Small Intestinal Bacterial Overgrowth (SIBO) can be a frustrating and relentless experience. Having suffered from SIBO myself, it can often feel as though your list of food options get more and restricted and that there is nothing that can really improve the condition. In the article below I provide an overview of SIBO and a few tips for starting the recovery process.
Small Intestinal Bacterial Overgrowth is a condition which results in an increase in the amount of bacteria in the small bowel and a change in the types of bacteria. The small intestine should in a healthy state not hold high levels of bacteria and be a place where food should be broken down and absorbed. The result of an overgrowth of bacteria in the small intestine is that food does not move quickly into the large intestine and a result a process of fermentation begins.
Symptoms of SIBO
If you are experiencing most of the symptoms below you may want to ask me about targeting SIBO:
- Extreme gas and bloating with most foods you are eating
- Abdominal pain and discomfort
- Frequent nausea and vomiting
- Nutrient deficiencies
- Constipation or Diarrhoea
Risk Factors for SIBO
The cause of SIBO is not definitive and in most cases the cause is a complex interplay of many factors. What we do know is that SIBO will arise when the motility or movement of contents through the small bowel slows down and when hydrochloric acid production is reduced. Some of the risk factors include:
- Food poisoning
- Traveller’s bugs
- Frequent courses of antibiotics
- Low Hydrochloric acid production
- Coeliac Disease
- Chronic stress
- Type 1 or Type 2 diabetes
- Heavy alcohol consumption
Effects of SIBO
Whilst the physical symptoms of SIBO are unpleasant, the health implications of the condition are also significant. SIBO can result in:
- Damage to the intestinal cell wall with prolonged SIBO resulting in “leaky gut” or permeability of the gut lining.
- Immune reactions including food allergies and food intolerances due to a permeable gut lining which allows food molecules and proteins to cross the intestinal barrier into the blood stream.
- Inflammation and auto-immunity,
- Malnourishment due to reduced absorption of vitamins and minerals. Interestingly the “pathogenic” gut bacteria which proliferate in SIBO will take up many of the B vitamins you are ingesting in particular B12. So if you are already deficient in B vitamins this can make things worse.
- Decreased absorption of protein due to reduced protein breakdown and the consumption of amino acids by pathogenic bacteria.
- Decreased absorption of fats as a result of the effect of SIBO on bile acid production and absorption of fat soluble vitamins including Vitamin A and D.
Antibiotics or anti microbial herbs are most often called for to address SIBO. However, as a first point of call there are few things that you can do to get SIBO symptoms under control before starting on herbs, supplements and/or medications to combat SIBO.
- Diet. Start by eliminating sugars, alcohol, dairy and processed foods in your diet. This is essential to stop the overgrowth of the pathogenic bacteria;
- Fermented Foods – Yes or No? If you are finding you are reacting to fermented foods, then stop them for four to six weeks until your SIBO feels like it is under control and then start to introduce them back into your diet. This goes against many popular gut healing protocols, however in my experience people with severe digestive health issues need to introduce fermented foods very slowly and gently into their diet.
- Improve your digestion. Improve your digestion and break down of food by having a teaspoon or two of apple cider vinegar in a shot of warm water before your meals. Ensure you are sitting down to enjoy your food and chewing your food well. If your digestion is very weak and/or you tend to engulf your plate of food in a few minutes, make sure your food is well cooked or even blended.
- Exercise. Exercising is a great way to increase motility or the contractions of the bowel wall to keep the food moving along. If you are too weak to exercise, then breathing exercises and certain yoga poses are wonderful for improving your bowel movements. Happy Baby Pose and Half Seated Spinal Twist are two good moves. See the below article for more https://yogainternational.com/article/view/5-yoga-poses-for-ibs-irritable-bowel-syndrome
- Take care of excess fibre. While fibre consumption helps maintain our healthy gut bacteria, less is more. Reducing fibre in the diet can be difficult. My advice would be to enjoy plenty of green, leafy, and stalked vegetables as well as nuts, seeds and berries that contain the less fermentable types of fibre.
- Reduce excess stress. I cannot emphasise this enough but reducing stress is one of the most important things you can do to reset your digestive system. Excess stress diverts your body’s resources away from digestion to fight or flight. It also makes it difficult for you to eat the best foods which will nourish your body.
- Supplements. There are many fancy supplements that you can take to address SIBO, everything from probiotics to bio-film ‘disruptors’ and immune boosting factors. However I would highly recommend that you see someone qualified to recommend the most individualised treatment and supplements for you.