More than ever, science, the media and the internet are pointing us toward gut health. The gut is comprised of the long pathway that goes from our mouths and comes out the other end. There are many disorders that can occur along this long stretch of digestive muscles and bacteria.
One of them, which seems to be more prevalent than ever, is called SIBO. This acronym stands for Small Intestinal Bacteria Overgrowth. It has plagued more people than ever, is often times misdiagnosed as IBS and can be difficult to treat. Let’s run down the gambit of SIBO, educate ourselves and find out what solutions are out there.
What is SIBO?
Pronounced SEE-BOW, SIBO occurs in the small intestine of the human digestive tract. There are many ways that you can end up with SIBO but at its heart SIBO is an overgrowth of bacteria in the Small Intestine.
The small intestine is the first step of digestion out of the stomach. After food leaves the stomach it enters the small intestine where it is broken down by a plethora of enzymes. When SIBO occurs the small intestine becomes overrun with bacteria.
This bacteria comes from the large intestine or colon. When this bacteria backs up it causes a major disruption in the enzymatic breakdown of food. Normally, the large intestine has more than double the bacteria than that of the Small intestine (1).
When this “back up” takes place malabsorption of nutrients occurs. As you can imagine, this can result in a host of symptoms. The major issue with SIBO is its reversal. It can be not only be hard to diagnose but as difficult to treat (1).
What Are The Symptoms?
Th major symptoms of SIBO can mimic those of IBS (1). That contributes to its difficulty in diagnosis. The symptoms are as follows:
- Excess gas
- Stomach Distension
- Abdominal Pain
- Sudden Unintended Weight Loss
SIBO and IBS seem to be related as well. In a study done in 2000 they found that treating SIBO eradicated many of the symptoms of IBS (2).
Another consequence of SIBO is moderate to severe vitamin and mineral deficiency (1). This problem stems from the food in the GI tract not being absorbed into the body. Occurring minimally at first, this can explode into a major issue.
With one of the main symptoms of SIBO being fatigue and malabsorption Vitamin B12 deficiency is a major consequence of this disease. If any of the symptoms of SIBO are prevalent one must keep an eye on their vitamin levels.
Symptoms of B12 deficiency can include weakness, heart palpitations, numbness or tingling of the extremities, pale skin, depression, memory loss and vision loss (3).
If these symptoms begin to rear their ugly head you need to visit a Functional Medicine Doctor immediately. If SIBO is present these symptoms will only worsen and no amount of supplementation will solve the issue.
What Causes SIBO?
Disruption in gut motility seems to be the major promoter of Small Intestinal Bacteria Overgrowth. Gut motility is defined as the bodies ability to move food through the body,
When there are spasms or blockages in the complex digestive tract SIBO often occurs. There are a couple of diseases that surely promote it. Let’s discuss them.
The first major disease that promotes SIBO is called Blind Loop Syndrome. This is when there is a portion of the Small Intestine that food passes by. As that food passes there tends to be stagnation of partially digested foods (4).
When this partial stagnation occurs there is fermentation. This fermentation causes unwanted bacteria to grow within those small pockets of the “blind loop.” This results in overgrowth and is often times treated by your physician with antibiotics.
Blind loop can be a consequence of digestive tract surgery. However, it can be a complication for someone that has never had surgery.
Celiac, as well as Blind Loop, can cause SIBO. The main way that Celiac causes SIBO is through disturbed gut motility. Celiac patients suffer from spasms and the disabling of major muscles that pass food through the gut.
When these muscles malfunction you create stagnation. This can either promote a push back of bacteria from the Large Intestine into the Small Intestine or create unwanted fermentation of food in the SI (1).
Finally, overeating can cause SIBO. When one overeats it allows the food to sit in their digestive tract for far too long. This disruption, although not as severe, can promote bacterial overgrowth.
How To Test For SIBO
There are multiple ways to test for SIBO. Yet, many of them are invasive and tend to be non-accurate. One of the methods is to stick a tube down your throat, through your stomach and garner bacteria to test in a lab.
The issue with this is that the bacteria can be contaminated at any point before reaching the petri dish for testing. Also, SIBO will occur most dramatically at the far end of your Small Intestine which the hose cannot reach.
The best way to test for SIBO is through an H2 Lactulose/glucose breath test. Multiple levels can be tested after a fasting base is set. Often times, the breath test is for lactulose, glucose, sucrose or xylose. If these are not being digested properly your breath will indicate it through the test.
