Hi, this is Dr. Alison Egeland, Attune Functional Medicine.
Today I am going to talk about small intestinal bacterial overgrowth, also called SIBO for
short.
And so I'll just cover some main points first; what is it, what causes it, how do you know
if you have SIBO and finally, how do you treat it.
And so first, as the name suggests, it's due to an overgrowth of bacteria located in the
small intestine and typically we want the majority of our bacteria to be in the large
intestine.
So when we have too much in the small intestine, as we eat specific carbohydrates the bacteria
will actually ferment those carbohydrates.
And this produces a lot of gas, which can make us very uncomfortable, can produce symptoms
of bloating, sometimes constipation or diarrhea, stomach cramping and then also sometimes GERD
or reflux.
And so if some of these symptoms sound familiar or if you've been diagnosed with IBS, it's
actually really important to get tested for SIBO.
It's estimated that up to 80% of cases of IBS are actually due to small intestinal bacterial
overgrowth.
You're probably wondering what causes SIBO and the short answer is, anything that decreases
motility.
And so motility it's the peristaltic waves that push or move food through the digestive
tract.
And so when that's not working properly, it can set us up for an overgrowth of the bacteria
in the small intestine.
There is actually a number of things that can lead to the slow motility.
First, is if we have poor digestion or if we're taking medications that block acid.
Second, hypothyroidism it slows our overall metabolism, but one of those effects is also
slowing of the gastrointestinal motility.
Still other conditions are things that can lead to adhesions like previous abdominal
surgery, endometriosis, inflammatory bowel disease.
There are other medications, such as; opioid medications, they can slow the motility.
And then also food poisoning believe it or not.
The toxins that are produced from food poisoning can actually damage the cells that line our
intestine and set us up for decreased motility because of the damage.
It's actually called post-infectious SIBO, sometimes also post-infectious IBS.
And so next, how do you know if you have SIBO?
The best way we have of testing right now is a breath test that looks at both hydrogen
and methane.
It's very important to know what gasses are being produced, because it helps determine
the optimal treatment.
And finally, how do you treat SIBO?
First, we always want to address the underlying factors.
We might need to investigate for conditions like; hypothyroidism or inflammatory bowel
disease.
We need to address those things as much as possible first.
Then, we want to focus on decreasing the bacterial load in the small intestine.
We can do that through antibiotic treatments or botanical or herbal treatments.
There is actually a really great study showing herbal treatments can be even more effective
than the antibiotic therapy.
So the next really important piece of treatment is to address the motility issue.
There are a number of different prescriptions and supplements that can support this, but
also lifestyle factors are very important.
And one of the most important lifestyle factors is to avoid eating for about four to five
hours between meals.
That means no snacking.
When our body is in the state of fasting or no food for four to five hours, that encourages
something called the migrating motor complex.
That's essentially again those peristaltic or those waves through the small intestine
that help push through any residual food or bacteria.
It really just helps keep things moving through.
And the final helpful piece of treatment is to address the diet.
A lot of people do find it helpful to decrease the fermentable carbohydrates in their diet.
There are a couple of options for this; there is something called the low FODMAP diet, there
is also the Specific Carbohydrate Diet.
And then a really great resource for this is actually Dr. Allison Siebecker.
She has a website called siboinfo.com and she likes to use a combination of the SCD
with the low FODMAP diet and gets really good results with that.
So try what works best for you.
And then finally just to recap, if you suspect that SIBO can be causing your digestive symptoms,
I do encourage you to get tested. Do the breath test that looks at both hydrogen and
methane because it's really important for guiding treatment.
You also want to look for and address any potential underlying causes for SIBO.
You want to decrease the bacteria with either antibiotics or herbal medicine.
You definitely want to support good digestion and motility.
And then consider following one of the recommended diets.
I hope you found this helpful.
Feel free to contact us with any questions or leave comments below.
Have a wonderful day!