Over the last three decades, there has been growing recognition for the role of gut bacterial in the health of the gastrointestinal tract. It has been found that up to 85% of cases of irritable bowel disease may in fact be attributed to an underlying overgrowth of bacteria into the small intestines, called SIBO (small intestinal bacterial overgrowth). It is important to note that this is NOT an infection, but an overpopulation of bacteria in a location not meant for such high concentrations.
Common symptoms include:
- Gas (belching or flatulence)
- Stomach pain
- Diarrhea, constipation, or both
Risk factors for SIBO:
- History of intestinal infections
- History of abdominal surgery
- Celiac disease
- Chronic pancreatitis
The small intestine’s primary role is nutrient absorption, and therefore overgrowth in this area allows the bacteria to rob essential nutrients. Vitamin D, K, iron and B12 deficiencies are popular among these patients. The inflammation produced by the endotoxins of the bacteria are also a potential cause of leaky gut syndrome and the development of multiple food sensitivities. Bacterial imbalance can also change the way hormones are metabolized and excreted, and have been correlated with acne, irregular periods, and other hormonal issues like adrenal fatigue.
It is possible to test for SIBO by performing a lactulose breath test, where a lactulose substance is administered after 24 hours of following a non-fermentable diet. Breath samples are assessed every 20 mins for 3 hours following administration of the substance, and hydrogen/methane gas is measured in each sample. A steep rise or overall elevation of either of these gases indicate that bacteria is fermenting the sugar, and is deemed positive for SIBO.
Treatment with Dr. Bell, ND involves a series of steps to ensure complete resolution of the overgrowth. If the results of the breath test reveal that the patient does have SIBO, the first step involves killing off the bacteria with the appropriate antimicrobials. In many situations liver support formulas are indicated to help prevent bacterial die off reactions. In stubborn cases, nutraceuticals are also used to help break down biofilm. Natural prokinetics are then employed to help promote the sweeping motion of the gut. Simultaneously, it is always necessary to re-establish balanced gut microflora and provide tailored dietary advice. Finally, it is important to address any underlying causes and repair the gut to minimize the risk of recurrence.
Most digestive disorders are multi-factorial, but eradicating SIBO is often a very important piece of the puzzle. With the new insights into SIBO testing and treatment that have been gained from research over the past few years, Naturopathic doctors have been helping many patients experience complete relief from symptoms they have been plagued by for years. If you think you may be experiencing SIBO, please contact the clinic for more information!