Sorry to disappoint you but SIBO is an acronym. It doesn’t matter whether you say “Sigh-Bow” or “See-Bow” because it’s not a real word: it’s an abbreviation.
SIBO stands for Small Intestinal Bacterial Overgrowth. Below, we share a ton more about what SIBO is, why SIBO happens, the problems with SIBO, and next steps if you think you have SIBO.
What is SIBO?
Small Intestine Bacterial Overgrowth is an accumulation of bacteria in the small intestine. It is an overgrowth of bacteria that normally lives in the gastrointestinal tract but have abnormally overgrown in a location not meant for so many, or these types of, bacteria.
The human bowel has more bacterial cells than human cells! This is incredible and also normal. Most of these bacteria are in the colon or large intestine. The reason for this is that the colon is the slowest area of transit. The slower the bowel, the easier it is for bacteria to grow and establish because they are able to stay in one place longer. On the other hand, the small intestine should normally have a low number of bacteria. When the GI tract is working properly, the small intestine should have stomach acid, pancreas, and bile juices. Bacteria overgrowth (SIBO) is not technically an infection. SIBO is the situation of having too many bacteria where they shouldn’t be!
Why does SIBO occur?
This is a complicated answer and we are learning more every year with new research. At the moment there are many reasons for SIBO. Anything that reduces gut flow (or increased transit time) will cause SIBO. Causes for this mechanical slowing could be bowel blockages, PPI use (such as omeprazole or any proton pump inhibitor medication), narcotic use, and even stress. However recently, there is a known link between irritable bowel syndrome (IBS) and SIBO. In fact, IBS can be the most common reason for SIBO. In the case of IBS, there is research that food poisoning or gastroenteritis (getting really sick from bad / pathogenic bacteria like Salmonella, E. coli, Campylobacter, Shigella and C. Difficile) leads to this, even if it’s not right away. Food poisoning and associated toxins can cause nerve damage to the small intestine. In part, this causes a reduction in the number of cleaning waves of the small intestine and this leads to bacterial overgrowth. We’re starting to learn just how important the “migrating motor complex” part of our nervous system is!
What’s The Problem with SIBO?
Remember, this problematic bacteria shouldn’t be in the small intestine. This bacteria can interfere with our normal digestion and absorption of food. Worse, it is associated with damage to the intestinal lining or membrane of the small intestine (also known as leaky gut syndrome).
Because of this, the following issues can occur:
- The bacteria consume some of our food which over time can lead to deficiencies in our nutrients, especially iron and B12, which can cause anemia or chronic low ferritin. This is a VERY common reason people are tired!
- The bacteria cause damage to the intestinal wall / small intestinal lining, causing leaky gut syndrome, which further worsens our ability to absorb food and continues the overgrowth.
- Because of the resulting leaky gut or damaged intestinal lining, larger food particles not able to be fully digested, can enter into the body which the immune system can react to. This can cause food allergies/ sensitivities.
- After eating our food, the bacteria produce gas within our small intestine. This gas causes abdominal bloating, abdominal pain, constipation, diarrhea or both (the symptoms of IBS). This excess gas also causes belching and flatulence (AKA unwanted burping and farting).
- The bacteria decrease proper fat absorption by deconjugating bile, which can lead to deficiencies of fat soluble vitamins like vitamin A and vitamin D
- The bacteria themselves can also enter the bloodstream through the gut. The immune system reaction to this bacteria and their endotoxin can cause chronic fatigue and body pain while also adding burden to the liver.
What to do if you think you have SIBO
First of all, remember the body is incredible and intelligent, it’s already working hard to combat this overgrowth if you have it. Second of all, we recommend you see a provider who is informed and has experience treating SIBO. At Virasoap Natural Medicine, we can test directly for SIBO by using a breath test. Once we have results back from this test, we can see what types of bacteria are present and how significant the problem is. Different bacteria are treated with different antimicrobial agents, so it’s important to be as targeted as possible.
What about the low FODMAP diet?
Yes, there is great data about using this diet to treat and eradicate SIBO. However, timing is key. There are specific times in a SIBO treatment protocol to implement using the low FODMAP diet, and an informed provider can help guide you through this ideal timing. You also don’t want to be on the low FODMAP diet too long as it is quite restrictive and time consuming. Ideally, we want to use it as a treatment option in combination with other antimicrobial agents for a short period of time only.