SIBO Explained

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Dr. Whitney Baxter

SIBO is the accumulation of bacteria in the small intestine. There should be little to no bacteria present in this section of your digestive tract. With the help of stomach acid and digestive enzymes, this section of the digestive tract is where food is broken down and nutrients are absorbed.

In the case of SIBO, the food you eat is fermented by the bacteria, creating gas in the process and some or all of the following symptoms:

  • Gas and bloating — including increased belching &/or flatulence

  • Constipation, diarrhea or both (IBS)

  • Pain and cramping

  • Fatigue or brain fog

  • Anxiety and other mood disturbances

  • Joint pain

  • Nutrient deficiencies causing fatigue, anxiety, brain fog, low weight or anemia (from poor absorption of B12, iron or ferritin)

These symptoms may have other causes. A thorough medical history and diagnostic testing by a naturopathic doctor will uncover the root cause & guide treatment.

What Causes SIBO?

SIBO is not the problem,
SIBO is the result of an underlying issue with the digestive process.

The most common risk factors and underlying causes of SIBO:

  • Disruption of the normal protective functions that would otherwise kill the bacteria

    • Low HCL/ stomach acid production

    • Immune system dysfunction

    • Ileocecal valve dysfunction (the valve between the small and large intestine)

    • Decreased digestive enzyme and/or bile acids (normally released into the small intestine to breakdown proteins, carbohydrates and fats for absorption)

  • Disruption of the normal cleansing function of the digestive tract (aka the MMC, explained more below)

  • Structural adhesions from surgery or an underlying medical condition

  • Food poisoning

  • OTHER: depending on your medical history, there may be other underlying causes not discussed here

The Intestine Sweep!

A ‘sweep’ occurs in the digestive tract that is crucial to cleanse away any lingering bacteria or microbes into the colon (where your microbiome exists).

This is known as the migrating motor complex (MMC)

What you need to know about the MMC

  • It ONLY occurs during fasting — it begins 90 minutes after eating and 3-4 times during sleep

  • It is INHIBITED with eating — if you graze a lot during the day, this cleansing sweep is not happening

There are other things that can impact the normal functioning of the MMC that include structural and neurological causes. Your medical history will uncover these potential causes and can be discussed during your consultation.

Do Fruits & Veggies Make You Bloated?

This may be a sign of SIBO…

FODMAPS

AKA Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols (hence the acronym!!)

These foods are short chain carbohydrates that are fuel for bacteria. If you have an overgrowth of bacteria in the wrong location, aka SIBO, then these foods will feed the bacteria and create the symptoms listed above.

Here’s a checklist! Track your symptoms 1-3 hours after ingestion of the following (*not an exhaustive list):

  • Onions & shallots

  • Garlic

  • Kombucha (and other fermented foods)

  • Dairy

  • Alcohol (especially beer)

  • Beans (baked, snap peas, red kidney beans, lima and haricot beans)

  • High fructose-containing fruit: avocado, apricots, banana, cherries, grapefruit, peaches (& more)

  • Grains/wheats and other cereals

Avoiding FODMAPs is NOT the long term goal. It is a temporary solution to find relief. Instead, the goal is to heal the gut and kill the excess bacteria so you can eat these foods symptom-free.

SIBO Diagnosis & Treatment

TESTING

Testing is easy, you can do it from home and have the results back within 2 weeks. The gas produced by the microbes in the gut will be absorbed and released by your lungs. This is measured by a breath test.

TREATMENT

The basic principles of treatment involve killing off the bacteria, re-igniting that intestinal sweep/ the MMC (read above!) and supporting normal digestion to prevent re-growth. Once this phase is complete, the focus shifts to supporting regular digestive system function, including regulating the MMC, and slowly re-introducing foods.

FOR MORE INFORMATION, SPEAK WITH YOUR NATUROPATHIC DOCTOR

OR BOOK IN FOR A COMPLEMENTARY CALL WITH DR. BAXTER (BC RESIDENTS)