Do you have Bowel problems or digestive issues that just won’t go away? Is your lifestyle being restricted because of gas or smelly wind or the need to be near toilets because of constipation or diarrhoea? Is there pain associated with food and after eating?
Do you feel as though you have you tried everything: gluten or lactose free diet, eating well, cutting out this and that, course of antibiotics which may even have worked for a while but then after all that the symptoms returned stronger than ever?
Have you been diagnosed with Crohns, Coeliac, IBS, Autism, Fibromyalgia, Leaky Gut, Restless Legs, Rosaceae, GERD (GORD)?
Well you may have a little known condition called ‘small intestine bacterial overgrowth’ or SIBO. That sounds ghastly and it can be a major problem for you.
What is it?
SIBO is an overgrowth of normal bacteria. But these bacteria have moved up from the normal location in the bowel to now live in the small intestine. The bacteria then cause damage to the microvilli of the gut lining because they eat the glycocalyx, (literally “sugar coat” or network of polysaccharides that project from cellular surfaces) and the membrane lining itself.
That affects the absorption of peptides in food leading to bacterial fermentation and gas production. And this is where life becomes difficult with the socially unacceptable symptoms of wind and gas.
What are the symptoms?
- Lots of wind and gas – belching and farting
- Bloating, stomach distension and pain
- Food allergies and intolerances particularly to gluten
- Malabsorption of fat which shows up as pale, oily, smelly stools
- Impaired mineral absorption particularly Zinc, Calcium, Magnesium which can lead to Osteoporosis and Fibromyalgia – nasty.
What conditions are directly linked to SIBO?
Many seemingly unrelated conditions can be linked to SIBO
- IBS, IBD
- Coeliac disease
- Interstitial Cystitis
- Restless Leg Syndrome – classic symptom
- Acne rosaceae
- GORD (Gastro oesophageal reflux disease)
- Diabetes (common)
- Chronic Prostatitis
What can I do to find out?
There is no perfect test with 100% accuracy But the following often confirm the problem although it does not tell us what bacteria are overgrown and where they are hiding:
Breath tests to assess methane and hydrogen gases – these gases are not produced by humans. Methane is associated with constipation which is often worsened by fibre and hydrogen is associated with diarrhoea.
It is the rise in breath gases of methane and hydrogen over a certain time frame – 90 minutes which is highly indicative of SIBO.
The benefits of testing are to establish a diagnosis to support why patients are having problems and also to establish a baseline against which improvements over time can be measured. Sometimes it is just a comfort to know what is wrong!
Can you treat SIBO?
YES but it takes time – up to 1 year to completely eliminate the bacteria overgrowth from the small intestine and you need to follow a specific protocol:
You are best to work with a trained naturopath or herbalist for support and the right dosages but the good news is that you can be cured.
The Way to Go
STEP 1: REMOVING THE OVERGROWTH
For 2-4 weeks either
- Antibiotics – Rifaximin or Neomycin but specific doses OR
- Herbal antibiotics – Garlic + Goldenseal, Cinnamon, Peppermint oil OR
- Elemental diet of protein (3 meals/day) + coconut oil + 2 T honey
STEP 2: DIET
Up to 1 year
- Specific Carbohydrate Diet (SCD) – based on work of Dr Haas in 1924 and well explained in Elaine Gottschal’s book ‘Breaking the Vicious Cycle’.
- We also use the SCD in our Optimal Digestive Health Wellness Guide as it starves the bacteria slowly but still allows some carbohydrates in the form of vegetables, fruit, nuts, seeds and some beans.
- It is a very structured diet and foods are added over time as the small intestine heals
- 75-84% success rate with die off symptoms within the first week but it does need rigid adherence
- Gut and Psychology Syndrome (GAPS) Diet by Dr Natasha Campbell-McBride is an offshoot of SCD but uses more fermented foods and is recommended for the severely ill.
- Healing Foods by Sandra Ramacher is book filled with recipes based on SCD principles
STEP 3: SUPPLEMENTS
- To heal the brush border of the gut lining – L-glutamine, Colostrum, Zinc, Vitamin A
- To improve digestive function – Betaine Hydrochloride, digestive enzymes
- To improve motility – combination of probiotics (only L. acidopholous and not Bifidus) and fish oil on an empty stomach before bed.
So if you have increasing gut problems but don’t know why, if you have been diagnosed with one of the above conditions, then you might be the perfect example of somebody with SIBO.