Some time back I wrote a blog post about bloating after meals. It’s a common and frustrating issue that many of my clients struggle with. While bloating is often resolved by removing certain foods and supporting digestion, sometimes it persists. That is usually my cue to dig a little deeper to find out what is going on.
More often than not, we are looking at SIBO as the reason behind bloating and other digestive complaints.
SIBO stands for Small Intestinal Bacterial Overgrowth and to summarise, it is a situation where there are too many bacteria (good and/or bad ones) in the wrong part of your digestive tract: the small intestine.
SIBO has been getting a lot of attention in the health & wellness space and much of the growing awareness can be credited to the amazing work of Dr. Pimentel who is doing extensive research into this condition as well as Dr. Alison Siebecker who is one of the leading SIBO specialists and educator.
Much of the existing research shows, with definitive proof, that SIBO is not a fad but that it is a real and common condition that is the underlying cause of many digestive related symptoms such as bloating, constipation, diarrhea, abdominal pain and discomfort, etc. but also many other common health concerns. The list is pretty long as SIBO can play a role in skin problems, mood related issues such as depression or anxiety, brain fog, fatigue, and so on.
What is really important and interesting to note is that SIBO is estimated to be the underlying cause of 60% of all cases of IBS (Irritable Bowel Syndrome), a condition that affects about 10 to 15% of the population.
The good news is that it is fairly easy to diagnose SIBO. It can be a bit more difficult to treat as there are several angles to consider but with a comprehensive strategy you can treat this condition and put an end to your frustrating symptoms.
What is SIBO
Our gut contains a large number of microorganisms, which play an important role in our biology. They assist in the digestion and absorption of nutrients, they support our immune system, our metabolism, our brain function and more.
Most of these beneficial bacteria are housed in the large intestine. There are comparatively few of these micro organisms in our small intestine: an estimated number of less than 10,000 per milliliter of fluid as compared to at least 1,000,000,000 bacteria per milliliter of fluid in the colon.
When bacteria overgrow in the small intestinal area, this can start to interfere with our ability to properly digest food, it can cause inflammation, leaky gut and with that all the various ripple effects that a compromised digestive system can have on our entire body.
What causes SIBO
The underlying root causes or risk factors for SIBO include:
- Food is not moving through the digestive tract fast enough allowing for bacteria to overgrow. This can be a result of structural issues such as obstructions in the small intestine, low motility or problems with the migrating motor complex (the peristaltic movement that sweeps food debris and bacteria through and out of the small intestine in between meals).
- The illeocecal valve allows bacteria to flow back up from the colon into the small intestine.
- The immune system is not able to fight off bacteria.
- Low stomach acid levels, enzymes or bile flow, all of which can affect natural protection against bacteria that find their way in.
- Medication, certain diseases, stress
What are the symptoms associated with SIBO
The bacteria in our gut feed on the food we eat, more specifically the fiber in carbohydrates that we as human beings can’t digest. In a healthy situation the bacteria in our colon ferment these fibers and the byproducts of this process are acid and gas. Which is why small amounts of gas are naturally expelled throughout the day, either through farting or sometimes without us even realizing it.
When there is bacterial overgrowth in our small intestines, gas builds up too high up in the digestive tract and this is what causes uncomfortable bloating, even pain (which can be ranging from mild to severe) or when the gas is pushed upwards it can cause nausea, acid reflux or excessive burping. Certain types of bacteria produce methane gas and this has been shown to cause constipation. Hydrogen gas is another type of bacterial gas and this can cause diarrhea. So there are a number of digestive related complaints than can all be traced back to SIBO.
What if you have these symptoms and suspect SIBO?
You can get further confirmation that SIBO may be the underlying reason for your digestive complaints by removing certain carbohydrates from your diet and watching if this helps to resolve your symptoms. It won’t help you to completely get rid of the bacterial overgrowth but it will help you manage your symptoms.
If this does help reduce symptoms, I recommend testing to get an “official” confirmation of SIBO and also to find out how severe the bacterial overgrowth is, and what type of bacteria your are dealing with: hydrogen producing bacteria or methane or both. This will affect the way you need to treat SIBO.
How do you treat SIBO?
The only way to get rid of SIBO is by removing the bacteria. This can be done in the following ways:
- Eliminating problematic carbohydrate foods from your diet (which often isn’t enough by itself)
- Pharmaceutical treatment that kills the bacteria
- Herbal treatment that kills the bacteria
- Elemental diet which starves the bacteria
To determine the best possible treatment plan it is best to discuss the pros and cons of each option with your health practitioner.
What can you do to support the treatment and prevent SIBO from reoccurring?
- During and after your treatment you will need to address the underlying causes. You can do this by supporting yourself in the following areas:
- Support every phase of your digestion, which includes ensuring adequate stomach acid levels, enzymes, and bile flow
- Improving motility
- Spacing your meals so that the migrating motor complex can do its job of sweeping out bacteria
- Performing abdominal massages
- Working with a chiropractor to support the ileocecal valve
- Managing stress levels which can help to stimulate the parasympathetic nervous system, which allows for a better digestion
- Eat the best possible diet to help prevent the problem from reoccurring
If you this article resonates with you and if you feel SIBO might be a problem for you, let’s get in touch here and let’s see if I can help.