Small Intestinal Bacterial Overgrowth (SIBO)

Small Intestinal Bacteria Overgrowth (SIBO)small intestinal bacteria overgrowth

Any person suffering from a gastrointestinal condition knows how incredibly difficult it is to live with. Not only does it affect your physical state because of reactions to food intake, but it can affect your mental well-being as well. This medical condition shares many of the same characteristics as other GI conditions which is why a medical evaluation is essential for a proper diagnosis. The more you know about how this medical condition affects the body, the more confident you will be in overcoming it.

What is SIBO?

Small Intestinal Bacterial Overgrowth (SIBO) is a gastrointestinal condition that is caused by abnormal amounts of bacteria present in the small intestine. Bacteria are an essential element to gastrointestinal health, but a surfeit in the small intestine can cause serious damage to the villi if left untreated. The National Center for Biotechnology Information[1] (NCBI) defines abnormal growth as 105–106 organisms per milliliter of culture fluids tested during an esophagogastroduodenoscopy (EGD). Although SIBO patients are subject to relapse, the condition can be cured with a lifestyle change that combines both homeopathy and traditional medicine.

What causes small intestinal bacterial overgrowth?

As food and healthy bacteria pass from the stomach to the duodenum, jejunum, and ileum (the small intestine) by way of peristalsis, it moves from each area into the colon during the normal transfer of body waste. If the muscular activity is interrupted because of a motility disorder, bacteria will rapidly reproduce and overpopulate the GI tract leading to the development of SIBO. People who suffer from illnesses involving the muscular, gastrointestinal, immune, or nervous systems are also susceptible to bacterial overgrowth because of the disruption of muscle activities in the small intestine. Scarring from various gastrointestinal surgeries, radiation damage, or the consumption of certain medications can also bring about an obstruction that can cause bacteria to overpopulate.

Common Symptoms of SIBO

Symptoms include bloating, gas, nausea, diarrhea, fatigue, regurgitation, weight loss, malnutrition, abdominal discomfort, and joint pain.  Patients may experience varying levels of symptoms based on the severity of their conditions which is why diagnosis can be difficult based on the association of other known GI conditions.  Doctors, however, can perform a variety of tests to determine if a bacterial overgrowth is the culprit of your ill health.

Can SIBO be cured?

SIBO is a curable disease with the right treatment and aftercare. There are several tests and treatments recommended by medical professionals.

  • The Lactulose Breath Test is administered to patients by the consumption of lactulose which the body is unable to break down. The presence of lactulose in the upper part of the small intestine allows doctors to test the bacteria count in the body by measuring both hydrogen and methane levels.
  • A Hydrogen Breath Test (also referred to as The Small Intestinal Bacterial Overgrowth Breath Test/BOSI) collects a breath sample at integral periods using a balloon to measure the amount of hydrogen in the body that is produced by the bacteria in the lower part of the small intestine as well as the presence of irritable bowel syndrome which is commonly associated with SIBO. Normally, the level will be low, but if it increases, it signifies that an abnormal GI issue exists.
  • A Glucose Breath Test is administered to patients using glucose to measure the amount of hydrogen and methane produced in the upper part of the small intestine.
  • An endoscopy is an invasive procedure that mainly measures bacteria in the upper part of the small intestine. The results may not be accurate if the bacteria are present in another part of the small intestine.
  • Stool sample testing allows doctors to test bacteria, but because the stool sample comes from the large intestine, it will be difficult to identify where the bacteria are present in the body.

Once a doctor interprets a positive result, there are several treatments available to patients including the use of antibiotics like Rifaximin, Erythromycin, Neomycin, or Metronidazole. A combination of these drugs may also be necessary depending on the severity of the condition or the presence of methane in the body. Some doctors also recommend a probiotic to improve motility in the small intestine. A SIBO natural treatment can include herbal treatments that include antimicrobials like allicin, neem, berberine. A small intestinal bacterial overgrowth natural treatment combines several forms of treatment to bring about better results. A small bowel bacterial overgrowth diet can also improve the chances of eliminating the symptoms within weeks using a SIBO supported medical regimen.

What is a SIBO supported diet? (Low FODMAP, GAPS, SCD)

  • The Specific Carbohydrate Diet (SCD) limits the amount of carb intake found in foods like dairy, grains, starches, and sugars.
  • The Low Fodmap Diet (LFD- fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) restricts high fodmap containing foods like wheat, lactose, or fructose that contribute to the symptoms of SIBO.
  • SIBO Specific Diet is a combination of SCD and LFD that targets symptoms of IBS.
  • Gut and Psychology Syndrome Diet (Gaps diet) eliminates foods that affect digestion, as well as those that damage the small intestinal tract. The diet then replaces the foods with easy to digest ingredients that help the small intestine heal.
  • SIBO Bi-Phasic Diet follows the FODMAP and The Specific Carbohydrate Diet reduce fibers and fermentable starches while also removing SIBO and SIFO (small intestine fungal overgrowth) from the GI tract. Cedars-Sinai Diet (C-SD) restricts foods like grains and dairy that contribute to the symptoms of SIBO as well as other GI diseases like IBS and Celiac Disease.
  • A Gluten Free Diet consists of eating foods that do not contain gluten, such as wheat, oats, barley, and rye.
  • The Elemental Diet replaces food with a mix of powdered nutrients that must be prescribed by a doctor.

What is important to understand is that the diet you choose will depend on the symptoms and other underlying diseases you may have. It may require a combination of antibiotics, probiotics, and diet to properly treat and prevent future bouts of SIBO.

[1] National Center for Biotechnology Information. Small Intestinal Bacterial Overgrowth. U.S. National Library of Medicine. 2007. Accessed 27 Sept 2017.