Small intestine bacterial overgrowth (SIBO)

Small intestinal bacterial overgrowth (SIBO) is a condition that occurs when bacteria from the large intestine inhabits the small intestine.  This bacteria is not generally pathogenic bacteria, but regular bacteria that support a healthy microbiome in the large intestine.

SIBO is a common condition, affecting millions of people worldwide, but it is still a relatively unknown condition and can go undiagnosed or misdiagnosed for years, if not decades.

Studies have shown SIBO is the most common cause of irritable bowel syndrome (IBS) with 50% of patients diagnosed with IBS having SIBO.   Some SIBO experts, such as Allison Siebecker, one of the founding researchers of SIBO, refers to it as a subset of IBS.

Symptoms begin when the misplaced bacteria in the small intestine ferment carbohydrates producing gases, methane and hydrogen.  These gases:

• Damage the mucosal layer of the small intestine and can cause leaky gut
• Damage the microvilli preventing nutrient absorption
• Impact gut motility causing either constipation, diarrhea or alternative constipation and diarrhea
• Disrupts the migrating motor complex
• Establish conditions perfect for Small Intestine Fungal Overgrowth (SIFO) often seen with SIBO

SIBO symptoms can include:

• Abdominal pain and cramping
• Bloating
• Diarrhea
• Constipation
• Alternating constipation and diarrhoea
• Burping
• Excessive flatulence
• Nausea
• Food intolerances and sensitivities
• Leaky gut
• Indigestion or acid reflux
• Feeling full after eating a small amount
• Fatigue

SIBO treatment involves a 5 step process:

Step 1: Prepare

Investigate and remove any food intolerances, address any nutritional deficiencies and ptimise detoxification pathways and liver function and gut health. 

Step 2:  Kill off bacteria and diet

Using either antimicrobial or antibiotic treatment or a combination of both.  Treatment depends on your symptoms, any prior treatment and the underlying cause of your SIBO.   

Step 3: Diet

There are a number of restrictive diets that have been shows to help resolve SIBO including: FODMap diet, Elemental Diet, Bi-phasic diet, specific carbohydrate diet and a lactose free diet.    Your practitioner will discuss the options with you and work out which diet, or a variation of a combination, will suit your needs.  They will help you implement these changes.

A restrictive diet should only be followed for the period of treatment, allowing you to return to a balanced diet after treatment.

Step 4: Support and restore migrating motor complex

SIBO disrputs your bodies migrating motor complex which impacts your bowel motility.  Working with a combination of herbs, exercise, and breathing, this can be restored and bowel motility normalised.

Step 5:  Heal and seal the gut 

Gut healing to repair the mucosal lining and restore microbiome using indicated herbs, nutrition and diet for you specific needs.  This is an important step in restoring your health and preventing reoccurance of SIBO.

Other factors that help with SIBO management include:

• Stress management
• Being mindful meditation
• Eating mindful slow down, chew and don't over eat
• Sleeping well build a sleep routine and prioritise sleep
• Exercising regularly
• Address any other underlying health issues such as nutrition deficiency

If you suspect you have SIBO or are struggling with your gut health make an appointment with a Naturopath at Elemental Health today and start your road to recovery.