Welcome to Journey Through SIBO!
SIBO can be difficult to understand and navigate. Below includes basic information about SIBO as well as links to helpful resources.
What is SIBO?
SIBO stands for Small Intestine Bacterial Overgrowth. SIBO is a bacterial overgrowth located in the small intestine. SIBO occurs when good, helpful bacteria normally found in the colon are located in the small intestine.
Bacteria can move into the small intestine in two ways. First, bacteria can move upward from the colon into the small intestine and towards the stomach. Second, bacteria consumed from food can move into the intestine if not killed by healthy acid in the stomach. A normal, healthy functioning body can push this bacteria down through the small intestine to the colon by a function called the Migrating Motor Complex or MMC.
The bacteria commonly located in the colon is helpful by breaking down the remaining foods processed from the small intestine. The bacteria here are good and healthy. However, when this bacteria remains in the small intestine for long periods of time it causes problems as the small intestine is not designed for large amounts of bacteria.
Bacteria in the small intestine cause irritation, inflammation, and destruction to the wall of the intestine. Located on the intestinal wall are microvilli that break down and absorb nutrients. When inflammation and irritation are present the microvilli and intestinal wall becomes damaged and unable to digest food or absorb nutrients. When undigested food pass through a small intestine with unwanted bacteria further damage and unpleasant symptoms result.
Symptoms of SIBO
The symptoms of SIBO include nausea, gas, bloating, intense pain in the abdomen, diarrhea, constipation, alternating diarrhea and constipation, exhaustion, brain fog, malnourishment (and associated symptoms), weight loss, weight gain, food intolerances, skin conditions, and more. As more and more research is being conducted, more associated diseases and symptoms are added to this list. Click here for a full list of associated diseases.
How is SIBO treated?
SIBO is treated with diet and special antibiotic protocols. SIBO diets are low carbohydrate diets designed to feed the patient but starve the bacteria. Click here for more information on SIBO Diets. For information on SIBO Treatments please click here.
What does life with SIBO look like?
Life with SIBO is hard.
When undiagnosed or untreated, SIBO disrupts the daily life of the patient. Having SIBO means every meal is painful and difficult. Food becomes the enemy because when food is eaten, symptoms result. Painful gas, shooting abdominal pain, a distended belly, belching, frequent trips to the bathroom, explosive diarrhea, or painful constipation can result.
When diagnosed, SIBO treatments can be difficult and expensive. Traditional antibiotics do not work for SIBO. So SIBO patients must resort to one special, and very expensive prescription antibiotic called Rifaximin (also known as Xifaxan) or herbal antibiotics, or the Elemental Diet. Doctors and researchers recommend SIBO patients change their diet to reduce symptoms and prevent the return of bacterial overgrowth. Prokinetic drugs or supplements may be prescribed to aid the Migrating Motor Complex.
Causes of SIBO
The underlying causes of SIBO agreed upon by doctors and researchers include*
- Deficient Migrating Motor Complex
- Structural Alterations like adhesions, scar tissue, malformations, tumors, etc.
- Frank Immunodeficiency Disease
The following underlying causes of SIBO are still under research
- Food Poisoning
- Deficient Stomach Acid (HCl)
Risk Factors for SIBO
The risk factors for SIBO agreed upon by doctors include*
- Deficient Stomach Acid (HCl)
- Absent or Inefficient Ileocecal Valve
- Drugs – Prescription or recreational
- Genetics
- Surgery
- Injury
- Stress
SIBO – IBS Connection
There is a strong connection between SIBO and IBS. Between 60% and 84% of IBS patients are reported to have SIBO. The associated symptoms of IBS and SIBO are similar. However, not all IBS patients have SIBO, and not all SIBO patients test positive for IBS through the blood test. More research is being done in this area all of the time.
Testing For SIBO
The most accurate way to test SIBO is a Lactulose or Glucose breath test. Other testing could include endoscopy with culture or IBS blood testing.
For information on The Ins and Outs of SIBO Breath Testing click here.
For SIBO Breath Testing Laboratories click here.
