SIBO? IBS? Whaaaat???
SIBO: Not just an anagram of IBS
Gas, Bloating, Abdominal Distention and Discomfort...
It seems almost everyone is plagued by digestive complaints lately, and it actually seems to be getting worse, not better. MDs and Gastroenterologists (digestive specialists) are quick to diagnose IBS (Irritable Bowel Syndrome), but tend to have little else to recommend.
Health food stores will often recommend a probiotic, “dr Google” suggests x, y and z diet, and while these suggestions may help some people, many others achieve little relief and sometimes even worsening of their symptoms.
So… what else might be the problem…?
Enter the “New kid on the Block”: Small intestinal Bacterial Overgrowth.
Also known as SIBO, this disorder is racking up a lot of attention lately, and for good reason. Research is showing that it may actually be the cause of a large percentage of IBS cases, particularly those that don’t improve with probiotics and simple dietary modification. And while it may seem like a new phenomenon, many Naturopathic and Integrative physicians and researches have actually been aware of SIBO for many years, it’s just taken this long for it to come into mainstream digestive health care.
First, a quick Anatomy & Physiology lesson:
The digestive system in brief:
Mouth (chew and break down foods)
Esophagus (move food down to the stomach)
Stomach (continue breakdown of foods into smaller particles)
Small Intestine (further breakdown and absorption of nutrients (very few/no bacteria here)
Large Intestine – absorption of fluids, some vitamin synthesis, processing of waste products (majority of bacterial population reside here)
So what exactly is SIBO?
SIBO, Small Intestinal Bacterial Overgrowth, is a condition where the “good bacteria” (meaning the normal digestive flora/probiotics), are in excess number in the wrong part of the digestive tract.
In a normal, healthy body, the small intestine is relatively void of flora. In contrast, probiotics should be ample in the LARGE intestine.
This separation is thanks to the iliocecal sphincter (valve) between the two segments that prevents bacteria from backing up into an area they shouldn’t inhabit.
So, how does that become a problem?
In SIBO, the bacteria interfere with normal digestion and absorption of nutrients, and can also cause damage to the intestinal lining. The misplaced bacteria:
Disrupt and destroy parts of the lining of the small intestine
Consume the food that should be absorbed through the small intestinal lining
Upon eating those foods, the bacteria produce large (typically very large!) quantities of gas
Resulting in bloating, distention and other symptoms
Cause nutritional deficiencies by preventing the body from absorbing appropriately
Cause immune system reactions, which can then produce further problems through the body
What are symptoms associated with SIBO? How will I feel if I have it?
The key symptoms relate to the digestive tract, but SIBO has been associated with many other disorders/diseases as well. Some examples include:
Digestion/IBS: Gas*, Bloating*, Abdominal distention*, Abdominal pain, Cramps, Diarrhea, Constipation, Alternating Diarrhea-Constipation, Reflux/Heartburn, Nausea
Leaky Gut: Food sensitivities, Fatigue, Headaches, Body aches, Skin rashes, Brain fog, Anemia, Weight loss, etc
Some associated conditions may include: Acne Rosacea (SIBO is found to be a primary cause!), Chronic Fatigue Syndrome, Fibromyalgia, IBD, Obesity, Restless Leg Syndrome, Some Autoimmune Disorders (i.e.: Rheumatoid Arthritis), and many more…
How do we test for SIBO?
Testing is done via a breath test, which measures the amount of gases being produced following ingestion of a lactulose solution. Bacteria eat the lactulose and produce gas, amounts of which are then measured. Testing then will reveal the type of bacteria present (Hydrogen producing, Methane producing or both), the degree to which they are overgrown and also how far through the small intestine overgrowth is present. The test is easy to preform and can be ordered through most Naturopathic Physicians.
So, then what? How do we fix it if you DO have SIBO?
There are several phases of treatment for SIBO including:
A) Reducing the bacteria:
Using one/a few of several treatment options. These may include antibiotics, herbal antibiotics, an elemental diet or both, and the best method for you can be discussed with your practitioner.
B) Healing the intestinal lining
Utilizing diet and supplementation
C) Preventing relapse
Determining the cause of the overgrowth and working on repairing this dysfunction.
Causes may include:
Malfunctioning ileocecal sphincter
Imbalanced flora due, possibly due to history of antibiotic use
Disordered peristalsis (normal “flushing” of the intestines)
Naturopathic Physicians see gastrointestinal health as key to lifelong health and longevity. In my practice, digestive health is a main areas of focus, and I treat SIBO as well as other related disorders daily.
If you think that you or anyone you're concerned about are suffering from SIBO or any other digestive ailment and are seeking help, please don't hesitate to call my clinic.
Dr Katarine Holewa,