SIBO

SIBO (Small Intestinal Bacterial Overgrowth) – Causes, Symptoms, and Prevention

Overview

What is SIBO?

SIBO or Small Intestinal Bacterial Overgrowth, in the simplest of terms, is a condition that causes the amount of bacteria in the small intestines to grow exponentially. Generally, bacteria are important for digestion, but their role is in the large intestine. A person living with SIBO would have an unhealthy amount of these bacteria in the small intestine, disrupting the natural and required absorption of food and nutrients.

Small Intestine

If you are not particularly familiar with the details of the human body, let’s break this down into clearer terms. The small intestine is a long tube right between the stomach and the large intestine. Its basic function is digesting food and absorbing the necessary nutrients thanks to the small finger-like protrusions called villi. This is one of the most important organs when it comes to food, so keeping it healthy is crucial.

Now, SIBO makes things a lot more complicated. Because it increases the amount of bacteria where they are not supposed to be, they can impair the digestion and absorption of nutrients, they can damage the lining of the small intestine, and so much more.

What Foods Trigger Small Intestinal Bacterial Overgrowth?

Many types of foods can trigger SIBO, which is not to say that you should stop eating these things altogether, but practicing control and avoiding overindulging should definitely be a priority. Some of the more common foods that can trigger SIBO symptoms include:

FODMAPs – This long acronym stands for Fermentable Oligosacchirades, Disaccharides, Monosaccharides, and Polyols. In other words, these are short-chained carbohydrates and their difficult digestion can lead to bacterial fermentation. Common FODMAPs include garlic, onions, leeks, wheat and rye products, lentils, beans, certain fruits like apples, pears, and vegetables, such as broccoli.
Sugar and Sweeteners – Sweet cravings are inevitable, but they can also lead to many unhealthy consequences, including SIBO. This is especially true for refined sugars, which can be found in candy and desserts, as well as artificial sweeteners, like sorbitol, mannitol, and xylitol. The latter are very common in “sugar-free- candies, potentially even worsening SIBO symptoms.
Dairy – Lactose found in milk, cheese and other dairy products can often be difficult to digest and absorb, especially when it comes to lactose intolerant people.
Fermentable Fiber – This category includes foods that are high in soluble fiber, such as barely, oats, asparagus, artichokes, and brussels sprouts.
Alcohol – The risks of alcohol cannot be stressed enough, but in the context of SIBO, it can damage the lining of the intestine, leading to the worsening of SIBO symptoms.

What Happens if SIBO is Left Untreated?

Like it is the case with any other condition, addressing SIBO and taking steps to have it under control is crucial. If left untreated, SIBO can lead to many different complications, with some of the more common ones being malabsorption of carbs, fats, and vitamins, which can lead to malnutrition and various deficiencies. If left untreated, the malabsorption can also lead to major vitamin deficiencies, especially of vitamins A, D, E, and K, as well as B12. This can further lead to anemia, bone health problems, neurological issues, and more. Another possible complication is something known as Leaky Gut Syndrome, which causes the lining of the gut to become compromised, leaking toxins and other microbes to enter the bloodstream, potentially causing even systemic inflammation.

Symptoms and Causes of SIBO

Just by the very nature of the SIBO condition, it would be impossible to narrow it down to a few specific symptoms or causes. However, let’s take a look at some of the more common ones.

Symptoms of SIBO:

Abdominal bloating
Diarrhea and constipation
Abdominal pain or discomfort
Excessive gas
Weight loss/gain
Fatigue
Nausea
Steatorrhea
Brain fog

Causes of SIBO:

Motility disorders – Such as IBS, gastroparesis, and diabetes that slow down digestion.
Anatomic abnormalities – Structural changes of the intestines, like adhesions can cause pockets for bacteria to overgrow.
Low stomach acid – Having low stomach acid, which is otherwise helpful for killing bacterias, can contribute to developing SIBO.
Chronic pancreatitis – Lack of sufficient digestive enzyme produced by the pancreas.
Immune dysfunction – Weak immune system due to illness or medication.
Previous gastrointestinal surgery – Any surgery that has changed the natural structure of the digestive tract.
Chronic use of opioids – Opioids are known for slowing down motility.

Diagnosis, Tests & Treatment for Bowel Overgrowth

When it comes to actually diagnosing and determining if you have SIBO, things may not always be very straightforward and simple. This is mainly because many of the SIBO infection symptoms are pretty much duplicated by other gastrointestinal conditions, including IBS. However, today’s medicine has lead to numerous diagnostic methods for SIBO, some of which you can even do yourself.

Breath Tests

The breath tests are some of the most common SIBO diagnostic methods used today, and can even be done at home. They work by testing the patient’s hydrogen and methane levels in the breath, after ingesting sugar. Intestinal bacterial overgrowth will cause the sugar to be fermented and to produce higher levels of hydrogen and methane, which can be easily detectable through the breath.

