A healthy, diverse gut bacteria is essential for well-being.
But, an excess of this bacterium in the small intestine, also known as SIBO is a serious cause of issues.
This article provides a thorough review of SIBO and the dietary changes that are proven to be beneficial.
What exactly is SIBO?
Small Intestinal Bacterial Overgrowth (SIBO) is an intestinal disorder that is characterized by an overgrowth of 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.
In contrast to that of the large intestine (also called the colon or the gut) which is the largest of your gut flora, the small intestine is not expected to contain a significant amount of bacteria.
SIBO is not common among middle-aged and young adults, however it is believed to be a common occurrence in 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 and intestinal motility.
Therefore, certain health conditions or lifestyle choices could increase the chance to develop SIBO:
Gastrointestinal diseases: For example, infections post-infectious IBS (Irritable Bowel Syndrome)
Antiacids that are used for a long time: The long-term use of antacids (such like omeprazole) decreases the production of acid 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 could suppress our immune system, like AIDS and IgA antibodies – can create the perfect conditions for harmful microbes to flourish.
Celiac illness: Celiac disease can disturb the way food is moved through digestive tract, particularly when it is not diagnosed or poorly controlled. This causes an increase in bacteria growth in the gut.
Aging: Generally speaking, those who are older are at greater risk of SIBO due to the fact that the digestive tract becomes weaker as we age. This could be due to decreased physical exercise, weight gain, continuous medication use, and general weakness of the gastrointestinal tract.
Alcoholism: Long-term alcohol consumption is believed to increase the chances of SIBO.
Gastroparesis: There’s significant overlap between the symptoms, and it appears people suffering from gastroparesis (also called delayed emptying of the gastric) have a higher likelihood to suffer from SIBO.
Many other diseases are associated with an increased SIBO risk, however more research is required. This includes hypothyroidism, the Crohn’s Disease, ulcerative colitis the fibromyalgia syndrome, arthritis, Parkinson’s disease and much more.
Summary: The chance of developing SIBO is increased significantly by many conditions and triggers that are often linked 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 conditions, such as IBS. The most frequently encountered issues are:
Fatigue
Nausea and vomiting
The bloating and diarrhea
Lack of absorption of nutrients, which can lead to deficiency
Insufficiency and weight loss.
Certain people might also experience anxiety and skin issues like acne and eczema.
The severity of symptoms may be different, too.
While some sufferers may experience diarrhea and vitamin deficiencies that are milder Others may suffer from extreme malabsorption of nutrients and poor digestion.
Nutrient Deficiencies
If left untreated for a long time, SIBO can cause several mineral and vitamin deficiencies.
Vitamin B12 deficiencies are among the most frequently occurring deficiencies along with fat-soluble vitamins, such as A, D, E and K.
Mineral deficiencies like calcium, iron and magnesium are also prevalent in SIBO patients.
Summary SIBO manifestations range from digestive distress to severe nutritional deficiency. They’re often identical to IBS.
Diagnosing SIBO: Hydrogen Breath Test
SIBO is a terribly undiagnosed and under-treated condition.
This is because a huge part in our small intestinal tract are not accessible without surgery.
Fortunately, tests that are non-invasive have been created for use, including tests that are non-invasive, such as the Hydrogen Breath Test. This test can also be used to identify the common foods intolerances that cause IBS as well as H. Pylori infection.
First Line of SIBO treatment: Antibiotics
Diet alone won’t rid you of SIBO So you’ll require medicines or herbal supplements (or either) as the first option for 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 are suffering from an infection.
The most common antibiotics used are rifaximin and ciprofloxacin, or metronidazole.
Rifaximin is among the studied antibiotic used to treat SIBO and has a success rate of approximately 50% after one week. Combining rifaximin with another antibiotic, neomycin has been proven to be about 90% efficient after a period of 10 days.
Here’s the recommended therapy as per information from an SIBO symposium held in 2014:
Patients who have a positive smell test for hydrogen: 550 mg of rifaximin 3 times daily during 14 consecutive for 14 days (not not taking the correct doses).
Patients who have positive breath tests for methane: 550 mg of rifaximin three times a day, plus 500 mg of neomycin twice per every day, for 14 days. Alternatively, 550 mg of rifaximin three times a day, along with 250 mg metronidazole, 3 times a every day, for 14 consecutive days.
Treatment with antibiotics should be followed by a prokinetic (which improves the intestinal tract’s mobility) for three months, followed by a second breath test, followed by an affluent FODMAP diet (more on that in the following).
Herbal Antibiotics
Herbal antibiotics are another alternative, with over 50 percent of patients who do not succeed on rifaximin achieving success using herbs for treatment. This particular research, it involved Dysbiocide as well as FC Cidal or Candibactin, Candibactin-AR and Candibactin.
A few people might have to go through multiple rounds of herbal or pharmaceutical antibiotics to stop all growth of bacterial strains.
Remember that herbal antibiotics should be administered in conjunction with 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 do not distinguish between bad and good bacteria They kill 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 temporary “band-aid” treatment and don’t address the root of the issue. That’s why people who are only treated with antibiotics are more likely to suffer relapses and develop SIBO yet again.
In actual fact, a study of antibiotic therapy by itself as opposed to antibiotics and guar-guar Gum supplementation (a fermentable carb) observed that results were increased between 62% and 87% when Guar gum supplementation.
This isn’t logical since it found that the addition of guar guar (which helps to feed the gut microbes) is more helpful than damaging. It’s also in line studies that show that prebiotics as well as probiotics, which are additional bacteria, are beneficial (more about that later).
Thus, antibiotics can be beneficial in the short-term (and frequently necessary) however they are not an all-time solution they are certainly not an end-to-end cure for the entire problem.
Summary: Antibiotics can be useful (and frequently necessary) in the short term for treating SIBO. However, patients who exclusively rely on them are most likely to suffer relapses. They also kill good and bad bacteria, which can be extremely harmful for long-term health.
