Do you experience discomfort within hours of eating a meal? Does your stomach bloat to the point of having to unbutton your waistband? Do you experience swelling, bloating, abdominal pain, and gas?
If so, these symptoms are frequently attributed to IBS (irritable bowel syndrome). However, many IBS sufferers are actually experiencing SIBO (small intestinal bacterial overgrowth).
What is small intestinal bacterial overgrowth? (SIBO)
Small Intestinal Bacterial Overgrowth (SIBO) is the overgrowth of bacteria in the small intestine. The gastrointestinal (GI) tract has many different species of bacteria and other microorganisms, which are commonly called the gut microbiome. The largest amount of bacteria exists in the colon, and the small intestine has fewer amounts.
SIBO describes the result of some bodily dysfunction or consequence of an existing disease rather than being a disease itself. There is a two part method for treating SIBO:
- Treat the excess bacteria
- Identify and treat the root cause of the SIBO.
If you ignore treating the root cause of SIBO, you may have relapses. The root cause must be treated and resolved in order to manage SIBO.
What is the source of the bacteria?
SIBO is the overgrowth of non-pathogenic, opportunistic bacteria in the small intestine as a result of many causes. The most common cause is food poisoning in which the motility of the gut has been damaged. High stress levels may also encourage SIBO. In addition, an imbalance of good and bad bacteria (dysbiosis), or an overgrowth of bacteria results in SIBO. It may be caused by a dysfunctional ileocaecal valve (the valve that attaches the small intestine to the large intestine). When the ileocaecal valve malfunctions, it can enable bacteria to move from the large intestine into the small intestine causing retrograde bacterial growth.
Dysbiosis may also result from:
- Infections from fungus.
- Parasites.
- Mold.
- Environmental toxins.
- Stress.
How does SIBO affect your system?
You have SIBO if the numbers of bacteria on test results in your small intestine are significantly higher than normal. The excess bacteria find fuel in recently ingested foods high in sugars and carbohydrates in your small intestine. The fermenting sugars produce hydrogen gas. That hydrogen gas is used by a species of bacteria called Archaea to produce methane gas. Other bacteria produce hydrogen sulphide. The result is SIBO.
These gases together or individually may cause the pain, bloating, constipation and/or diarrhea that are common symptoms of SIBO, which makes it a common cause of IBS.
In addition to these symptoms, SIBO may result in nutrient deficiencies and issues such as:
- Pain issues from B12 deficiency,
- Higher levels of the B vitamin Folate,
- Rashes and eczema,
- Malnutrition,
- Weight loss,
- Anemia,
- Thyroid problems,
- Insomnia
What are the typical symptoms of SIBO?
Some individuals will experience no symptoms at all. Others will have symptoms similar to IBS. In some rare cases, SIBO may be identified from other symptoms such as fat malabsorption or iron deficiency anemia. Thus, SIBO may disrupt other systems in the body and even the brain.
The SIBO bacteria excrete acids that are toxic to the brain and can cause neurological and cognitive problems. Many patients experience brain fog and, which is a consistent symptom of SIBO. These are the most common symptoms of SIBO:
- Diarrhea
- Flatulence
- Tummy pain
- Bloating
- Constipation
- Belching
- Nausea
- Acid reflux – heartburn
- Malabsorption of food and nutrients
- Weight gain, weight loss
How does the body naturally protect itself from SIBO?
- Normal functioning of the intestines called the migrating motor complex
- Pancreatic juice, enzymes, and bile to destroy bacteria in the small intestine
- Correct gut motility, by nerves and interstitial cells
- A good level of intestinal mucus that traps bacteria
- Normal levels of immune proteins that prevent the growth of bacteria
- Adequate levels of stomach acid and bile acid secretions to destroy microbes before entering the small intestine to the stomach
- A properly functioning Ileocecal valve
What are the risk factors of SIBO?
SIBO is associated with a considerable number of disorders and diseases, the majority of which slow down the small intestine’s ability to move things through the GI tract. Risk factors include:
- Leaky gut and a slowing down of gastric motility of the gut which can both be caused from stress and anxiety
- Disorders of the gut which reduce blood into the area
- Age related changes
- Dysfunction to the valve that separates the large and small intestine, the ileocaecal valve Fibromyalgia
- Reduced or low stomach acid levels
- Underactive thyroid.
- Structural abnormalities (which are all associated with a small intestinal obstruction and stagnation)
- Chronic fatigue syndrome
- Medications such as antacids and antibiotics
How is SIBO diagnosed?
Many physicians will diagnose SIBO based on a patient’s symptoms. Testing is not always required. Previously, clinicians used a procedure in which a tube is put down the mouth into the small intestine to take a sample of bacteria. This is an invasive procedure and as such is not usually performed.
A less invasive procedure, the SIBO breath test, is more commonly used to diagnose SIBO. This simple test can be performed at home by the patient using the test kit and is designed to test for hydrogen and methane, which are produced only by bacteria present in SIBO. SIBO may also be inferred but not diagnosed from performing a stool analysis.