Food poisoning is a common cause for SIBO, but it can also occur from too much stress, hypothyroid, diabetes, stomach acid blockers, surgery and overconsumption of carbohydrates. Once established SIBO creates a multitude of symptoms and associated ailments.
Bloating, gas, flatulence, belching, abdominal pain, cramps, diarrhea, constipation, heartburn, gastroesophageal reflux disease, nausea, food sensitivities, lactose and or fructose intolerance, headaches, joint pain, skin conditions and cognitive problems are symptoms of SIBO. And if this isn’t enough, there are over 30 conditions associated with SIBO including acne rosacea, autism, chronic fatigue syndrome, prostatitis, diabetes, fibromyalgia, colitis, diverticulitis, Parkinson’s, restless leg syndrome, obesity, liver cirrhosis and interstitial cystitis (chronic bladder inflammation).
If you have some of these symptoms, plus one or more associated conditions, plus one or more key indicators, then likely you have SIBO. Here are several key indicators. Temporary yet dramatic improvement of symptoms after taking antibiotics. Worsening of symptoms after taking prebiotics, for example FOS or fructooligosaccharides. Constipation and other symptoms worse with fiber. Celiac patients who see little improvement despite eliminating gluten. Labs show chronic low serum ferritin (iron storage) without another clear cause.
SIBO bacteria are smart, industrious and they know how to create a self sustaining environment. They secrete toxins that damage the small intestine lining. This results in maldigestion, malabsorption and digestive enzyme deficiencies thereby ensuring an ample supply of bacterial food. This digestive disruption coupled with toxic SIBO waste products is the cause for so many SIBO ailments.
I generally make the diagnosis of SIBO based on my patient’s history. Some practitioners use breath tests, which measure the amount of respired gas after ingesting a bolus of sugars. I have found these tests to be unreliable and expensive and rarely order them anymore.
Initial treatment is aimed at starving the carbohydrate loving bacteria. I have four variations of carbohydrate deprivation diets that I employ depending on my patient’s history. My Got Gas newsletter describes one type of diet that often works. While it may take several weeks to see clear improvement in some individuals, results are often seen after just a few days. Finding the correct diet is essential and the first step to correct SIBO. Once symptoms have quieted down an intestinal retrofit is in order.
The goal is to reduce unhealthy bacterial populations in the small intestine, heal the lining and establish a healthy balance and proportion of bacteria which is about one tenth the population found in the large intestine. I use natural herbal antibiotics such as berberine, oregano, garlic concentrate and Laktoferrin coupled with the correct diet in order to reduce SIBO populations. At the same time it is important to heal the small intestine with anti-inflammatory nutrients such as Boswellia, zinc carnosine, turmeric concentrate and or licorice concentrates.
Probiotics, if tolerated, such as Saccharomyces, Lactobacillus acidophilus and bifidus help to further reestablish healthy bacterial colonies. Probiotics activate what is called the migrating motor complex (MMC). This neurologic mechanism creates a sweeping and emptying effect on the small intestine about every 90 minutes when we are fasting ie when we’re asleep. This activity is one of the main ways the small intestine eradicates unwanted undigested food and or bacteria. With SIBO this neural mechanism is inactivated, yet probiotics and healthy diet help to reestablish this essential preventive and protective natural purge. Opiates inhibit the MMC and that is why some people develop SIBO from opiate type prescriptions.
In summary, there is a solution for gastrointestinal symptoms that have previously proved recalcitrant to treatments. The solution requires integrated natural medicines to address bacterial imbalance in the small intestine. Dietary modification and natural supplements can resolve the symptoms of SIBO and address many of the SIBO associated health concerns.
I hope you have enjoyed this month’s newsletter. As always, comments and feedback are welcome.
Jon Dunn, ND