Uncovering the Hidden Culprit of Your Digestive Issues: Everything You Need to Know About SIBO

S - small

I -intestinal

B - bacteria

O - overgrowth

SIBO is an abnormal number of bacteria that colonize in the small intestine. These are normal bacteria, usually they are found in the large intestine. They are Pathobionts (not harmful when not overgrowth) and not Pathogens. These bacteria ferment starches and fibers into gasses that damage the small intestine and cause a lot of symptoms.

The symptoms of SIBO can vary from person to person, but some of the most common include

• Bloating and gas

• Constipation/diarrhea

• Abdominal pain

• Belching, flatulence

• Nausea

• Reflux

• Leaky gut symptoms: rashes, food allergies

• Steatorrhea (excess fat in feces)

There are three types of SIBO:

Hydrogen dominant SIBO: This type of SIBO is characterized by an overgrowth of bacteria that produce high levels of hydrogen gas. Hydrogen Gas is associated with diarrhea or alternating diarrhea/constipation, abdominal cramping, and fibromyalgia.

Methane dominant SIBO: In this type of SIBO, the overgrowth of bacteria produces high levels of methane gas. Methane gas is associated with constipation, nausea, and belching.

Hydrogen sulfide dominant SIBO: This type of SIBO is caused by an overgrowth of bacteria that produce high levels of hydrogen sulfide gas. Hydrogen sulfide gas is associated with diarrhea, foul gas, bladder pain, and joint pain.

It's important to note that some people may have a combination of two or more types of SIBO. The type of SIBO a person has, can impact their symptoms and treatment plan, so it's important to work with a healthcare provider to determine the type of SIBO and develop an appropriate treatment plan.

There are several underlying causes of SIBO, which can include:

IMPAIRED MOTILITY

• Autoimmune 

• IBS (Irritable Bowel Syndrome)

• MMC (Migrating Motor Complex) damage

• Traumatic brain injury

• Hypothyroidism

• Chronic infections

• Diabetes

• Mold / CIRS (Chronic Inflammatory Response Syndrome)

• Dysautonomia (autonomic nervous system (ANS) does not work properly)

• EDS (Ehlers-Danlos syndrome, which affects connective tissues such as skin, joints, and blood vessel walls)

• POTS (postural orthostatic tachycardia syndrome-blood circulation disorder)

• MCAS (mast cell activation syndrome)

• Scleroderma (may cause problems in the blood vessels, internal organs, and digestive tract)

IMPAIRED DIGESTION

• Microbiome dysfunction

• Chronic stress “fight or flight”

• Secretory IgA deficiency

• Deficiency of pancreatic or brush border enzymes

• Poor bile flow

• Low stomach acid

IMPAIRED FLOW THROUGH INTESTINES

Ileocecal valve dysfunction

EDS (Ehlers-Danlos syndrome)

Endometriosis

Abdominal surgery/Adhesions

If you are experiencing symptoms of SIBO, it's important to talk to your healthcare provider to determine the underlying cause and develop an appropriate treatment plan.

SIBO is often associated with  the following conditions:

• IBS PMID: 28274108

• IBD PMID: 28134633

• Celiac disease PMID: 28191721

• Fibromyalgia PMID: 25119830

• Interstitial cystitis PMID: 17932763

• Restless leg syndrome PMID: 21570907

• Acne rosacea PMID: 18456568

• Atherosclerosis PMID: 28275304

• GORD PMID: 25914466

• Diabetes PMID: 28149017

• Hypothyroidism PMID: 28223728

• Scleroderma PMID: 28443513

• NASH (non-alcoholic steatohepatitis) PMID: 26212089

• Chronic Prostatitis PMID: 21854715

• Diverticulitis PMID: 15884120

• Gallstones PMID: 24598592
  
  

The common clues that you may have SIBO are:

• You get worse with prebiotics or probiotics

• Symptom onset after a case of gastroenteritis

• Symptoms may transiently improve while on antibiotics for an unrelated problem

• Fiber worsens your constipation

• Symptoms worsen with xylitol and other sugar alcohols

• Celiac patients who continue to have symptoms whilst on gluten-free diet

SIBO has been associated with a number of gastrointestinal symptoms and conditions. Here are some examples of what SIBO can cause:

Microvilli damage

• Leaky Gut and Food allergies

• Histamine intolerance

• Damage to brush border enzymes

Bile acid deconjugation. Fat and fat soluble vitamins A, E, D, K malabsorption.

Impaired migrating motor complex (motility of the small intestine) causing bacteria to stay in the small intestine.

B12, magnesium, and iron malabsorption.

Small intestinal fungal overgrowth (SIFO)

SIFO is often found in conjunction with SIBO. It has been suggested that the overgrowth of bacteria in the small intestine can create an environment that is conducive to the growth of fungi. SIFO causes the same symptoms as SIBO including bloating, abdominal pain, diarrhea, constipation, and malabsorption. 

Diagnosing SIFO can be challenging, as there are no established guidelines for its diagnosis. SIFO is often suspected when high antibiotic use for SIBO does not improve symptoms of SIBO. 

Most common organism of fungi is candida. Candida is a type of yeast that is a normal resident of the gastrointestinal tract, along with other fungi and bacteria. However, when there is an overgrowth of candida in the small intestine, it can lead to symptoms of SIFO. This condition is commonly referred to as "candida overgrowth" or "candidiasis."

There are several risk factors for candida overgrowth, including the use of antibiotics, corticosteroids, and other medications that can disrupt the balance of microorganisms in the gut. Additionally, a diet high in sugar and refined carbohydrates can promote the growth of candida and other fungi.

Candida is strongly suspected if a person experiences a lot of yeast infections, rashes, histamine intolerance and if symptoms get worse with sugar.

Candida overgrowth can happen in the colon as well which is easier to test with stool tests but even then not always the test results are positive.

Usual diagnosis of candida overgrowth may involve a comprehensive assessment of symptoms and risk factors, as well as laboratory testing. 

Treatment of candida overgrowth typically involves a combination of dietary modifications and antifungal medications. Herbs are often better for treatment especially in cases when both SIBO and SIFO are present. Herbs work as antibacterial and antifungal.

A low-sugar, low-carbohydrate diet that is rich in whole foods and fiber can help to reduce the growth of candida and promote the growth of beneficial bacteria in the gut. 

In conclusion, small intestinal bacterial overgrowth (SIBO) is a condition that is characterized by excessive growth of bacteria in the small intestine. It can lead to a range of gastrointestinal symptoms, as well as malabsorption, food intolerances, and other complications.

It's important to note that SIBO is often associated with another condition known as small intestinal fungal overgrowth (SIFO). These two conditions often occur together, as the overgrowth of bacteria in the small intestine can create an environment that promotes the growth of fungi.

Diagnosis of SIBO and SIFO can be challenging, as symptoms can overlap with those of other gastrointestinal disorders. However, your nutrition therapist will help you with proper testing and effective treatment, and dietary protocol.

If you are experiencing symptoms of SIBO or SIFO, it is important to seek professional guidance to properly diagnose and treat the condition. Working with a nutritional therapist can help you develop an individualized treatment plan to manage your symptoms and improve your overall gut health.

If you're interested in learning more about how nutritional therapy can help you manage your SIBO symptoms, I invite you to book a discovery call with me. During this call, we can discuss your symptoms, review your medical history, and address your specific needs and goals.

As a nutritional therapist, my goal is to empower you to take control of your health and improve your overall well-being. If you're ready to take the first step in managing your SIBO symptoms and improving your gut health, I encourage you to book a discovery call with me today.