How can I know the cause of this SIBO for me?
This is one of the most frequent questions I get over email. Researchers have determined so far, that there is no one answer. There are a vast amount of risk factors that set up the circumstances to allow Small Intestinal Bacterial Overgrowth to occur. But, that doesn’t mean you cannot figure out the cause for your individual case. The very best solution to find your answer is to talk to your doctor and go over your entire health history, and lifetime history to know what kinds of diseases, traumas, inflammations, risks, and stresses your body has experienced over your lifetime. Then, with this information run additional testing so you have scientific results.
We all know spending three or four hours with our doctors is virtually impossible. So here are a few more in-depth ideas to help you think through what some causes of your SIBO might be.
- Make a list compiling your health history.
- Gather a list of all of your current symptoms. Include things that do not seem SIBO related but are not what someone who is “healthy” or “normal” would experience.
- Take some time to think about what was going on in your life when you started experiencing digestive symptoms. Add these thoughts to your lists.
- Take notes on your microbiome. Were you born vaginally or via c-section. How many antibiotics have you had over the course of your life? What medications have you had that may have altered your gut bacteria? Have you taken proton pump inhibitors (ant-acids).
- Write about what stresses you have had in your past and have in your life currently.
Next, with your lists in hand, read through the following information and see if there is something that sticks out to you. Known that this list is not even close to being comprehensive so if you don’t find what you need here, take your notes to your doctor (you’ve just saved yourself an entire appointment with your notes). Some doctors will let you email or drops off information ahead of time so they have a week or two to review your notes before seeing you. Four doctors have done this for me and each time the doctor has done additional research that they brought to our appointment that provided the next treatment options leading to success.
Underlying Causes of SIBO
Most of the time, SIBO is the result of another issue. The following are some known causes of SIBO and known contributing factors to SIBO.
Additional Infections and Imbalances
A healthy and diverse microbiome prevents the infiltration of bad bacteria, unwanted parasites, and harmful yeasts. Anytime the microbiome is disrupted, diminished, or prevented the body is at risk for infection and imbalance.
Studies show those who live in urban and industrialized societies often have less diverse microbiomes as food and the environment is sterilized. Cesarian Section births and antibiotics will prevent the growth of diversity in the human microbiome. Imbalances like parasites, yeasts or fungi, archea, or other bacterial infections often develop before SIBO and result in inflammation, pH imbalance, brain-gut disturbances, or even adhesions. These disturbances can set the stage for allowing SIBO to occur. Infections are often easy to determine with stool sample testing.
If you have SIBO, a stool test is a great way to know what other microbes might be playing a part in your overgrowth.
Motility Issues
The Vagus Nerve and The Migrating Motor Complex
The vagus nerve is the main digestive nerve and begins at the base of the brain in the back of the throat, traveling down into the chest and abdomen where it breaks off at each organ. The vagus nerve connects the function of the brain with the function of the body. When the vagus nerve is not working properly then the brain cannot talk to the digestive system.
When the brain does not talk to the digestive system, the body does not know when to digest food. This means biles and acids are not released when food is consumed and food and bacteria are not broken down, killed, or moved through the small intestine to the colon effectively. When the vagus nerve does not work properly, the Migrating Motor Complex often does not work properly either.
The Migrating Motor Complex (MMC) is the system that dislodges food and biota from the lining of the intestines. The Migrating Motor Complex sweeps through the small intestine cleaning and ridding it of anything left over and pushes down residual bacteria and food particles into the colon. When the Migrating Motor Complex does not work, bacteria can sit in the small intestine for long periods of time and cause an overgrowth leading to SIBO.
Both the vagus nerve and the MMC have easy, free, and proven ways for support. Aggressively gargling water, stimulating the gag reflex with a tongue depressor and singing loudly can trigger the vagus nerve and help retrain its function. Simply waiting 3-4 hours between meals allows time for the MMC to kick in. If more is necessary, additional supplements and medications are known to help with the MMC and are often prescribed as part of SIBO treatment.
Head Injuries
While not as common, head injuries can effect the function of the Vagus Nerve and the Migrating Motor Complex, preventing normal digestion and creating an environment conducive for SIBO. Head injuries should be taken seriously, and any head injury/SIBO combination should include retraining the vagus nerve and MMC support.
Structural Disorders
Structural Disorders like adhesions, malformations, cancers or tumors, and birth defects all can affect the ability of the body to move food through the small intestine properly.
Adhesions
Adhesions are scar tissues formed inside the body. Adhesions are a way the body helps to heal itself. For example, if you got punched in the stomach or hit with a baseball or softball in the abdomen and the impact created a small internal tear, the body would create an adhesion to protect that tear and allow it to heal. Adhesions are one of the body’s first response to contain an injury. This means adhesions are VERY easy to get. Endometriosis, tripping and falling, riding a horse, playing a contact sport, abusive relationships, car accidents (even minor), surgeries, and even chronic inflammation can all cause adhesions.
