Symptoms of SIBO often go unnoticed and untreated, sometimes for years. If you suffer from chronic abdominal issues and/or IBS, it could be due to SIBO!
What is SIBO?
SIBO stands for Small Intestine Bacterial Overgrowth; quite literally, it’s an imbalance of good vs. bad gut bacteria. While bacteria are absolutely essential to a healthy digestive tract, this imbalance can lead to problems like IBS and Leaky Gut.
The small bowel is 20 feet long and home to trillions of bacteria whose primary functions are to absorb/digest nutrients from the food you eat and support the immune system. These trillions of bacteria also play major roles in thyroid function, bone health, and more. Most of the gut bacteria, however, is housed in your colon, where they aid in waste breakdown for elimination. It’s when these bacteria begin to invade the small intestine that a problem arises. While these bacteria are “healthy”, an overabundance can lead to some bowel issues.
The excess bacteria in the small intestine feed mainly off of carbohydrates, starches, and simple sugars. When bacteria consume carbs, they give off hydrogen as a byproduct. This can lead to destruction of the intestinal wall, interfere with proper nutrient absorption, and cause damage to the intestinal mucosa, leading to Leaky Gut Syndrome. If things go untreated, SIBO can cause significant nutrient deficiencies.
Your symptoms of SIBO may vary depending on what type of gas byproduct is produced by bacterial overgrowth. You’re already thinking along the right lines:
SIBO → Gut Inflammation → Gas Byproducts → Bloating, Belching, Flatulence, etc.
What Causes SIBO?
The body has defense mechanisms in place to protect itself from SIBO. There’s a reason your stomach is so acidic! The cause of SIBO is complex and varies from person to person, but there are certain risk factors you should be aware of.
SIBO Risk Factors
- Suppressed stomach acid (yes, that includes the acid reducers your doctor prescribes!)
- Celiac Disease
- Inflammatory Bowel Disease, like Crohn’s or Ulcerative Colitis
- Antibiotic Overuse
- Prior Intestinal Surgeries
- Oral Birth Control
- Moderate/Excessive Alcohol Intake
SIBO is widely under-diagnosed! Many practitioners chalk the symptoms up to Irritable Bowel Syndrome, but in fact, as many as 80% of patients with IBS actually have SIBO! Most often, IBS is caused by SIBO.
What are the Symptoms of SIBO?
- Abdominal gas, bloating, and distension
- Abdominal pain or cramping
- Constipation (less common than diarrhea)
- New food intolerances: gluten, dairy/casein, lactose
- Symptoms worsen when taking a probiotic, specifically ones that contain Lactobacillus or bifidobacterium
- In severe cases, weight loss due to nutritional deficiencies
Testing & Treatment for SIBO
SIBO can be difficult to diagnose and even more difficult to treat. Though antibiotics like rifaximin are commonly used to treat SIBO, recurrence happens more often than not. Botanical antimicrobials showed better outcomes, but recurrence can still be an issue. This suggests that treatment of the bacterial overgrowth alone isn’t enough for most people. Because patients with SIBO often suffer from reduced gut motility and transit time, many require the addition of a prokinetic. Prokinetics help stimulate gut contractions to propel things in a forward direction.
Testing options include:
- Breath Test: though a bit cumbersome, this test can help identify if your gut is hosting hydrogen-producing bacteria or methane-producing bacteria. This is by far the most common test and the best test to help identify the cause of your issues.
- Organix Dysbiosis Test: this is a functional urine test that tests for the byproducts of bacteria or yeast. Though much easier, it doesn’t differentiate between hydrogen- and methane-producing bacteria, which is its biggest drawback.
- Comprehensive Stool Test: another functional medicine test, the stool test evaluates flora of the large intestine.
Treatment is multi-faceted.
- Step 1: Starve the gut bacteria: eliminate sugar, alcohol, and starchy carbohydrates for a period of time. When the bacteria have nothing to feed on, they’ll begin to die off. Focus on non-starchy vegetables, leafy greens, lean protein, healthy fats, and minimal fruit. Dietary changes are the number one place to start healing your gut!
- Step 2: Antibiotics like Xifaxan and Neomycin attack the gut bacteria directly. For a botanical protocol, you’ll want to look into Microb Clear. It’s gentler on the GI tract, but just as powerful.
- Step 3: Restore the good gut bacteria and find balance. Adding a probiotic can be a good option, but if you’ve just fought the battle against SIBO, you’ll want to be cautious. Probiotics may cause bacteria to proliferate and make symptoms of SIBO worse. Soil-based probiotics are generally a better way to go!
Healing Through Diet
Symptoms of SIBO can be healed naturally, and, as stated above, treatment is multi-faceted. Diet plays a major role in the healing process because it’s necessary to starve the bacteria overgrowth of carbohydrates.
The Low FODMAP elimination diet aims to do just that. FODMAPs are not completely absorbed by the body and can ferment in the digestive tract, increasing your symptoms. When first starting the Low FODMAP, it’s key to avoid these types of foods:
- Lactose, found in conventional dairy products
- Fructans, which are found in wheat, garlic, onions, broccoli, cabbage, artichokes and asparagus
- Galactans, found in cabbage, Brussels sprouts, soy, and legumes
- Polyols: artificial sweeteners, xylitol, malitol, erythritol, and sorbitol
Your diet should consist of veggie-heavy meals, with a complete protein source. Enjoy foods like wild-caught salmon and other fatty fish, chicken and turkey, grass-fed beef, free range eggs, almond and coconut milk, and fruits and vegetables.
Did you enjoy this article? Check out these gut-friendly recipes!
- Sweet Potato Buddha Bowl with Miso Tahini Dressing
- Kale Edamame Superfood Salad
- Adobo Chicken Tacos with Yogurt Slaw
- Banana Blueberry Kefir Smoothie Bowl
Pin this Symptoms of SIBO infographic for later!
Campbell, Becky. SIBO 101.
Kresser, Chris. 2015. Why Diet Alone is Not Enough to Treat SIBO.
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