Here are some signs of SIBO you may be ignoring...

Small Intestine Bacterial Overgrowth (SIBO) is a condition where there is an excessive amount of bacteria in the small intestine, which can cause an imbalance and lead to a range of gastrointestinal symptoms. 

What are the Signs of SIBO?

If food travels slowly in the digestive tract or there is reduced stomach acid, it can create the perfect environment for bacteria to start to overgrow! They begin to feed off the food we eat and produce hydrogen methane gas which can lead to significant and uncomfortable symptoms. An immediate sense of fullness can be one of the first signs as can abdominal pain, bloating, nausea/vomiting, abnormal stools, smelly flatulence (due to fat malabsorption) and diarrhea or constipation. SIBO can also cause indigestion and malnutrition which can lead to weight loss. If SIBO goes untreated and is severe, it can lead to vitamin deficiencies as the bacteria consume some of the nutrients you should be getting.

What are the causes of SIBO?

The causes of SIBO are not fully understood, and there are several factors that are believed to contribute to its development.

One of the main factors is a disruption in the normal motility or movement of the small intestine. This can involve anatomic abnormalities (post bowel procedures including resections) or malfunction/weakness in the muscular activity of your digestive system. When digestion is slowed or halted and food is sitting in our digestive tract for a longer period of time, this can allow bacteria to accumulate and grow. This can be caused by conditions such as diabetes, scleroderma, and certain autoimmune disorders.

Low gastric acid secretion can also cause SIBO, as the growth of bacteria in the digestive tract is not suppressed by a low pH. This can occur with the use of histamine type 2 receptor blockers (H2RAs) or proton-pump inhibitors (PPI).

Other risk factors that may contribute to SIBO include:

A weakened immune system

Viral gastroenteritis

Celiac disease

Inflammatory bowel disease

Irritable bowel syndrome

Parkinson’s disease

Hypothyroidism

Poor diet

Low stomach acid levels

High alcohol intake

Medications, particularly those that impact gastric motility

How is SIBO treated holistically?

Probiotics

Probiotic use has also been suggested to be an effective treatment in not only managing SIBO but also in reducing gut disturbances associated with antibiotic use.

Saccharomyces Boulardii and Lactobacillus Rhamnosus GG are two probiotic strains that have been studied specifically for their effectiveness when taken alongside antibiotics. Other probiotic strains that have been suggested for SIBO included Bifidobacterium (bifidum; lactis; and longum); Bacillus Coagulan; and Lactobacilli (casei; acidophilus; and plantarum).

Diet

A low FODMAP diet may be recommended to prevent reoccurrence and manage symptoms. This is based on two ideas- one- that reducing fermentable carbohydrates in the diet “starves” the bad gut bacteria; and two- that the diet is effective in helping to manage the gastrointestinal symptoms of SIBO including bloating and gas.

A healthy, balanced diet, low in refined sugars and carbohydrates is a more simple diet that may be recommended to help balance the microbiome and promote growth of the good gut bacteria.

A diet high in prebiotics and probiotics will help to support and maintain the gut microbiome back to a balanced state. This includes consuming probiotics as above in supplement form or also through foods including yogurt and kefir. Prebiotics can also be found in supplement form or in a diet varied in wholegrains, legumes, nuts, seeds, fruits and vegetables.

SIBO can sometimes cause nutritional deficiencies due to digestion and absorption issues. Therefore, seeing a dietitian will ensure all your nutritional needs are being met whilst following an appropriate diet.

How do I improve my stomach acid levels?

Low stomach acid may be a contributor to SIBO as the acidity is responsible for killing harmful bacteria, regulating the balance of bacteria and neutralizing enzymes.

One simple but effective way to improve stomach acidity is by thoroughly chewing your food. This not only makes digestion of food easier for our body, but also stimulates secretion of digestive enzymes in the mouth and stomach.

Introduction or addition of some foods in the diet can naturally help to improve stomach acidity levels.

Probiotic-rich, fermented foods such as kefir, sauerkraut and kimchi can help to increase the good bacteria in the gut, which can aid in digestion and improve stomach acid levels. Certain spices and herbs can also help to stimulate stomach acid production, including ginger, turmeric, and cinnamon, which can be incorporated into meals such as curries or consumed in more simpler forms such as tea or supplements.

Additionally, avoiding trigger foods that may exacerbate acid levels, such as spicy or fried foods, caffeine, and alcohol, can help improve stomach acid levels.

How do I improve my gut motility?

Poor gut motility is another major cause of SIBO as slowly digested food sitting in the digestive tract can encourage bacteria to accumulate and grow. Poor motility can also impact on our bowel movements and result in constipation, which can allow bacteria in the large intestine to move up into the small intestine and populate, also leading to SIBO.

Our Migrating Motor Complex (MMC) is a system of electrical waves that migrates digestion from the stomach and through the small intestine. It is particularly active between meals for a duration of 80-220 minutes, with its main goal to move undigested food particles and bacteria from the small intestine. Poor or incomplete movement of the MMC can result in bacteria building up in the small intestine, leading to SIBO.

Specific strategies that can improve our MMC include having smaller meals and leaving enough time between eating periods to allow the MMC to do its thing.

Some other strategies to promote movement of the digestive system include humming and singing which stimulates the vagus nerve. The vagus nerve is activated when we are in our rested state and regulates our digestive organs including production of stomach acids, stomach churning and stimulation of the small and large intestine to push food and waste through the digestive tract.

Slow, deep breathing not only helps us to relax and de-stress, but it is another way to activate the vagus nerve and helps us enter “rest and digest” to get digestion moving. Meditation and other activities that help us to slow down such as yoga benefit in the same way.

Exercise can also help to get the digestive system moving. Low-medium intensity exercise on a daily basis can promote regular bowel movements and aid digestion.

The bottom line

SIBO more commonly occurs from an underlying cause. Therefore, most medical and dietary treatments for SIBO are more immediate and may not be effective for eliminating and reducing SIBO in the long term. At Kelsey Mauro Wellness we can help with planning appropriate dietary management.

If you suspect you could have SIBO or if you are suffering from gut symptoms and need help, book a time for a free initial consultation here.