The benefit of these breath tests is their minimal invasiveness and ease of use. However, they may not always be reliable for a concrete diagnosis, since they are not able to differentiate between SIBO and other gastrointestinal conditions.

Stool Tests

SIBO can also be diagnosed through a stool sample, and can lead to findings on both fat malabsorption, bacterial composition, and changes in the colon. This is one of the easier and less invasive tests that you can opt for in order to determine if you have SIBO or not.

Jejunal Aspirate and Culture

This type of test is considered the best and most accurate when it comes to diagnosing SIBO. A sample will be taken endoscopically directly from the fluid in the small intestine and analyzed to determine the presence of SIBO.

This is a highly accurate and reliable method for diagnosing SIBO, but it is also a more invasive one, which may not be available everywhere.

If you want to test for potential SIBO but are not sure where to start, the answer is simple – right here! Take a look at the various functional testing options we offer here at BioIntelligent Wellness, and start working on improving your lifestyle!

Treatment of SIBO, on the other hand, requires a lot of dedication and many lifestyle changes, especially when it comes to the diet. The main goal of SIBO treatment is to reduce the intestinal overgrowth, manage symptoms, and address any underlying causes. Some of the more common treatment options for people with SIBO include:

Antibiotics

As is the case with most bacterial conditions, bowel overgrowth can also be targeted with antibiotics in order to regulate the amount of bacteria in small intestine. The most common antibiotic prescribed for SIBO treatment is Rifaximin, mainly because of its effectiveness against non-systemic bacteria. However, we advise you to never take treatment in your own hands, especially when it comes to antibiotics. A medical professional can determine which antibiotic is best to treat your SIBO infection. This type of treatment usually last up to two weeks on average.

Dietary Changes

Considering the fact that the bowel bacterial overgrowth is mainly caused by fermented food, changing your dietary habits can be the most useful treatment plan, even long-term. The first thing that will need to be done is implementing a low FODMAP diet, which we explained previously.

In some cases, certain carbohydrates will need to be further restricted in order to stop bacteria overgrowth in stomach – this includes bacterial overgrowth in large intestine
and bacterial overgrowth in colon as well. Lastly, some extreme cases will require the elemental diet, which relies solely on liquid-based formula.

Probiotics

Although the use of probiotics in SIBO treatment is still under debate, they have proven beneficial in some cases. Probiotics are, in fact, beneficial bacteria, which can contribute to regulating the infection.

Surgical Interventions

This treatment option is only considered when the small bowel bacterial overgrowth is caused by structural issues, such as adhesions and strictures.

SIBO and IBS

As we previously mentioned, SIBO and IBS have a correlation and are linked in some cases. Both small bowel overgrowth and IBS have similar symptoms, such as bloating, gas, and varying bowel habits, and research has shown that patients with diarrhea-predominant IBS have underlying small bacterial overgrowth (SIBO). Based on experience, addressing SIBO and treating it with antibiotics can also alleviate IBS symptoms. So, in other words, even though not all patients who have IBS have SIBO as well, treating one can also lead to relief and betterment of the other.

Risk Factors Contributing to Intestinal Overgrowth

Despite an unhealthy diet, previous surgeries and other more common factors that can cause SIBO, there are also many risk factors that, even though may not directly cause this small intestine overgrowth condition, can still contribute to its development. Some of the more notable ones include:

Use of Medication – This refers specifically to the long use of medications used to reduce stomach acid, such as proton pump inhibitors. These can lead to a disruption in the natural regulation of bacteria in small intestine.
Dysfunctional Immune System – Any type of immunosuppressive therapy or the presence of chronic illnesses such as HIV/AIDS can compromise the bacteria.
Aging – Aging is one of the leading risk factors for many things, including slower motility and SIBO.
Chronic Disease – This includes chronic pancreatitis, celiac disease, and even Crohn’s disease, which can disrupt natural functions.

Prevention

Like the saying goes, it’s better to be safe than sorry, so it is crucial to minimize the risks and prevent the possibility of developing a SIBO infection beforehand. There are many ways to do that and to enjoy a safer, happier, and healthier way of life.

Dietary Changes – As we already explained, nutrition can play a big role when it comes to SIBO, both as a trigger and a cause. It’s important to make changes on time, including implementing a low FODMAP diet, avoiding refined carbohydrates, and minimizing the alcohol intake.
Gut Motility Support – make sure to make a habit of eating regular meals with sufficient intervals in between in order to avoid bacterial overgrowth. It’s also important to intake a good amount of fiber and adequate hydration.
Reduce Stress – Stress and other types of psychological strain can significantly impact digestion and increase bacterial overgrowth.

Living with SIBO

Living with SIBO is not a walk in the park, but it is definitely something that can be managed and treated. Patients usually have persistent abdominal pain or discomfort, bloating, and even irregular bowel movements. On top of that, the malabsorption of nutrients and vitamins often leads to fatigue, nausea, and brain fog.

From an emotional aspect, living with SIBO is usually accompanied by stress and anxiety, as well as a degree of social isolation mainly because of the unpredictable symptoms and limiting food choices. SIBO cannot be completely cured and recurrence is usually frequent, but overall, it is a complex balance of symptoms management, healthy diet, and treatment.

Success Stories

Brittany – Encinitas, CA

To say that BioIntelligent Wellness has changed my life is not an exaggeration. For years I’ve dealt with many symptoms, such as bloating, acne, unknown weight gain and difficulty losing weight, and stomach pain that I just couldn’t improve no matter what I tried or which medical professional I went to. After just my first visit with BioIntelligent Wellness I knew that my issues were finally going to be dealt with. The doctor ran proper blood work and other tests to get a clear look at exactly what was going on with me. From that point, she narrowed it down to my main issue, SIBO. I’ve attempted 2 other times in the past to heal from SIBO with no luck.

Her SIBO protocol was clear, easy to follow and obviously very effective because I am happy to say that I am SIBO free! Although I still have other issues we are focusing on now, I just have so much hope that I will be healed.

I’d say my favorite part of BioIntelligent Wellness is how clear and understandable they make everything. Lets face it, having to be on a strict medical diet isn’t easy, but somehow they customize it to make it realistic to my lifestyle so I don’t get overwhelmed and give up (which is easy for me to do).

I have recommended countless friends, family and clients to BioIntelligent Wellness over the years and again it’s not uncommon to hear them use the words “life changing” after working with them.

Conclusion

Overall, SIBO is a challenging condition that comes with unfortunate symptoms, such as bloating, gas, diarrhea, and abdominal pain. Even though the exact causes of SIBO can vary drastically, it is crucial to have effective diagnosis and treatment. By implementing appropriate care and lifestyle changes, a person living with SIBO can still reduce symptoms and continue enjoying life.

Don’t hesitate to reach out to us and schedule a consultation in order to make sure that you have your SIBO under control.

FAQs

How do I know if I have SIBO?

Some of the earliest SIBO side effects can include loss of appetite, abdominal pain, nausea, bloating, unintentional weight loss, and diarrhea. However, these overlap with many other conditions, so the best way to know if you have SIBO is to get tested.

Can SIBO lead to other health complications if left untreated?

Yes, if left untreated, SIBO can lead to malabsorption of nutrients, weight loss, and other serious health complications. Therefore, it’s important to seek treatment if SIBO is suspected.

Can stress cause SIBO?

Stress doesn’t directly cause SIBO, but it can contribute to conditions like impaired parasympathetic function, gut motility and lowered immune function, which can increase the risk of developing SIBO.

How is SIBO diagnosed?

SIBO is typically diagnosed through a breath test that measures the amount of certain gasses produced by bacterial metabolism in the small intestine. However, consulting with a healthcare professional for a proper evaluation, testing, and diagnosis is essential.

Does SIBO ever go away?

No, SIBO doesn’t go away for good, and patients usually report recurrences in symptoms.

What foods trigger SIBO?

The main foods that can trigger SIBO include sugars and sweeteners, some fruits and starchy vegetables, dairy products, and grains.

What does SIBO poop look like?

SIBO can cause your stool to be unusually smelly and oily, mainly because of the fat malabsorption. It can also be watery and soft.

What can be mistaken for SIBO?

SIBO is usually confused with IBS, as they both share similar symptoms. However, IBS affects the large intestine, while SIBO is caused in the small intestine.

Are bananas bad for SIBO?

Bananas should generally be restricted when it comes to SIBO, but it all depends on the diet you are following. The smartest choice would be to consult your chosen medical professional.

Can probiotics make SIBO worse?

According to research, probiotics can both improve and worsen SIBO, and there is still no clear evidence for either one.

Do you fart a lot with SIBO?

In many cases yes. SIBO causes bloating and gas is usually part of that as well.

Is SIBO worse at night?

This is not supported by fact, but logically this can be true for many patients, as they have gone through a whole day of eating and working.

Why am I so hungry when I have SIBO?

The malabsorption caused by SIBO causes many deficiencies and leads to an increased appetite.

Can you smell SIBO?

Because of the buildup of gas caused by SIBO, many patients can also experience bad breath.

Does drinking more water help with SIBO?

Staying properly hydrated throughout the day can be beneficial with the symptoms of SIBO.

Can SIBO affect your eyes?

There have been some cases where SIBO and the nutritional deficiency caused by it have lead to some form of visual impairment, but not enough for a proper research on it.

Is coffee bad for SIBO?

Caffeine can worsen SIBO symptoms and it is also known to cause slower motility and higher irritability.