Normally, there will be an increase from the baseline fasting hydrogen concentration to a value greater than 10-12ppm followed by a 50g glucose load or a 20ppm or greater of Lactulose (1). You can take those figures to your doctor to perform this test.
How To Treat SIBO
There are a few ways to treat SIBO. Sadly, the methods are costly, time consuming and can tend to be ineffective. The reoccurrence rate of SIBO is extremely high in individuals treated with common medical methods.
Surgical. This common treatment includes invasive surgical treatment of the gut. Some people will require to have a tumor or obstruction to be removed from their intestinal tract. If this is needed because of a blind loop then surgery may be necessary.
However, this should be the last and final treatment considered. It can also result in many other issues. On top of that, once you’ve gone through surgery you cannot reverse it. Again, always consult your physician and get a second opinion before any treatment of any disease.
Medical. The most accepted method in the medical field includes heavy doses of antibiotics. These antibiotics are ineffective for most. Multiple rounds will most likely be necessary. If this is not covered by your insurance this may prove costly.
Diet and Lifestyle Change. This should be the first method that you utilize to reverse SIBO. Obviously, here at Vital Gut Health this is what we recommend you try first for any gut disease you may have. So, let’s dig deep into some of the things we would recommend for SIBO.
Eliminate and Change
First things first, you’re going to have to remove some foods from your diet. SIBO is a tricky disease and continuing to eat the SAD diet is simply not an option. So there are some foods you’ll want to consider eliminating immediately. These include:
- Conventional Dairy and dairy products in general.
- Fructose laden foods or foods that turn into sugar such as sugar cereals, breads, pastas, cookies, pastries, cakes, pies, honey, maple syrup, coconut sugar, rice and processed foods in general.
- Sugar substitutes such as xylitol, aspartame, Splenda and most sweetener founds in sugar free sodas, candy and gum.
- Starchy foods such as corn, white potatoes, sweet potatoes and any kind of grain. This includes rice, millet, oats, quinoa and wheat.
- Other gut irritants that can cause trouble in the Small Intestine to avoid for at least 6 weeks include cabbage, wheat, garlic, asparagus, leeks, soy, Brussels sprouts, onion and broccoli.
- One of the most important foods to eliminate is fermented foods. For a period of 6-8 weeks these should be avoided completely. This includes, fermented dairy like cheese, yogurt and kefir along with fermented vegetables.
Foods To Add To Your Diet In Abundance
As important as it is to eliminate foods that may be promoting your problem you must add foods that are going to heal your gut.
Foods that you can enjoy during the healing phases of SIBO will include:
- Coconut Milk
- Free Range eggs
- Grass-fed Beef
- Free Range Chicken
- Organ Meats
- Rich Leafy Greens
- Low Sugar Berries such as Strawberries and Blueberries
- Coconut Oil
- Olive Oil
You should also add some key essential oils to your diet. These need to be pure oils that can be consumed internally. Please check the packaging.
- Oil of Oregano
- Clove Oil
- Lemongrass Oil
- Garlic Capsules
- Peppermint Oil
- Tea Tree Oil
You can ingest these through a pill or through the oil itself. These should be taken in moderate doses 4 times a day at least an hour away from any meals. So, with an Oil of Oregano supplement you will want to take 3 pills 4 times a day for at least 6 weeks.
Then, you will want a probiotic supplement while you’re doing this. I recommend Prescript Assist Probiotic which is a soil based probiotic. You can also take a straight bifidobacterium supplement. You will want to stay away from all other strains of probiotics!
How To Enjoy These Foods
There are some key ways to eat these foods as well. SIBO can be caused by terrible eating habits as well as by diseases that result in disrupted gut motility.
You must discontinue overeating. It would be better to receive your allotted calories for the day through 4 or 5 small meals than eating 2 or 3 large meals. Having the smaller meals multiple times a day will allow food to pass much more easily through your system.
Also, eating fruit on top of a meal must be discontinued. Fruit should be enjoyed by itself or before a meal. If not, the fruit will ferment in the small intestine and cause bacterial overgrowth.
Last but not least, never eat before bed. Eating before bed will allow food into your digestive system right before it slows down during your rest period. As that digestive tract slows down the food will slowly ferment throughout the night.
Well, I hope that this post helps you move toward a healthier you. Let me know, what was the one thing that caught your attention most about the cause of SIBO in the comments below!!