Do you have the following symptoms?
Millions of Americans suffer from gastrointestinal symptoms. The diagnosis of GERD, gastroparesis, gastritis, irritable bowel syndrome (IBS), Crohn’s, and celiac disease continues to grow each year. In my practice, we seek to get to the root of what may be driving these illnesses. (Sometimes gut issues can often show up in other ways such as rashes, anxiety, joint pain, weight loss, and more). Food, environment, genetics, medication use, stress, and lack of sleep can be part of the problem. However, it is important to determine the state of the digestive tract to know how to provide the best intervention. You could be eating the “perfect” diet but if your gut and body are out of balance, it will not heal until this imbalance is corrected.
Recently, research has revealed there is a digestive disorder that is much more prevalent than previously believed, and it is suspected to be the possible cause of many gut symptoms…especially IBS (1). According to the World Journal of Gastroenterology 30-85% of IBS may be related to SIBO, and researchers suggest physicians give consideration of excluding SIBO before giving a definitive diagnosis of IBS. (2)
What is SIBO & What Causes it?
SIBO stands for “small intestinal bacterial overgrowth” and is a condition in which there is an excessive amount of bacteria in the small intestine. SIBO is associated with a number of conditions including: motility disorders of the intestine (IBS, gastroparesis), dysfunction of intestinal nerves/muscles (related to food poisoning), autoimmune diseases, blind loop syndrome, untreated celiac disease, Crohn’s disease, and more. The symptoms listed above are typical in those that suffer with SIBO. Do any of these sound like you?
Normally the muscles in the stomach and the small intestine move food through the intestine in a synchronized fashion. These series of contractions are called peristalsis. The migrating motor complex (MMC), a small intestine cleaning wave, occurs only when food is not present, about every 90-120 minutes or when fasting. If the intestinal motility is altered, such as in IBS, the MMC waves occur less frequently. These movements help clear bacteria out of the small intestines, so when the action is distrupted…bacteria and food may remain in the small bowel leading to overgrowth of microbes.
There are a number of underlying conditions believed to be associated with SIBO such as systemic disorders (diabetes, hypothyroidism, immune dysfunction); motility disorders (IBS, gastroparesis); celiac and Crohn’s disease; gastroenteritis from food poisoning; surgical alterations of GI tract; or prior bowel obstruction with scaring. Also the use of medications, especially proton pump inhibitors (PPI’s), stress, hormonal imbalance, age, and diet can be a factor in why someone may develop SIBO.
Low stomach acid production is one of the main contributing factors to SIBO that I see in my practice. This is because stomach acid is protective and helps kill any pathogen or bacteria that enters the upper GI region. Stomach acid is necessary for optimal digestion, especially protein. Too many people have been on long-term use of acid suppressors such as omeprozole, prevacid, protonix, etc….that will be a risk factor for SIBO and for optimal gut function.
How to Test for SIBO?
Accuracy of current test methods remain limited, as there is a lack of standardization of the normal bowel flora. However, the best testing we have currently is using a lactulose or glucose breath test. The bacteria in the gut will produce either hydrogen or methane gas, and this is why the breath test is the best tool used to diagnose SIBO. There is a third gas that these bacteria can emit and that is called hydrogen sulfide. Consequently, those individuals that present with this gas will have inaccurate or negative testing results (soon there will be testing to detect his gas).
Treatment for SIBO?
Small intestinal bacterial overgrowth is most often treated with antibiotics. Both prescription drugs, such as Xifaxin, or antimicrobial herbs may be used to treat the bacterial overgrowth. Treatment regimens will vary depending on the type of SIBO- hydrogen or methane gas predominant. Elemental diets are another option for treating SIBO. In my practice working with SIBO clients on a weekly basis, it is important to tailor an intervention that is best for each individual case. This will involve key foods, supplements, probiotics, and lifestyle interventions to help kill the bad bugs and repopulate the good bacteria.
SIBO can be very challenging to treat and often individuals may experience a reoccurrence. That is why is it important to identify the underlying cause and any factors that increase the risk of developing it again such as poor gut motility, nutrient deficiencies, autoimmune dysfunction, stress, medications, and eating habits.
Can Diet Alone Treat SIBO?
No, there is no evidenced based diet therapy for SIBO treatment or prevention. Diet alone cannot reverse SIBO… you must work with your MD or provider to find the best treatment plan for you. However, what you eat is an essential part of the intervention plan to help eradicate SIBO. Often diets like the FODMAP diet or SCD (Specific Carbohdyrate Diet), or GAPS may be used. When working with SIBO clients, I tailor the intervention specific to each situation. It is important to also realize that just taking the medication is often not enough to clear the bad bugs…and a comprehensive approach and intervention is key to long-term success!
If you think you may have SIBO, talk to your GI doctor to be tested! It is important to get to the root cause of your symptoms and not suffer. My practice also offers testing for SIBO if your doctor does not currently make this available to you. Remember, when treating SIBO it takes a comprehensive approach and often a team to help support you in your healing process. It is important to give your body time to repair and heal while fighting the bacterial overgrowth and to nourish it well after.
I have worked with many client’s who suffered and are now FREE from SIBO, check out some of the “success stories“. I would love to help you heal from within and find a PEACEFUL Gut!