But, adhesions are not limited to physical force. Chronic infections, parasite infections, even a small, undiagnosed infection in other digestive organs could cause adhesions.
Adhesions are very, very strong. According to Larry Wurn at Clear Passage, adhesions can be as strong as 2,000 pounds per square inch. The main problem with adhesions is that they do not go away on their own after the initial problem has healed. Adhesions often never cause problems. But if they form in or around the digestive system, they can trap food, infection, or SIBO bacteria in the small intestine.
Symptoms and lifetime history of events are the best way to determine if you have adhesions. Adhesions do not show up on scans like MRI’s or CT scans unless they are extremely thick as they are similar to fascia and are made of collagen.
Adhesions can be removed with surgeries- although surgeries will cause additional adhesions, as well as with manual therapies like Wurn Therapy with Clear Passage.
Some ways to know if you have adhesions might be if you had surgery (even a Cesarean Section), your SIBO returns within days of treatment, you have had clear trauma to your gut, or chronic inflammation in your gut, or if you experience tightness in your abdomen that prevent general, normal movement.
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 contribute to SIBO or prevent treatments from working effectively if left unresolved. All of these can be tested. While colonoscopies aren’t necessary for most SIBO cases if you have other symptoms this test may be beneficial. Basic blood testing can show other issues that could be better supported during treatments. And, while not common for most SIBO cases, there are cancers in the digestive system that lead to SIBO. Doctors do see it, and I do hear about it at every SIBO conference I attend.
Not Digesting Food Well
Stress
Stress is one of the biggest underlying causes of SIBO. When the human body experiences stress, it tells itself to stop digesting food and send all of its energy to the hands, feet, legs, and arms. This is a great thing. We are designed to be able to fight and flee from dangerous situations in order to protect ourselves. Once we are safe and the stress is removed, normal digestive function returns.
In our modern world of go, go, go, and stress, stress, stress our bodies are often in a constant state of chronic stress and our digestive system doesn’t know what to do, or our bodies don’t know how to process food.
If you experience symptoms almost instantly when you eat, this might be a good indicator that your body isn’t digesting food when it reaches your stomach. Ways to combat this include creating a calm environment to settle into before you eat and while you eat. Turn off the T.V and devices, play soothing music, eat outside in a calm and quiet environment, discuss safe, relaxing topics with your family at dinner (reserve those financial conversations and difficult topics with your children for a later time). Additionally, taking 5 minutes to calm your body prior to eating can help dramatically. Quiet meditation and envisioning your body digesting food or focusing on your favorite quote or scripture can calm your body into digesting food well.
Low Hydrochloric Acid
Insufficient stomach acid or low hydrochloric acid can lead to all sorts of issues. From not breaking down food properly, not killing bacteria and fungi, to allowing parasites to move through the digestive tract, insufficient stomach acid causes a lot of problems. Sometimes, the body just doesn’t make enough and sometimes we take over the counter drugs to decrease stomach acid because it is a common misconception to calm the stomach during stress.
Low stomach acid is fairly easy to determine by testing. Taking supplements or drinking a small amount of apple cider vinegar in water with a meal can help with this.
Food Allergies and Inflammation
While food allergies may not cause SIBO directly, food allergies cause irritation and chronic inflammation to the lining of the intestines. Chronic inflammation leads to adhesions which can lead to SIBO. If you suspect food allergies or intolerances please get tested. Accurate information about allergies and inflammation could increase the speed of your healing.
Food Poisoning
Food poisoning tends to be a hot topic with SIBO. Does it lead to SIBO or not? Doctors and researchers seem to have differing opinions on this one. But the research is saying that food poisoning can trigger an immune system response that leads to IBS-D (Irritable Bowl Syndrome Diarrhea), which is often hand in hand with and an indicator of SIBO. We also know that major disruptions in the stomach and intestines can lead to SIBO and food poisoning is one of those.
Summary
Additional infections, imbalances, motility issues, structural disorders, not digesting food well, allergies, inflammation and food poisoning are all risk factors for SIBO but there are many more contributors that can set the stage for Small Intestine Bacterial Overgrowth. This post is just a start to help you begin another conversation with your doctor. I hope these examples provide good ideas to help get you along a faster path to healing. Remember to always talk to your doctor before starting or implementing any changes. And nothing on Journey Through SIBO should ever replace the advice of a doctor!
And remember! Collect your lists of symptoms and histories and get them to your doctor for customized guidance!
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