What is SIBO?
SIBO is a condition where excessive amounts of bacteria are found in the small intestine (where you absorb all your nutrients) that causes hydrogen, methane or hydrogen sulphide gas production. These gases mimic Irritable bowel syndrome symptoms and can cause major damage to the intestinal wall. While these bacteria naturally occur throughout the digestive tract, the highest concentrations are intended to be located in the Large Intestine to perform the normal symbiotic functions.
SIBO diagnosis has become more prevalent to clinicians in recent years, with researchers now acknowledging SIBO occurring alongside the diagnosis of Chrohns and Celiac disease, IBS as an underlying issue.
Why is excess bacteria bad for our digestive tract?
The small intestine (SI) is the longest section of digestive tract where food works with digestive juices and nutrients are absorbed into the blood stream. Here is where the issues arise, excess bacteria invading the SI causes malabsorption of monosaccharides and proteins, vitamins
(B12 and Folic Acid) and minerals commonly (iron, magnesium, calcium) causing major deficiencies. In addition, SIBO increases the fermentation of disaccharides by bacteria producing hydrogen, methane and hydrogen sulphate gasses which are damaging to the gut wall (leaky gut), this allows undigested particles entering the blood stream, causing an immune response. Often people with SIBO find it difficult tolerating starches, sugars and fibres.
The bacterium associated with SIBO start to consume food and nutrients in the small intestine producing uncomfortable symptoms such a gas, bloating and pain.
Symptoms of SIBO
- Alternating diarrhea and constipation
- Malnutrition (B12 and Iron)
- Unexplained weight loss
- Abdominal Cramping
- Acid Reflux and Burping
- Joint pain
- Respiratory symptoms (asthma)
What is the cause of SIBO?
SIBO can occur when there is a dysfunction with the illeocecal valve, which allows bacteria from the large intestine to move upwards in the small intestine. The consequence of this affects the normal cleansing wave referred to as Migrating Motor Complex (MMS) to be disturbed and in some cases it stops completely. MMS function is to wash out the accumulated bacteria and push them back towards the colon every 90 minutes. The build of bacteria damages the absorptive surface of the small intestine called Villi which act to secrete enzymes that break starches into absorbable single molecules and proteins into single amino acids.
Conditions believed to contribute to SIBO
- Post infectious gastroenteritis
- Overconsumption of simple carbohydrates
- Abdominal Injury
- Medications (protein pump inhibitors, morphine, narcotics, opiates)
- Decreased Hydrochloric acid in stomach caused by stress or poor diets
What Happens If SIBO Is Left Untreated?
Serious health complications occur if SIBO is left untreated. Essential nutrients, protein, carbohydrates, fats and vitamins cannot be absorbed effectivity enough to maintain a healthy system. This puts you at risk of associated conditions to SIBO such as Chronic fatigue, IBS, IBD, Acid Reflux, Celiac Disease, Liver Cirrhosis, Diverticulitis, hypothyroidism and restless leg syndrome to name a few!
How Do We Test For SIBO?
To test for SIBO you will need to complete a breath test which measures the Hydrogen and Methane gas produced by bacteria in the small intestine. The gas is then measured over 2-3hours and you drink a solution of glucose or lactulose after a 24hour prep diet.
Before you invest take the quiz
this will give you some idea if you have SIBO 🙂
Treating SIBO requires a combination of different approaches tailored to the individual and other lifestyle factors are considered. Determining whether you are higher in methane producing bacteria or hydrogen is also important, this result is found in the breath test.
Most importantly a Bi Phasic diet has proven successful in eradicating SIBO. It consists of two phases, gut healing and antimicrobial action as a therapeutic treatment. In combination to diet consuming probiotic rich foods and supplements containing specific bacteria (Lactobacillus casei, Lactobacillus plantarum and Bifidobacterium) and herbal remedies are effective in SIBO treatment.
In addition to combating SIBO addressing the nutritional deficiencies are very important, vitamin B12, Vitamin D, Vitamin K, Probiotics, Digestive Enzymes, Iron and Zinc. Step by step you can improve your gut function.
It is always great to get more than one perspective so please see our friends at SIBO Survivor
who also expand on the complex issue of SIBO including a video with Dr Weinstock.