Big Problems with Small Intestinal Bacteria
SIBO is the acronym for Small Intestinal Bacterial Overgrowth. This is an increasingly common condition when too much bacteria grows in the small intestines. Now, you may be thinking, isn’t all the rage in the health world getting enough bacteria in the intestines? Yes, but which part of the intestine and what types of bacteria are crucial. The majority of the beneficial bacteria in your body should be in your LARGE intestines or colon.
7 Signs It Could Be SIBO
- Diagnosis of Irritable Bowel Syndrome (IBS) or Inflammatory Bowel Disease (IBD)
- Abdominal pain/cramping
- Multiple food intolerances and/or fat malabsorption
- Chronic illness like fibromyalgia, chronic fatigue syndrome and autoimmune diseases
These are not all the symptoms of SIBO but they are the most common. It is also quite often labeled as IBS or IBD, but IBS and IBD can be considered symptoms of SIBO. In other words, the wrong types and amounts of bacteria in the wrong places is often what is causing the symptoms diagnosed as IBS and/or IBD.
Diagnosing and Treating SIBO
Diagnosing SIBO is best done through a lactulose breath test which measures the levels of gases the problem bacteria produce when they are consuming nutrients in the wrong part of the intestines. There are a few different patterns of hydrogen and methane has that show up when SIBO is occuring so it is important to work with an experienced functional medicine practitioner to be sure results are interpreted correctly. Follow up testing is usually done after treating to be sure the issue has been corrected since multiple rounds of treatment are sometimes needed.
While different practitioners will have different ways of treating SIBO, they will all agree on 2 things: 1. SIBO can be stubborn and often needs repeat or ongoing treatment. 2. Diet changes are imperative in adequately treating SIBO. In general, SIBO needs something to kill the bacteria (antibiotics or antimicrobial herbals), diet changes to restrict/change the bacteria’s food source, decrease inflammation and heal the gut, and aids to address constipation, diarrhea or gut motility issues. There are a variety of food approaches that are used to support the treatment of SIBO and some people benefit from complete bowel rest in the form of an elemental diet. For most people, following a low carbohydrate, very low sugar and low FODMAP diet is enough during treatment and then a transition back into a Plant Dominant Paleo eating plan works well.
Some advocate for not restricting carbohydrates during SIBO treatment in order to keep the bacteria active and thriving so the antibiotics/antimicrobials can kill the most bacteria possible. This is a newer approach to the SIBO and is thought to aid in fewer repeat treatments for SIBO. Regardless of approach, carbohydrate levels do not need to be severely low to treat SIBO. If you suffer from any of the symptoms listed above, don’t wait to get tested for SIBO!