Today I am going to talk about small intestinal bacterial overgrowth, also called SIBO for short. And so I’ll just cover some main points first; what is it, what causes …
Hi, this is Dr. Alison Egeland, Attune Functional
Medicine.
Today I am going to talk about small intestinal
bacterial overgrowth, also called SIBO for
short.
And so I'll just cover some main points first;
what is it, what causes it, how do you know
if you have SIBO and finally, how do you treat
it.
And so first, as the name suggests, it's due
to an overgrowth of bacteria located in the
small intestine and typically we want the
majority of our bacteria to be in the large
intestine.
So when we have too much in the small intestine,
as we eat specific carbohydrates the bacteria
will actually ferment those carbohydrates.
And this produces a lot of gas, which can
make us very uncomfortable, can produce symptoms
of bloating, sometimes constipation or diarrhea,
stomach cramping and then also sometimes GERD
or reflux.
And so if some of these symptoms sound familiar
or if you've been diagnosed with IBS, it's
actually really important to get tested for
SIBO.
It's estimated that up to 80% of cases of
IBS are actually due to small intestinal bacterial
overgrowth.
You're probably wondering what causes SIBO
and the short answer is, anything that decreases
motility.
And so motility it's the peristaltic waves
that push or move food through the digestive
tract.
And so when that's not working properly, it
can set us up for an overgrowth of the bacteria
in the small intestine.
There is actually a number of things that
can lead to the slow motility.
First, is if we have poor digestion or if
we're taking medications that block acid.
Second, hypothyroidism it slows our overall
metabolism, but one of those effects is also
slowing of the gastrointestinal motility.
Still other conditions are things that can
lead to adhesions like previous abdominal
surgery, endometriosis, inflammatory bowel
disease.
There are other medications, such as; opioid
medications, they can slow the motility.
And then also food poisoning believe it or
not.
The toxins that are produced from food poisoning
can actually damage the cells that line our
intestine and set us up for decreased motility
because of the damage.
It's actually called post-infectious SIBO,
sometimes also post-infectious IBS.
And so next, how do you know if you have SIBO?
The best way we have of testing right now
is a breath test that looks at both hydrogen
and methane.
It's very important to know what gasses are
being produced, because it helps determine
the optimal treatment.
And finally, how do you treat SIBO?
First, we always want to address the underlying
factors.
We might need to investigate for conditions
like; hypothyroidism or inflammatory bowel
disease.
We need to address those things as much as
possible first.
Then, we want to focus on decreasing the bacterial
load in the small intestine.
We can do that through antibiotic treatments
or botanical or herbal treatments.
There is actually a really great study showing
herbal treatments can be even more effective
than the antibiotic therapy.
So the next really important piece of treatment
is to address the motility issue.
There are a number of different prescriptions
and supplements that can support this, but
also lifestyle factors are very important.
And one of the most important lifestyle factors
is to avoid eating for about four to five
hours between meals.
That means no snacking.
When our body is in the state of fasting or
no food for four to five hours, that encourages
something called the migrating motor complex.
That's essentially again those peristaltic
or those waves through the small intestine
that help push through any residual food or
bacteria.
It really just helps keep things moving through.
And the final helpful piece of treatment is
to address the diet.
A lot of people do find it helpful to decrease
the fermentable carbohydrates in their diet.
There are a couple of options for this; there
is something called the low FODMAP diet, there
is also the Specific Carbohydrate Diet.
And then a really great resource for this
is actually Dr. Allison Siebecker.
She has a website called siboinfo.com and
she likes to use a combination of the SCD
with the low FODMAP diet and gets really good
results with that.
So try what works best for you.
And then finally just to recap, if you suspect
that SIBO can be causing your digestive symptoms,
I do encourage you to get tested. Do the
breath test that looks at both hydrogen and
methane because it's really important for
guiding treatment.
You also want to look for and address any
potential underlying causes for SIBO.
You want to decrease the bacteria with either
antibiotics or herbal medicine.
You definitely want to support good digestion
and motility.
And then consider following one of the recommended
diets.
I hope you found this helpful.
Feel free to contact us with any questions
or leave comments below.
Have a wonderful day!

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