Small intestinal bacterial overgrowth or SIBO, as it’s commonly known, is a situation in which there are too many bacteria in the small intestine. This results in several digestive symptoms.
It’s only recently that SIBO has gained exposure as an important contributor and potential cause of digestive conditions like irritable bowel syndrome (IBS).
In a healthy gut fermentation should really only begin once food reaches the local gut bacteria in our large intestine. This is a vital process that helps transform partially digested food waste into healthy gut-promoting nutrients. These feed and maintain the cells in our gut.
SIBO on the other hand results when bacteria from the large intestine don’t stay in the large intestine. Instead, migration of colon bacteria up to the small intestine results in fermentation happening sooner.
This can then lead to excessive gas production. This causes stretch on the gut walls. Think of it like a balloon blowing up in our belly… yeah, it’s a distressing feeling some of us are all too familiar with!
– Bloating
– Excessive and foul-smelling gas
– Diarrhea
– Abdominal pain
– Nausea
– Heartburn
– Constipation
– Nutrient deficiencies (B12, iron)
– Fatigue
– Brain fog
Setting the stage for SIBO
The digestive tract has its own self-cleaning service that operates throughout the day and night to “sweep” debris and bacteria along so that things don’t stagnate. This system is known as the migrating motor complex (MMC) and when it gets damaged (see below) it loses the ability to clear the small intestine of bacteria.
“I commonly hear patients say: I’ve never felt well since…”
How Does SIBO Develop?
Gut infections – Traveller’s diarrhea, food poisoning, the flu, doesn’t matter – all gut infections are disruptive to the normal environment in the gut and can cause damage to the MMC resulting in SIBO.
I commonly hear patients say: “I’ve never felt well since that gut infection”
Protect yourself from travellers diarrhea
Ileo-cecal valve dysfunction – this valve connects the small to the large intestine and is the physical barrier that prevents bacteria from the large intestine in migrating and setting up shop in the small intestine, effectively preventing SIBO from ever occurring. When it becomes damaged or dysfunctional such as in Crohn’s disease the physical barrier fails and SIBO can occur.
Low stomach acid – having adequate stomach acid is crucial in preventing SIBO as it can directly kill bacteria so it never reaches the small intestine. Equally important is that stomach acid helps breaks down food, limiting excessive fermentation in the small intestine.
Heartburn medication – especially Proton pump inhibitors use (think Nexium and Prevacid) as these are really good at lowering stomach acid! Chronic use has been associated with SIBO.
Concerned about the dangers of prescription antacids?
Abdominal surgeries – even an appendectomy – can cause scar tissue or adhesions that alter the mechanics of the digestive tract.
Diabetes – nerve damage from diabetes doesn’t just affect the fingers and toes. One of the most vulnerable areas for nerve damage occurs in the gut! This digestive neuropathy also affects the function of the MMC.
Stress – well… because chronic stress makes everything worse!
Learn how stress affects digestion
SIBO & IBS: How common is it?
Well studies say that anywhere from 25-40% of people who suffer with IBS diarrhea have SIBO. That’s a significant amount considering that roughly 15% of North America suffers from IBS!
Is it really just IBS or is there something else going on?
Other known conditions associated with SIBO include:
- Scleroderma – an autoimmune connective tissue disorder that often affects the skin, digestive tract and lungs
- Rosacea – a rosy skin condition that can affect the entire face but most commonly the cheeks and the nose
- Crohn’s disease – an inflammatory bowel disease which often affects the ileo-cecal valve – an open invitation to SIBO!
- Atrophic gastritis – this condition results in the inability to secrete hydrochloric acid which keeps the bugs at bay
- Restless legs syndrome – you know, that uncontrollable urge to move your legs at night?? For more info on this connection check out the article I wrote for NDNR here
SIBO is 9x more common in this condition
So how do you find out if you have SIBO?
The answer lies in your breath!
While your gastroenterologist can stick a scope down your throat that can sample bacteria, a breath test is a much less invasive way to test for SIBO.
You start by ingesting one of two sugar molecules and then you wait over specified time points to breathe into a bag to measure the amount of gases in your breath.
This breath test measures the hydrogen and methane that are produced when you ingest these test sugars. A significant rise in either of these gasses after ingestion can identify SIBO with good precision.
Check out my article on SIBO Testing
“But testing is expensive”
Self-treating or trying things that don’t work over and over again is expensive!
Testing allows us to narrow down the potential causes of your digestive, skin or autoimmune symptoms and to focus your treatments – saving you time and money in the process!
Most importantly though, with proper testing and treatment we can start to take back your health, decrease the amount of bloat, and reduce your need to map out every toilet within a 5 kilometer radius!
Curious to see if you have SIBO? Let’s chat.
Click here to book an appointment.
To be notified of new blog posts, fill out and submit the form below
[wpforms id=”13663″]