Gut motility in SIBO is a huge issue. After all Small Intestinal Bacterial Overgrowth is the result of unwanted bacteria hanging out in the small intestine and not moving down and out through the colon. How this bacterial overgrowth gets there can be the result of a reflux from the large intestine combined with the body not pushing the bacteria back down, disruption in the stomach to allow live bacteria to travel down into the small intestine combined with the body not pushing the bacteria through, or bacteria and food getting caught in the intestine from adhesions, tumors, or other obstructions. Whether this bacterial overgrowth begins by coming up from the colon or down from the stomach Small Intestine Bacterial Overgrowth happens when the body is unable to move the unwanted bacteria in the small intestine out, so helping the body to move food and waste through the gut in a timely manner is of the greatest importance.
One of the wisest nuggets of wisdom I heard in all of my doctor’s appointments to treat SIBO was, “Healthy people don’t have SIBO. So even a reflux from the colon or a bout of food poisoning would get pushed down and out clearing the small intestine of any overgrowth.” So with SIBO, we have to help the body move food and waste through the intestines.
The very best method for this is to retrain the Vagus Nerve to work properly. The Vagus Nerve is the cannel the brain uses to tell the body to release digestive juices to kill bacteria and break down food when it is consumed as well as to trigger the Migrating Motor Complex to dislodge and force waste away from the walls of the small intestine and out through the colon. You can read more about that here.
But while we are retraining the Vagus Nerve there are things you can do to help with motility.
Help Trigger The Migrating Motor Complex
You can help trigger the Migrating Motor Complex or MMC through different prokinetic options. There are several pharmaceutical options which require a prescription as well as herbal options. All prokinetics should be used under the guidance of your doctor. Please talk with your doctor about the right one for you.
- Low Dose Naltrexone (requires a compounding prescription)
- Low Dose Erythromycin (requires a prescription)
- Resolor
- Ginger Root (1,000mg at bedtime)
- Bitter Herbs (work with your doctor for the right herbs for you)
- Iberogast (30-60 drops at bedtime)
- SIBO-MMC (Dr. Morstein’s)
Physical Therapies
Physical activity and physical stimulation are two great options for helping the body move food and waste through the small intestine.
- Self Abdominal Massage – Click here for my favorite instructional video And click here for massaging near the Ileocecal Valve.
- Yoga for digestions – Read and learn some techniques here
- Walking or moderate exercise – gentle activity can be one of the best ways to stimulate gut motility
- Castor Oil Packs
Food and Supplements
While these options do not trigger the MMC, they can help to move food and waste down and out.
- Magnesium – Taking magnesium at night before bed is an easy trick to help trigger morning bowel movements.
- Oranges – A trick that I used during pregnancy was to eat a whole orange every day. A wise, old nursing friend of mine told me she always told her pregnant patients to peel an orange and eat the fruit every day to prevent constipation. This trick worked beautifully and I never struggled with constipation during pregnancy. There is no research on if it will work for SIBO, but it might be an easy option to help move food and waste out.
What other practical means of gut motility have your SIBO doctors recommended for you? Leave a comment below with your insights.
31
Carole Pilon says
Fast tract diet by Dr. Norm Robillard was a lifesaver for me.
Sandra Shields says
Hi Elena,
I love your blog. It is a wealth of great recipes and information!
I have had reoccurring SIBO and treatments for the past 5 years. Can you tell me in your experience, did you find diet played an important role in preventing relapse? I am very interested to hear what your personal experience with this is. Mine is Hydrogen driven with constipation, and I just finished another round of Xifaxan. I am gargling to get the Vagus Nerve to activate the MMR. I want to prevent a relapse. Also, doing the Yoga for better digestion.
Thanks you. Blessings!
Elena Wistey says
Hi Sandra,
I think diet plays a huge role in preventing relapse for most people. It is extremely important to go slow when you begin introducing higher FODMAP foods or larger quantities of foods. And, never be afraid to go back to a SIBO diet for a few days. Anytime I feel like my tummy is struggling or I get nervous my SIBO may have returned I go back to the safest foods I know for a few days to see how my body responds. If I go through a time of intense stress I always move my diet back towards a SIBO diet because I know I don’t digest my food well when I am stressed out. Sometimes we can overwhelm our system and a few days of calm can help prevent relapse.
Good luck!
Elena