbohydrates can contribute to fluid and gas buildup, exacerbating symptoms of SIBO.

It’s important to understand that when treating SIBO, following a low-FODMAP diet can help manage symptoms. However, it’s crucial to find the right balance. You don’t want to completely eliminate all FODMAPs because some of these carbohydrates actually feed the bacteria in your gut. The key is providing enough nourishment to the good bacteria while using antimicrobial treatments to eliminate harmful bacteria. This approach aims to create a favorable environment for healing and restoring a healthy balance in your gut.

Long-Term Maintenance and SIBO Recurrence Prevention

Unfortunately, SIBO does have the potential to recur. However, the good news is that when it does return, it is often less severe and requires less treatment. In such cases, we typically advise patients to resume herbal remedies and probiotics and eliminate any specific foods that make them uncomfortable. This tends to resolve any recurrence effectively.

There are instances when SIBO proves to be stubborn. Factors like stress play a significant role in the reappearance of SIBO, underscoring the importance of managing stress levels.

While the potential for SIBO recurrence exists, implementing appropriate treatment strategies, managing stress levels, and adhering to a comprehensive maintenance plan can significantly reduce the likelihood of its reappearance. Regular communication with your care provider will ensure ongoing support and guidance throughout your journey toward sustained digestive wellness.

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Resources

1. “Small Intestinal Bacterial Overgrowth – PMC – NCBI.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099351/. Accessed 6 Jun. 2023.

2. “Your Digestive System & How it Works – NIDDK.” https://www.niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-works. Accessed 6 Jun. 2023.

3. “Small Intestinal Bacterial Overgrowth: Clinical Features and … – NCBI.” 3 Oct. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6884350/. Accessed 6 Jun. 2023.

4. “Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347643/. Accessed 6 Jun. 2023.

5. “Small intestinal bacterial overgrowth syndrome – PMC – NCBI.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2890937/. Accessed 6 Jun. 2023.

6. “Systematic review with meta‐analysis: rifaximin is effective and safe ….” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5299503/. Accessed 6 Jun. 2023.

7. “A combination of rifaximin and neomycin is most effective in treating ….” https://pubmed.ncbi.nlm.nih.gov/19996983/. Accessed 6 Jun. 2023.

8. “Herbal Therapy Is Equivalent to Rifaximin for the Treatment of Small ….” 1 May. 2014, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030608/. Accessed 6 Jun. 2023.

9. “Probiotics, prebiotics & synbiotics in small intestinal bacterial … – NCBI.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311309/. Accessed 6 Jun. 2023.