09 Jul Are You Concerned About Digestive Health?
Are you worried about your digestive health? Learn about the symptoms and risk factors of small intestine bacterial overgrowth (SIBO), a treatable condition that has been seeing a growing number of diagnoses.
Digestive issues are a common complaint in today’s fast-paced society. Many of us want to eat better but just can’t find the time, and meanwhile stress caused by our day-to-day lives can take a further toll on our physical health.
You might blame digestive issues like gas, bloating, diarrhea, abdominal pain and even irritable bowel syndrome (IBS) on these stressors, but they could be underlining a more serious health concern: small intestine bacterial overgrowth (SIBO).
SIBO is a relatively new diagnosis, although it is not a new problem. Some studies estimate that 40 percent to 60 percent of people with IBS actually have SIBO when tested for it.
In addition to the most obvious symptoms listed above, other symptoms can include:
- Constipation
- Flatulence
- Abdominal pain
- Dyspepsia
- Malabsorption
- Weight loss
- Malnutrition
- Anemia (usually low B-12)
Many symptoms previously diagnosed as IBS are now being linked to SIBO, which is significant because IBS affects as much as 15 percent of the population and is one of the highest causes of missed work due to illness. However, IBS can be managed but is rarely cured, while SIBO can be cured.
What is SIBO?
Our intestine is normally full of bacteria, but it congregates in much larger quantities in the large intestine compared with the small intestine. With SIBO, the small intestine often has more of the bacteria normally seen only in the large intestine.
That part of the intestine simply isn’t able to support such a large number of bacteria. The overgrowth of bacteria diminishes the small intestine’s ability to do its job properly, making it harder for your body to digest food and absorb nutrients. Over time, that can lead to more long-term symptoms including leaky gut, food allergies, autoimmune diseases or skin disorders.
Diverse Risk Factors
When determining whether you might have SIBO, I will note not only your symptoms, but also risk factors that are common causes of SIBO. Those include:
- History of intestinal infections such as food poisoning, especially at a higher rate.
- History of abdominal surgery
- Diabetes, which can disrupt the nerves and affect your intestinal functions
- Anatomical issues (some people might simply be more prone to SIBO because of the way their anatomy is aligned, or if the valves between the large and small intestine are more prone to leaking bacteria between the two organs)
- Motor neuron problems
- Diverticula
- Celiac disease
- Chronic pancreatitis
- Intestinal fistula
- Hypochlorhydria
- Ehlers-Danlos syndrome
If your symptoms and risk factors signal that you might have SIBO, we may order a lactulose breath test to help determine your diagnosis or we can proceed with formulating a treatment plan consisting of herbal anti-microbials to see if you improve.
Diet is Key
Diet is often a part of the treatment, as some foods are more likely to inflame the small intestine, while others can help it heal faster.
You don’t heal by just eliminating foods, you heal with good nutrition. I often encourages SIBO patients to increase their intake of omega-3 fatty acids, zinc, vitamin A-rich foods, glutamine-rich foods and supplements and bone broth, while also decreasing foods that are high in what are known as FODMAPS, which stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols.
FODMAPS are components of plant-based foods that are digested by bacteria. If you have an overgrowth of bacteria in the small intestine, they are going to get really energized by those plant components and that is where the digestive symptoms come from.
FODMAPS in general are difficult for your to body digest, but if you decrease your intake of these foods and your digestive issues decrease, it could be an indicator that you have SIBO. Some common examples of FODMAPS include:
- Avocadoes
- Onions
- Garlic
- Asparagus
- Apples
- Cherries
- Watermelon
- Legumes
- Milk because of lactose (cheese is not as much of a problem because the lactose gets broken down in the aging process)
Dietary changes are almost always necessary and are a very important part of treatment. In addition to diet, I often prescribe a patient herbs or medications to stimulate motility of the small intestine after eradication of the bacteria is complete.
One of the most common reasons that people develop SIBO is due to poor intestinal motility. This is really the underlying cause of SIBO in most cases and results in bacterial overgrowth. If you do not address the motility issue, you are not treating the underlying cause and the SIBO will likely return.
Treatments your team may recommend, depending on your breath test results, include:
- Many NDs and MDs use antibiotics at low doses so they’re not absorbable, typically for a duration of two weeks, however I have found equal success using herbal medicine.
- Herbs, typically for six to eight weeks.
- A) A liquid-based elemental diet of three “shakes” per day for 14 days. The shakes can be made at home, but you may not eat any other food, solid or otherwise. Or B) A very basic elemental diet for 14 days.
It is important to make sure that the eradication is complete before moving onto the next phases of treatment to prevent SIBO from retuning. This often includes dietary changes and treatments to improve gut motility.
Acupuncture also can help with some of the symptoms of SIBO, such as constipation and abdominal pain.
People with SIBO often have other heath complaints that exacerbate their symptoms such as stress, anxiety and other digestive disorders which acupuncture can address. Acupuncture in conjunction with naturopathic medicine is very helpful, however, acupuncture alone is unlikely to cure SIBO.
Can’t I Just Take A Probiotic?
If you’ve been following the plethora of research behind probiotics, you’d think they could heal anything. However with SIBO the type of probiotic and a person’s constitution is critical to consider as this is one disorder where probiotics may worsen the condition.
With SIBO, you have an overgrowth of pathobionts – the bacteria that are not good. Think of it like you’ve got a bunch of bad bacteria having a party in the gut. Then if you add good bacteria, sometimes they just join the party and make it worse since they’re in the wrong place.
Some people feel better with probiotics, but others will get worse particularly if the wrong type is used.
However, once you’re in recovery mode, I always consider a probiotic – without FOS and only human-strained such as the ProFlora Blend I have compounded as part of my line.
Make an Appointment
If you have some of the symptoms and risk factors of SIBO and would like to make an appointment, please call my reception service at (604) 224-2124.