Healing SIBO
Healing SIBO can take time. Two-thirds of SIBO cases are reported as chronic. But, this does not have to be the case. SIBO is still a relatively new diagnosis and not all doctors know how to treat SIBO properly. Even current treatments for SIBO change or are modified each year. Staying up to date on current research and understanding and healing the underlying causes of SIBO is the best place to start to heal SIBO.
1.) Identify the underlying cause of SIBO
Identifying the underlying cause or associated diseases of SIBO is one of the most difficult aspects of treatment. However, without knowing the underlying cause treatments may be ineffective long term.
- How long have symptoms been present?
- If symptoms have been present and persistent for a long time adhesions may have formed or other imbalances like parasites, yeasts or fungi, archea, or other bacterial infections may exist and need to be addressed. For yeast overgrowth, also called SIFO- Small Intestine Fungal Overgrowth, herbal anti-microbial protocols are a more effective option than the Elemental Diet or standard antibiotic protocols.
- Surgeries and adhesions
- Surgeries resulting in adhesions and scar tissues can cause problems for SIBO as unwanted tissues will lock in SIBO and make antibiotic treatments ineffective long term. Therapies to address adhesions and scar tissue may be required. Click here for the most trusted physical therapist and treatments for adhesions.
- Malformation and birth defects.
- Cancers, autoimmune issues, birth defects, a twisted colon, bowel obstruction, and other imperfections could be a part of the equation that prevent treatments from working effectively if left unresolved.
- Did you get food poisoning recently and now have SIBO?
- This may mean one course of antibiotic or antimicrobial treatment might be for you. Research in this area is still underway.
- Migrating Motor Complex
- When the brain does not talk to the digestive system, the Migrating Motor Complex may not be working properly. This means food and bacteria are not being moved down through the small intestine to the colon effectively. Click here for more information on Supporting The Vagus Nerve and Migrating Motor Complex.
For more in-depth information on the Underlying Causes of SIBO click here.
2.) Target the cause of the SIBO infection
Identifying the cause of SIBO can be difficult and time consuming. However, randomly treating SIBO without addressing the underlying cause may allow bacterial overgrowth to return, making expensive and difficult treatments ineffective. Treating the cause of SIBO before or in conjunction with SIBO treatments is the best case scenario for results.
3.) Treat the SIBO infection
There are LOTS of different ways to treat SIBO. No one method is a cure-all and finding the right solution should be based off of underlying factors. Treatment plans for SIBO should be customized to each individual dietary, financial, physical, and personal needs. Treatment options include antibiotics, herbal antimicrobials, the elemental diet (homemade or pharmaceutical) and diet. For common SIBO treatment protocols click here.
4.) Heal the whole body
The only way to heal SIBO completely is to heal the whole body. Bombing the microbiome with antibiotics and antimicrobials will not be effective long term if other issues are not addressed. Healing the whole body takes time, effort, and energy. Finding a healthy diet solution as part of treatment is a helpful option for preventing the return of SIBO while the body is healing. After the body has recovered, rebuilding the diversity of the microbiome is crucial.
Hope for SIBO
There is lots of hope for SIBO. Every year, doctors and researchers release new statistics, treatment protocols, diet modifications, and research on underlying causes of SIBO. The future of SIBO is exciting and constantly changing with great information!
Additional Resources
The Ins and Outs of SIBO Breath Testing
Why Traditional Antibiotics Do Not Work For SIBO
Underlying Causes of SIBO
Reduce SIBO Bloating
SIBO Q&A: Supporting The Ileocecal Valve
Supporting The Vagus Nerve and Migrating Motor Complex
Tips For Gaining Weight With SIBO
5 Ideas For Lowering The Cost of Rifaximin
SIBO & Gut Motility
Common SIBO Mistakes
SIBO Diet: To Cheat or Not To Cheat
*Information from Siebecker 2011-2017 http://www.nutritionaltherapyconference.com/wp-content/uploads/2017/03/SIBO-Overview-Allison-Siebecker.pdf