What is SIBO and What Are Its Symptoms?
Are there natural therapies that help with SIBO? Let’s dive into those questions with our natural health guide to SIBO.
SIBO: A Quick Overview
SIBO stands for Small Intestinal Bacterial Overgrowth. Normally, our digestive systems depend on a delicate balance of bacteria, but disruptions can cause overgrowths. SIBO specifically refers to an increase or change in the type of bacteria in the upper gastrointestinal (GI) tract. Common symptoms include gas, bloating, and abdominal swelling. SIBO can often be mistaken for other conditions, making proper diagnosis important. A breath test is the usual method for detecting SIBO. Natural treatments like diet changes, supplements, and probiotics can help manage the symptoms.
How a Healthy Gut Works
To understand SIBO, we first need to understand how the gut functions. The gut environment houses much of your body’s microbiome, which is a community of microorganisms. Although the idea of bacteria in your body might sound unappealing, many types of probiotic bacteria are beneficial, boosting your immune system and helping maintain health.
Under normal conditions, your body digests food efficiently as it moves through the GI tract. Muscles, nerves, and neurotransmitters such as serotonin help transport food through various stages of digestion. Digestive juices and enzymes break down macronutrients, which are then absorbed into the bloodstream. Probiotic bacteria play a vital role in absorbing vitamins and minerals, producing beneficial enzymes, and keeping harmful bacteria in check. However, imbalances can lead to overgrowths like SIBO.
What Is SIBO?
SIBO is an increase or change in the type of bacteria in the upper gastrointestinal tract. Normally, the small intestine has fewer bacteria compared to the large intestine. In SIBO, this balance is disturbed. Diagnostically, having more than 100,000 colony-forming units (CFU) of bacteria per mL in a small intestinal aspirate indicates SIBO.
Under healthy conditions, several mechanisms help control bacterial levels in the small intestine. These include gastric acid secretions, the proper muscular movement of food through the GI tract, bile’s bacteria-killing properties, and an intact ileocecal valve, which separates the small and large intestines. Issues with any of these processes can lead to SIBO. While some people with SIBO show no symptoms, others experience significant discomfort, often caused by underlying conditions that contribute to bacterial overgrowth.
Symptoms of SIBO
The symptoms of SIBO can vary widely and may include indigestion, bloating, gas, flatulence, abdominal pain and swelling, constipation, diarrhea, nausea, fatigue, bad breath, weight loss, and deficiencies in vitamins such as B12, iron, and fat-soluble vitamins (A, D, E, and K). Because SIBO often leads to nutritional deficiencies and issues with nutrient absorption, it can closely resemble conditions like Irritable Bowel Syndrome (IBS).
What Conditions Does SIBO Co-Occur With?
SIBO is frequently misdiagnosed because its symptoms overlap with many other conditions, making its prevalence difficult to estimate. Studies suggest that SIBO might affect between 2.5 and 22 percent of the population, with some experts believing that it might be more common in women.
SIBO is more prevalent among people with certain conditions. Low stomach acid (hypochloridia) is a common co-occurrence. In symptom-free individuals, a high percentage of morbidly obese people and the elderly have SIBO. It is also common among those with IBS, celiac disease, or certain connective tissue disorders. The condition also appears more frequently among alcoholics and people with liver cirrhosis and Type-2 diabetes.
SIBO can co-occur with several nutrient deficiencies, particularly with vitamins and minerals such as B12, iron, and fat-soluble vitamins. Experts believe that the overgrowth consumes these nutrients, leaving less for the body to absorb.
What Causes SIBO?
Several factors can contribute to small intestinal bacterial overgrowth. SIBO can result from both “bad” and “good” bacteria becoming unbalanced. Maintaining healthy bacterial levels depends on multiple processes such as gastric acid secretion, normal GI motility, bile production, and an intact ileocecal valve. Any disruption in these processes can lead to SIBO.
Conditions that affect these processes, like diabetes, immunodeficiency, autoimmune diseases, celiac disease, or Crohn’s disease, may trigger bacterial overgrowth. Physical damage to the GI tract, whether from surgery or another health condition, can also lead to SIBO. This includes issues such as a damaged ileocecal valve or intestinal obstructions.
There is an ongoing debate about the relationship between IBS and SIBO. Some believe that IBS disrupts gut motility, leading to overgrowth, while others think SIBO causes IBS symptoms. Another viewpoint is that they are distinct but interrelated conditions that need separate treatments.
How Is SIBO Diagnosed?
SIBO often mimics other gut conditions, making it difficult to diagnose. However, if you suspect SIBO, you should discuss it with your healthcare provider and ask for specific tests.
Testing for SIBO
Two main tests are used to diagnose SIBO: a breath test and a bacterial culture. There’s some scientific disagreement over which is best, but the breath test is the most common due to its simplicity and non-invasiveness. Common breath tests involve drinking a solution with glucose or lactulose, and then providing breath samples over a few hours. This measures the gases produced by bacteria in your intestines.
The lactulose breath test is more often positive in individuals with GI symptoms. However, these tests may sometimes miss SIBO if the responsible bacteria don’t produce hydrogen gas. The alternative method involves obtaining a bacterial culture via endoscopy, but this is more invasive and has its own set of complications.
How Is SIBO Treated?
Most doctors initially treat SIBO with antibiotics such as Augmentin or Xifaxan, often for a course of one to two weeks. However, antibiotics may not offer a permanent solution, as many people experience a relapse once they stop taking them. Furthermore, antibiotics can have side effects and contribute to the development of antibiotic-resistant bacteria.
Natural Approaches to SIBO
If you’re looking to manage SIBO naturally, there are several complementary methods to conventional treatments, including dietary changes, natural supplements, probiotics, and lifestyle adjustments.
SIBO Diets
Altering your diet is one way to ease SIBO symptoms. The Specific Carbohydrate Diet (SCD) and the Gut and Psychology Syndrome (GAPS) diet are two such plans. The SCD eliminates all complex carbohydrates, focusing on simple, easy-to-digest foods. The GAPS diet is similar but also includes detoxification and supplementation with probiotics and essential nutrients. Another option is the Low FODMAP diet, which avoids certain carbohydrates and sugar alcohols that can exacerbate SIBO symptoms.
Additionally, a gluten-free diet may help by preventing intestinal hyperpermeability and promoting a healthy gut. Regular exercise also supports healthy digestion and overall wellness.
Herbal Remedies and Supplements
Herbal treatments can be effective for SIBO. Some studies have shown nearly half of SIBO patients improved with herbal therapy compared to those using antibiotics. Effective herbs include oregano oil, Pau d’arco, lemon balm leaf, and red thyme oil. Turmeric and zinc-carnosine supplements may also support gut health and alleviate symptoms.
Probiotics
Combining probiotics and prebiotics can support gut health and counter harmful bacteria. Consuming probiotic-rich foods or supplements can restore the balance of bacteria in your gut, relieve discomfort, and are often more effective than antibiotics.
A multi-strain, high-quality probiotic like Global Healing’s Ultimate Probiotic, which contains 25 unique strains and 75 billion CFUs, can significantly support digestion and intestinal health.
Avoiding SIBO
Prevention is better than cure. A nutritious, plant-based diet, low in sugars and processed foods, supports a healthy gut. Regular fitness, meditation, and periodic fasting can also enhance your overall health. Performing a colon cleanse can help maintain a balanced gut, rid your body of toxins, and boost energy levels.
