SIBO is one of those sneaky culprits that can cause various health issues.  As a wide variety of GI and non-GI symptoms, SIBO is also extremely common in those who suffer from IBS. And new research now shows that SIBO is the #1 cause of IBS and its related symptoms.

WHAT IS SIBO?

SIBO (Small Intestinal Bacterial Overgrowth) is when you have an overgrowth of bacteria in your small intestine.  With larger amounts of bacteria normally supposed to be present only in your large intestine, this bacterial overgrowth in the small intestine can cause a host of issues.

Bacteria in your intestines are necessary as it helps to aid digestion, but when they're in the wrong place (like your small intestine), they can wreak havoc on your body.

And since the bacteria isn’t meant to be in your small intestine, it can cause issues such as nutrient deficiencies, IBS, leaky gut, and malabsorption.

TYPES OF SIBO

There are 3 different types of SIBO, each determined by the type of gas produced by the overgrowth of bacteria.

1.  Hydrogen-dominant - the most common type of SIBO, it can cause severe bloating, gas, diarrhea, and abdominal pain/discomfort
2. Methane-dominant - this type of SIBO presents primarily with constipation and weight gain and is the second most common type
3. Hydrogen Sulfide-dominant - harder to detect, it often presents with foul-smelling gas (smells like rotten eggs) and diarrhea; it is caused by high amounts of hydrogen sulfide due to the bacterial overgrowth

You can also have Mixed (Methane/Hydrogen SIBO combined), which occurs when bacteria that cause both gasses are produced and elevated.

NOTE: If you have SIBO, you may also have SIFO (Small Intestinal Fungal Overgrowth) caused by high numbers of fungi in the small intestine.

SYMPTOMS OF SIBO

SIBO can cause various symptoms, which are often unexplained and recurring.  Persistent bloating is a major red flag and the most common symptom for clients. Other symptoms of SIBO include:

● Gas
● Nausea
● Cramping
● Pain
● Constipation
● Diarrhea
● Poor digestion
● Malabsorption
● Brain fog
● Fatigue
● Skin conditions
● Thyroid imbalances, including Hashimoto's
● Leaky gut
● Autoimmune diseases (including multiple sclerosis, Lupus, etc.)

WHAT CAUSES SIBO?

Numerous factors can cause SIBO. Common causes include, but are not limited to, food poisoning (particularly Salmonella), staph bacteria, overuse of antibiotics, slow gut motility (often due to chronic constipation or underlying condition including celiac disease), stress, digestive enzyme deficiency, stomach acid deficiency and diets high in carbohydrates.

COMMON TESTS

As bacteria ferment carbohydrates, it releases either hydrogen or methane gas. Breath testing is done after consuming a mixture of glucose and water and measuring the amount and type of gas produced.

Breath testing is the only test currently available for SIBO.  However, it cannot determine if you have hydrogen sulfide SIBO or SIFO.

HOW FUNCTIONAL MEDICINE CAN HELP

Because of the potential to cause very serious health issues, it is important to treat SIBO as soon as possible. Here at the Heartland Natural Clinic, there is no blanket approach, and each individual’s plan depends on their unique symptoms and underlying causes.

Knowing the type of SIBO you have is imperative to understand what kind of treatment can help. But note that SIBO can be stubborn, and repeated treatments may be needed.

Since the bacteria in your small intestine are fed by carbs (which break down into sugars and are then fermented, causing bloating, gas, and abdominal discomfort), a low FODMAP diet is suggested to most clients who have SIBO.

In terms of any suggested herbal medicine, we try to attack SIBO in 2 phases:

● Phase 1 - aimed to clear bacterial overgrowth, we commonly suggest herbal medicines such as Berberine, Allicin (garlic extract), Oregano, and Neem seed oil. In addition, we may suggest an antifungal, depending on the type of SIBO you have. This is in conjunction with any antibiotics your physician might prescribe and is adjusted as needed
● Phase 2 - we call this the repair phase, where the goal is to support the body’s healing process. We often use herbal medicines, including N-acetylGlucosamine, Zinc, Probiotics, Licorice root, and Marshmallow root

If you think you or a family member may be suffering from SIBO, feel free to contact me directly at This email address is being protected from spambots. You need JavaScript enabled to view it. or 905-361-0149 and ask for Azadeh.

Feel free also to check out my other blogs here.

*This article is for informational purposes only

REFERENCES:
1. Small Intestinal Bacterial Overgrowth: Comprehensive Review of Diagnosis, Prevention, and Treatment Methods

2.  Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management

3.  Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy