Understanding and Addressing SIBO (Small Intestinal Bacterial Overgrowth)
Are you struggling with persistent bloating, gas, or digestive discomfort? Do you often feel tired or experience other seemingly unrelated health issues? You might be dealing with SIBO, or Small Intestinal Bacterial Overgrowth. It's a condition where an excessive amount of bacteria, normally found in the large intestine, proliferates in the small intestine. Basically, good bacteria in the wrong place.
What Exactly is SIBO?
It's crucial to understand that SIBO isn't about "bad" bacteria. The bacteria involved are generally beneficial, but they're in the wrong place. In a healthy digestive system, the small intestine has a relatively low bacterial count, while the large intestine houses a vast amount. With SIBO, this balance is disrupted, leading to various uncomfortable symptoms.
How Does SIBO Develop?
Several factors can contribute to the development of SIBO. One of the biggest problems is something that interrupts what's called our migrating motor complex (MMC). The MMC is a wave-like movement that sweeps your small intestine clean and prevents the bacteria from overgrowing. Things that cause that to malfunction include diabetes, damage to the vagus nerve, antibiotics, and eating too frequently. Other factors that can slow motility and contribute to SIBO include hypothyroidism, stress, heavy metals, neurotransmitter imbalance, insufficient stomach acid, pancreatic enzymes or bile salts, H. pylori, parasites, structural defects, and surgery.
Common SIBO Symptoms
SIBO can manifest in a range of symptoms. The number one symptom is bloating and gas. But it can also cause constipation (often associated with methane-dominant SIBO), diarrhea (often linked to hydrogen-dominant SIBO), histamine intolerance, food sensitivities, skin issues, nausea, heartburn, acid reflux, chronic fatigue, and joint pain. It's not fun.
Testing for SIBO
Accurate testing is essential for diagnosis. While endoscopies only examine a small portion of the small intestine, in my experience helping my clients, I’ve learned that breath tests are more effective.
Breath Tests: Glucose and lactulose breath tests measure the gases produced by bacteria in the small intestine. Lactulose tests the entire small intestine. It's important to note that lactulose tests only measure hydrogen and methane, not hydrogen sulfide.
Hydrogen Sulfide SIBO: This type of SIBO may be indicated by symptoms like gas with a rotten egg smell, especially after consuming sulfur-rich foods.
Test Preparation: SIBO breath tests require a specific diet for 1-2 days beforehand, often restricting carbohydrates. Certain medications, probiotics, and laxatives must be avoided for a period before the test.
SIBO Treatment Approaches
Addressing SIBO involves a multi-faceted strategy. You need to address other gut problems, such as parasites or H. pylori, before focusing solely on SIBO. I’ve worked with too many clients who tried (and failed) to go straight into SIBO work and things really backfired. Don’t make the same mistake.
Treatment Options: Treatment options include antibiotics, herbal antimicrobials, and in more extreme cases an elemental diet.
Dietary Considerations: During SIBO treatment, it's generally recommended to eat a diet that feeds the bacteria to make them more susceptible to treatment. After treatment, a low-FODMAP diet may be helpful temporarily to manage symptoms.
Probiotics and Colostrum: Some probiotics can worsen SIBO symptoms, while others like MegaSpore and S. boulardii may be beneficial. Colostrum is generally contraindicated for SIBO, as it can feed the bacteria.
Important Considerations:
It's crucial to work with a knowledgeable practitioner to diagnose and treat SIBO effectively. Self-treating can lead to complications and may not address the root cause of the problem.
Conclusion:
SIBO is a complex condition that can significantly impact quality of life. By understanding its mechanisms, identifying the underlying causes, and employing appropriate treatment strategies, it's possible to find relief and restore gut health.