Small Intestinal Bacterial Overgrowth (SIBO) is a phenonomon that as naturopaths we have been treating for years, but in more recent years the diagnosis of SIBO and it's related digestive conditions like IBS has really been able to bring the science to what we have always spoken about to our clients.
SIBO is just as it suggests, an overgrowth of bacteria in the small intestine that causes digestive symptoms like bloating, diarrhoea, constipation and every symptom that goes in between. SIBO can be a tricky one to diagnose, and many of our patients undergo many years of test, diets, investigations all to be told that 'they are fine'. But experiencing digestive symptoms to the point of pain and impacting the quality of life is far from 'fine' in my opinion.
SIBO is diagnosed with a breathe test, and this gives us information to proceed with treatment. It will give us an idea of gut motility, the levels of the overgrowth and if the SIBO is hydrogen or methane dominant.
Hydrogen Dominant: Commonly associated with diahhroea
Methane Dominant: Usually used to diagnose IBS and most common in people presenting with constipation.
Common symptoms associated with SIBO include:
- Changeable bowel motions
- Food sensitivities
What causes SIBO?
So many factors can contribute to the development of SIBO. Antibiotic use, especially multiple courses in a small period of time, this can have a big bearing on SIBO, as they are stripping bacteria from the gut.
Restricted diets is another one that can contribute, as this will be meaning that only certain areas of the bowel and bacteria are being fed, we need a wide variety of food in our diet to support all of the different strains of bacteria to keep our digestive system balanced.
Poor diet that is low in fibre, high in sugar and saturated fats will be
It is a breathe test that is used to measure any SIBO that may be present. A sugar solution- generally lactulose is consumed after an initial baseline level of breathe being given. And then we measure the levels of hydrogen and methane in your breathe as the solution travels through your digestive tract. When the gasses are produced by any bad bacteria, Hydrogen or methane are absorbed from the digestive tract, and travel to the lungs where they are expelled by the body- this is what we measure in the breathe test.
Your breathe is measured in 20 minute intervals over a course of approx 3 hours. This allows us to get a graph of how the sugar solution (generally lactulose) is being absorbed - or not absorbed by the digestive tract.
If your test comes back with certain values of elevated methane, hydrogen or both, this results in a positive SIBO diagnosis. Each test will be individual so if you do have the test done its so important that you get qualified health practitioner to interpret the results, so that you can make sure you receive the best advice and treatment possible for your specific condition.
How we reduce SIBO:
1. Reduce the fuel that is feeding the SIBO - ie food- we often reduce all fructose
2. Soothe the gut and begin repair
3. Increase good bacteria and reduce bad bacteria
4. Increase motility within the gut and introduce foods back in.
Now this is very very broad and each persons plan will be different. But as a general rule, we want to reduce the overgrowth of bad bacteria, increase good bacteria, heal and repair the gut and increase foods back in to maintain a balanced internal environment. Depending on the person we may need ongoing maintenance for preventing SIBO, and other cases are able to maintain good gut health with dietary intervention long term, without the need for probiotic supplements long term.
If you think you may be interested in chatting to us more about SIBO feel free to get in touch either by email (firstname.lastname@example.org) or make an appointment to see one of our practitioners by clicking HERE
Karah is a degree qualified Naturopath with over 8 years experience in the health profession. She is the owner and director at The Sana Co and has a special clinical interest in digestive health, seeing many patients with IBS, reflux/GORD, bloating and many other digestive conditions.