SIBO (Small Intestinal Bacterial Overgrowth)
What is SIBO?
If you happen to google anything about gastrointestinal symptoms or tummy aches and bloating, you may have come across the term “SIBO” on numerous websites. The term “small intestinal bacterial overgrowth” or SIBO means that the small intestine has an abnormal buildup of bacteria that for some reason migrated from the colon (large intestine) to the small intestine. The bacteria can be a part of normal flora (such as Lactobacillus or Bifidobacteria – commonly present in most types of probiotic supplements) or it could be a pathogenic type of bacteria. That is one of the reasons that some of my patients do not feel well when starting a probiotic supplement. Unfortunately, the diagnosis is difficult and only a few gastrointestinal doctors or primary care doctors utilize SIBO tests in their practice.
There are several ways to diagnose SIBO, but the easiest and the least invasive one is the breath test through one of the functional medicine laboratories. The test requires a 1-2 day preparation diet consisting of lean meat, fish, eggs, some jasmine rice and avoiding any sources of fiber and sugar (no fresh or cooked vegetables, fruits, etc.) There are some other conditions that would help to ensure the accuracy of the results and to avoid false positive and false negative results.
Symptoms of SIBO
- GERD (acid reflux)
- Joint pain
- Malabsorption of fats, vitamins, and nutrients
- Weight loss/gain
- Brain fog
- Diagnosis of IBS-D or IBS-C or mixed type
- Food Intolerances
- Chronic diseases (diabetes, fibromyalgia, chronic fatigue syndrome)
Causes of SIBO
- Scarring (can be caused by Crohn’s disease)
- Pelvic adhesions (due to major abdominal surgery, such as Cesarean section)
- Damage to the nerves and/or muscles of GI tract
- Food poisoning or Enteroviral acute illness (norovirus, rotavirus, Hand-Foot-Mouth Disease)
- Underlying conditions (for example, slow thyroid function – causing constipation and stagnation)
- Low stomach acid and long-term use of PPIs, such as omeprazole.
There are a number of other causes that can express as SIBO. Every patient has to be treated individually to find the root cause of SIBO.
SIBO diagnosis may involve 2-3 functional lab tests. The three tests I use most commonly in my practice are:
SIBO breath test is done at home with 1-2 days of simple diet rules and shows what kind of bacteria is present in the small intestine. The treatment will differ depending on the results of the gases obtained in this test.
Organix Dysbiosis Urinary Test helps to identify if there is yeast or bacterial (or both) overgrowth in the small intestine. This test can be done at home by the patient and requires one urinary sample. It also helps to monitor the progress of the patient treatment (as well as a decrease in patient’s symptoms). Comprehensive Stool Analysis in some cases is beneficial to find out if there are any parasites wreaking havoc in the large intestine.
The treatment depends on the level and types of gases present in SIBO breath test. In general, there are herbal antimicrobial treatments that can be as effective as pharmaceutical antibiotics, but incur fewer side effects. The treatment is decided with every patient individually, depending on the preferences and the outcomes if the patient was treated previously.
Should you need more help with managing the symptoms and finding out the root cause of SIBO, schedule a consultation with Zhanna Tarjeft, FNP Here.