Small intestinal bacterial overgrowth (SIBO) is when bacteria dislodge themselves and overgrow in the small intestines. SIBO is not always 'bad' bacteria/pathogens, it can also be good bacteria that have overgrown in the wrong place (the small intestine). This can cause a host of issues including inflammation, nutrient deficiencies (as the bacteria can feed off the nutrients we need such as iron and B12), damage to the intestinal lining (leaky gut) and a number of food allergens/reactivity.
Common symptoms of SIBO include:
Bloating
Flatulence
Nausea
Constipation or diarrhoea
joint pain
Food sensitivities/intolerances
stomach pain
Skin rashes
Fatigue
Respiratory symptoms
Nutrient depletion (particularly B12, Iron, protein)
Fat malabsorption (depending on the type of SIBO present)
IBS symptoms/diagnosis
Negative reaction to fermented and high fibre foods.
Healing SIBO
I. Always test for SIBO first
There are different types of SIBO - methane dominant and hydrogen dominant. A SIBO Breath test is most commonly used. Depending on the SIBO you have can influence your SIBO treatment protocol.
II. Herbal Antimicrobials (can last from 6-12 weeks)
The Herbal antimicrobials used can differ, depending on what SIBO type you have. Common herbs used can include oregano, garlic (allimax), berberine, wormwood, thyme & myrrh.
Bi-phasic diet
I normally use a bi-phasic diet in combination to remove food irritants to reduce inflammation and minimise foods bacteria prefer to feed off, stunting growth.
Motility agents
Depending on the type of SIBO present, motility agents such as bitters may be used to support the production of gastric juices, enzymes and improve digestive motility. This can help move the bacteria along through the digestive tract.
Specific probiotic strains
Specific probiotic strains are also important as they can act as antimicrobial agents and improve SIBO treatment. This commonly includes probiotics such as SB and LGG.
It's important to not eat any fermented foods or other probiotics other than the ones recommended by your practitioner as this can add fuel to the fire and contribute to further overgrowth.
III. Restore a healthy microbiome & heal the intestinal lining
Specific nutrients and herbals may be used to restore a healthy microbiome and intestinal lining. Common nutrients include zinc carnosine, vitamin A, vitamin D, L-glutamine, PHGG, turmeric, quercetin and probiotics/prebiotics.
IV. Address cause of SIBO
SIBO can be caused by a number of conditions and dietary/lifestyle influences including:
Hypothyroidism
Endometriosis (commonly experienced in endometriosis but not specifically a cause)
Low stomach acid (use of PPIs)
Poor diet - high sugar/processed foods, alcohol
Poor gut motility
Chronic stress
GIT infections
Surgery to abdomen
Medications: including PPIs & oral contraceptive pill, antibiotics
Liver dysfunction/toxic burden.
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