What is it?
SIBO stands for Small Intestinal bacterial overgrowth. SIBO may be the cause of symptoms for up to 60% of people with a diagnosis of Irritable Bowel Syndrome ( IBS ) (1).
If you are suffering from bloating abdominal pain, constipation and/or diarrhoea, there is a chance that you may have SIBO.
As the name implies, in SIBO, there is an overgrowth of bacteria in the small intestines. These bacteria are not pathogens. They are the ones that normally live in your large intestine but in SIBO they are found in greater than usual numbers, higher up in the digestive tract, in the small intestine.
This means that your bacteria have access to your food too early in the digestive process. You will find that carbohydrate rich foods cause you the most problems because these bacteria love to ferment sugars, starches and soluble fibres.
It can be really frustrating to realize that even many healthy fruit and vegetables contain fermentable carbohydrates and can make you feel worse! The fermentation process creates gases which are responsible for causing belching, flatulence, heartburn, bloating and pain. Increased fermentation gases irritate the small intestine leading to increased intestinal permeability (sometimes called leaky gut). Increased permeability means that incompletely digested food particles can cross the gut lining and enter the blood stream.
Bacteria are also more easily able to cross the gut barrier causing immune reactions. Malabsorption of nutrients such as iron, B12, Vitamin D, magnesium, calcium and folate are common in SIBO.
SIBO is much more than a bit of bloating and pain – if left untreated SIBO can progress to cause symptoms can such as:
- food sensitivities,
- brain fog, headaches
- acne, eczema, rashes,
- joint pain or muscle aches
- depression and/or anxiety
- Nutrient deficiencies.
Of course not all bloating and distension is caused by SIBO. It’s important to look at other causes such as low stomach acid, gallbladder problems, pancreatic enzyme deficiency anything that interferes with the nerves in the gut, immune reactions like coeliac disease or structural changes to the gut such as adhesions or scaring after surgery.
A proper evaluation of your individual presentation is essential to guide the correct plan to promote healing.
A Naturopath can help!
A Naturopathic approach begins with removing sources of fermentable carbohydrates (FODMAPS) from the diet. FODMAPS are Fermentable Ogliosaccharides, Disaccharides, Monosaccharides and Polyols.
These foods contain carbohydrates that are difficult to digest if you have SIBO. Many people have tried this diet and failed to see any results because they have not been given the tools and support they need to succeed. Doing this step well can quickly reduce symptom so healing can begin. I recommend working with an experienced naturopath or nutritionist to understand what foods will be well tolerated and which foods need to be avoided (at least in the short term).
A Naturopath can help you with dietary and also prescribe herbal medicines. Herbal medicines can be as effective as antibiotics to reduce bacterial levels in SIBO. They can also be used prevent relapse of symptoms by improving stomach acid, gallbladder function and small intestine motility.
Working with a naturopath to identify and correct nutritional deficiencies and correcting with is another important step in healing from SIBO .
The ultimate aim is to help you develop a plan for lifelong maintenance of a happier healthier you.
- Small Intestinal Bacterial Overgrowth in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Case-Control Studies. Am J Gastroenterol. 2020 Feb;115(2):190-201. doi: 10.14309/ajg.0000000000000504. PMID: 31913194.
- Chedid V, Dhalla S, Clarke JO, Roland BC, Dunbar KB, Koh J, Justino E, Tomakin E, Mullin GE. Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth. Glob Adv Health Med. 2014 May;3(3):16-24. doi: 10.7453/gahmj.2014.019. PMID: 24891990; PMCID: PMC4030608.