A healthy, diverse gut bacteria is essential for well-being.
But, an excess of this bacterium within the small intestine – referred to as SIBO is a serious cause of issues.
This article offers a comprehensive examination of SIBO and the dietary changes that are proven to be beneficial.
What exactly is SIBO?
Small Intestinal Bacterial Overgrowth (SIBO) is a digestive disorder marked by the presence of excessive bacteria that reside in the small intestine.
The bacteria then undergo fermentation (interact to food particles as well as other nutrients) to produce a broad spectrum of symptoms.
Contrary to your large intestine (also called the colon or gut) that is home to the majority of your gut bacteria the small intestine shouldn’t contain a significant amount of bacteria.
SIBO is not common among middle-aged and young adults, however it is believed to be present in about 14% of patients older than on average.
Common Risk Factors for SIBO
Researchers believe that SIBO is caused due to a combination of lower pancreatic enzymes along with bile acids as well as gut motility.
In turn, certain medical conditions or lifestyle choices could increase the chances to develop SIBO:
Gastrointestinal disorders: Examples include the post-infectious IBS (Irritable Bowel Syndrome)
The long-term use of antacids A long-term usage of antacids (such like omeprazole) lowers the amount of acid produced within the stomach. Inconsistently low levels stomach acid can cause an overgrowth of bacterial cells within the stomach as well as the small intestinal.
Immunodeficiency Syndrome: Disorders that can affect our immune system, like AIDS and IgA antibodies – can create the perfect conditions for harmful microbes to flourish.
Celiac disorder: Celiac disease can disturb the way food is moved through intestinal tract, especially when it is not diagnosed or poorly controlled. This causes an increase in bacteria growth in the gut.
Aging is a general term that indicates that older individuals are at a higher risk of SIBO due to the fact that the digestive tract becomes weaker as we age. This could be due to decreased physical activity, weight gain continuous medication use, and general weakness of the gastrointestinal tract.
Alcoholism: Consistent drinking is believed to increase the likelihood of SIBO.
Gastroparesis: There’s significant overlap between the symptoms and people suffering from gastroparesis (also called delayed emptying of the gastric) have a higher likelihood to be suffering from SIBO.
Other conditions are also associated with an increased SIBO risk, however further research is required. They include hypothyroidism and C. r. o. colitis, ulcerative Rheumatoid arthritis, fibromyalgia Parkinson’s disease and much more.
Summary: The chance of developing SIBO is significantly increased due to many conditions and triggers which are usually related to the reduced function and efficiency of the intestines.
SIBO Symptoms
Many SIBO patients have various symptoms and signs.
They often occur in conjunction with other ailments, like IBS. The most frequently encountered issues are:
Fatigue
Nausea and vomiting
The bloating and diarrhea
Inadequate absorption of nutrients which can lead to deficiency
Insufficiency and weight loss.
A few people also suffer from issues with their skin, such as acne and eczema.
The severity of symptoms may vary, as well.
Although some people may suffer from diarrhea and mild vitamin deficiencies Some suffer from massive nutrient malabsorption as well as impaired digestion.
Nutrient Deficiencies
If it is not treated for a few months, SIBO can cause several mineral and vitamin deficiencies.
Vitamin B12 insufficiency can be among the most frequent deficiencies, along with fat-soluble vitamins, such as A, D, E and K.
Mineral deficiencies like magnesium, calcium, and iron are also prevalent in SIBO patients.
Summary SIBO manifestations range from digestive distress to severe nutritional deficiency. They can be identical to IBS.
Diagnosing SIBO: Hydrogen Breath Test
SIBO is a terribly undiagnosed and under-treated condition.
This is due to the fact that a significant part of the small intestines are not accessible without surgery.
Fortunately, tests that are non-invasive have been created to help with this, such as those that use the Hydrogen Breath Test. The same test can be used to identify the common foods intolerances that cause IBS or H. Pylori infections.
The First Line of Treatment: SIBO and Antibiotics
Diet alone won’t rid you of SIBO So you’ll require herbal remedies or antibiotics (or the two) as the first method of treatment.
Conventional treatment for preventing unwanted growth of bacteria is antibiotics.
Antibiotics are made to kill bacteria. That is the reason they are prescribed if you suffer from an infection.
The most common antibiotics used include rifaximin, ciprofloxacin and metronidazole.
Rifaximin is among the studied antibiotic to treat SIBO and has a success rate of approximately 50% after one week. The combination of rifaximin with another antibiotic, neomycin has been found to be 85percent efficient after a period of 10 days.
Here’s the recommended treatment according to the information provided by an SIBO symposium held in 2014:
Patients who test positive for carbon dioxide breath test should take 550 mg of rifaximin 3 times daily over 14 weeks (not not taking the correct doses).
Patients who have positive breath tests for methane: 550 mg of rifaximin three times a day and 500 mg of neomycin twice per each day over 14 days. Alternatively, 550 mg of rifaximin 3 times per day and 250 mg metronidazole, 3 times a each day over 14 days.
SIBO treatment with antibiotics should be followed by a prokinetic (which increases intestinal tract mobility) for 3 months, then a follow-up breath test, followed by following a low FODMAP diet (more about that later).
Herbal Antibiotics
Herbal antibiotics can also be an alternative, with over 50 percent of patients who are unsuccessful with rifaximin report success with herbs for treatment. For this study,, it involved Dysbiocide along with FC Cidal or Candibactin AR and Candibactin BR.
Certain people might need to go through multiple rounds of herbal or prescription antibiotics in order to stop the growth of bacteria.
Be aware that herbal antibiotics should be administered with the guidance of a physician. They may interfere with other medicines.
But don’t depend too heavily on Antibiotics
The issue with antibiotics, either pharmaceutical and herbal remedies is that they don’t distinguish between bad and good bacteria and eliminate all bacteria.
In the long run, prolonged use can lead to severe digestive issues and is linked to many other health issues, including obesity and insulin resistance.
SIBO antibiotics are likewise an indefinite “band-aid” treatment and don’t address the root of the issue. That’s why people who are only being treated with antibiotics are most likely to experience SIBO relapse yet again.
In reality, a research study on antibiotic therapy only as opposed to antibiotics and guar-guar Gum supplementation (a fermentable carb) observed that results were increased between 62% and 87% when addition of guar gum.
This isn’t logical since it found that the addition of guar guar (which provides a source of the gut microbes) is more helpful than damaging. It’s also in line research that shows that prebiotics and probiotics – a type of bacteria that is added – are beneficial (more about that later).
Thus, antibiotics can be helpful in the short term (and frequently necessary) however, they aren’t an all-time solution or even a cure for the entire problem.
Summary: Antibiotics can be useful (and often required) for short-term use for treating SIBO. However, patients who exclusively depend on them are more likely to suffer relapses. They also kill good and bad bacteria, which can be very detrimental to the long-term health.