What is SIBO?

Originally Posted 2/25/2018

Since my last FB posting about SIBO (Small Intestinal Bacterial Overgrowth), more people have asked about this topic. So here is more information. Please note this is for your information only and not medical advise. For diagnosis and treatment, please speak with a qualified health care professional.

Each one of us has trillions of bacteria in our intestines. However, most of the bacteria reside in the colon. Fewer and perhaps different types of bacteria is in the small intestine. SIBO occurs when abnormally large number of, or inappropriate bacteria occupies the small intestine.

Signs and symptoms that you may have SIBO include:

  • Bloating, abdominal pain or camping, belching, gas, diarrhea or constipation
  • Delayed gastric emptying
  • Anemia, malnutrition, decreased bile acid, fatty stool,
  • weight loss or weight gain, food allergies,
  • brain fog, systemic inflammation, chronic fatigue, low energy, restless leg syndrome
  • Micronutrient deficiencies (B12, Vitamins A, D, E, iron, thiamine (Vitamin B1), niacinamide (B3), minerals such as magnesium, calcium, sodium and potassium)

Causes of SIBO can vary. Low stomach acid(achlorhydria) is associated with SIBO. Similarly, those who use Proton Pump Inhibitors to suppress acid production may also be at risk for SIBO or fungal overgrowth. Remember that acid is one way for us to kill off certain harmful bacteria. Take away the acid, more bacteria will enter your intestine. Motility issues, or small intestinal obstruction may create problems. Generally, we want most of the bacteria to move down to the colon, where they can happily breakdown fibers and push things along.  But with motility problems, the bacteria don’t move so well and get stuck in the small intestine.  People with Celiac or Crohn’s Disease and short bowel syndrome also have higher prevalence of developing SIBO, potentially due to motility issues. There is also evidence that Type 1 diabetes patients with autonomic neuropathy may also have a higher chance of getting SIBO due to impaired motility.

We’ve known about the importance of gut health for a while now. But seldom is this translated into clinical practice. Poor gut health may instigate inflammatory response. The inflammatory response moves into the brain and increases the chance of brain fog or other neurological disorders. Or, inflammation may occur on the skin.  A research article in Clinical Gastroenterology Hepatology stated: “Rosacea patients have a significantly higher SIBO prevalence than control population; and that eradication of SIBO induced complete remission of cutaneious lesions.”

Treatment for SIBO varies greatly depending on the person and type of bacterial overgrowth. It may be probiotics or antibiotics, dietary change, motility agents or herbal antibiotics or supplements. You will need to speak with a qualified health care professional who will go through all your history and order diagnostic tests, such as lactulose breath test or upper GI aspiration. Sometimes further testing may be required, that may be organic acid test or stool analysis.

The great news is that more research is being done to increase our knowledge of the gut microbiota. And as a result, more treatment options and protocols have been developed to treat various seemingly unrelated diseases through optimization of gut health. The medical world is finally getting that human body’s organs are very much connected and in constant communication. We cannot just treat one organ and expect the person to heal.

We really need to respect our entire body and its environment to gain optimal health!