SIBO is the presence of an abnormally high number and/or abnormal type of bacteria in the small intestine.
This results in a range of symptoms including:
- Diarrhoea
- Flatulence
- Upper abdominal pain
- Loss of appetite.
- Nausea.
- Bloating.
- An uncomfortable feeling of fullness after eating.
- Unintentional weight loss 🚩
Prolonged SIBO may interfere with digestion and absorption of food, increasing the risk of vitamin and mineral deficiencies. It may even lead to damage and hyper permeability of the gut (Leaky gut).
SIBO is also associated with a number of conditions such as IBS, acne rosacea and diabetes.
What is the cause?
- Low stomach acid may have a role to play by impairing carbohydrate digestion. Prolonged presence of undigested carbohydrates in the small intestine feed bacterial overgrowth, which is why some people feel symptoms after eating carbohydrates
- H.Pylori infection may reduce the acidity of the gut increasing the risk of bacterial overgrowth.
- Chronic stress, which may effect the gastric secretions increasing the risk of bacterial overgrowth
- Increasing age, is associated with a decrease in stomach acid secretion and often an increase in medication use, increasing the risk of SIBO
- Heart burn medication like PPI’s if taken long-term increase the risk of developing SIBO
- Reduced bile flow due to gallstones, cholecystectomy may also play a role since bile acids have antimicrobial properties.
- Disordered gut motility can lead to slowing of the bowels increasing the overgrowth of abnormal bacteria
- Diverticulitis
- Uncontrolled diabetes can lead to damage of the nerves that control the intestinal muscles, impairing gut motility and potentially increasing the risk of SIBO.
Standard Medical treatment
Antibiotics - A short course of antibiotics often significantly reduces the number of abnormal bacteria. But bacteria can return when the antibiotic is discontinued, so treatment may need to be long term.
But there is another way………….
A Nutritionists approach:
Address the underlying cause…..
- Refer 🚩to GP
- Diagnosis based on set of symptoms and detailed case history, including breath test and/or comprehensive stool test.
- Cautious use of natural anti-microbial oils
- Reduce simple carbohydrate consumption
- Consider the use of established diets, GAPS (Gut and Psychology Syndrome Diet), SCD (Specific Carbohydrate Diet and Low FODMAP diet. These diets encourage foods that are readily digested and absorbed.
- Vagus Nerve regulation, to increase gastric secretion
- Improve gut motility - increase fibre and water
- Reduce the burden of stress on the body to improve digestion
- Recommend probiotics (but not always!)
- Restore gastric acidity and digestion with the use of supplements.
Top SIBO tips:
If you regularly suffer with SIBO like symptoms keep a food and symptom journal to connect the dots, this will be very helpful for your GP of Nutritionist to understand what is potentially going on.
Don’t ignore persistent symptoms, your body is trying to tell you something!