SIBO

SIBO, or Small Intestinal Bacterial Overgrowth, is a condition where an abnormally high number of bacteria are present in the small intestine. Unlike the large intestine, which normally houses a large number of bacteria, the small intestine typically has relatively few. SIBO can lead to various digestive symptoms and health issues. One of the biggest symptoms I hear as a naturopath is the phrase “I look pregnant by the end of the day”. Bloating can be quite severe!

Symptoms of SIBO

Bloating: Excessive gas production from bacterial fermentation leads to bloating and discomfort.
Diarrhea or Constipation: Altered bowel habits, including chronic diarrhea or constipation, are common.
Abdominal Pain: Cramping or discomfort in the abdomen.
Nutritional Deficiencies: Malabsorption of vitamins can lead to deficiencies and weakness. Vitamin B12 and folate can be especially affected. Malabsorption of minerals (especially, magnesium, iron, and calcium).
SIBO can cause leaky gut, with a damaged gut wall allowing larger particles to pass through, causing an immune response
Fatigue: General tiredness and lack of energy due to malnutrition and the body’s response to bacterial toxins.
Burping and Acid Reflux/GORD
Food sensitivities
Joint pain
Skin rashes
Fibromyalgia and Chronic Fatigue Syndrome – SIBO is also thought to be a possible factor in some cases.

Causes of SIBO

Stress: chronic stress can decrease stomach acid output (hypochlorhydria). Normal stomach acid levels are required to kill bacteria.

Motility Disorders: Conditions that slow down the movement of the small intestine, like constipation and irritable bowel syndrome (IBS), can lead to SIBO.

Structural Abnormalities: Anatomical issues, such as strictures or diverticula, can cause bacterial overgrowth.

Immune System Deficiencies: Weakened immune systems can allow bacteria to proliferate.

Low Stomach Acid: Conditions or medications that reduce stomach acid like Nexium, Pariet, Losec, Somac and Zoton etc can make it easier for bacteria to survive and grow. Normal stomach acid levels are required to kill bacteria. As part of treating SIBO, you would have to also work on addressing the factors causing you to need these medications or else continual low stomach acid will not resolve SIBO.

Other Medical Conditions: Diseases like diabetes, scleroderma, and Crohn’s disease can contribute to the development of SIBO. It is commonly found alongside endometriosis, so I would encourage anyone with this condition to be tested for SIBO as treatment of SIBO can help your endo.

Post infectious: a case of gastroenteritis can often be the “heralding event” for the development of SIBO.

Overconsumption of simple carbohydrates processed white flour products etc

Diagnosis of SIBO

Breath Tests: The most common diagnostic tool, where the patient drinks a solution containing either glucose, fructose or lactulose (all three is best for the most thorough testing), and breath samples are taken to measure hydrogen and methane levels, which indicate bacterial overgrowth.

NOTE: Initial testing for SIBO did not include all three (glucose and fructose and lactulose) so if you tested for SIBO in the past, did not have all three and were told you did not have SIBO, it may be worth considering re-testing more thoroughly.

Small Intestine Aspirate and Culture: A direct method involving the collection of fluid from the small intestine for bacterial culture, though less commonly used due to its invasive nature.

A double-blind randomised study* revealed that 84% of IBS patients exhibited bacterial overgrowth based on lactulose breath testing.

* Am J Gastroenterol. 2003 Feb;98 (2):412-9. Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. a double-blind, randomized, placebo-controlled study. Pimentel M, Chow EJ, Lin HC.

Watch a video explaining more about SIBO

Think You Might Have SIBO?

Your next step is testing!

Enrol for our SIBO testing. You will receive your SIBO testing kit from our lab with full instructions. When the results are back we will contact you to let you know they are available in our Patient Portal.

If you have tested positive for SIBO, you can then opt for a one on one consultation with Naturopath Lisa and/or enrol in our SIBO program which outlines EVERYTHING you need to resolve this condition.