What is SIBO?
Small Intestinal Bacterial Overgrowth (SIBO) is a complex gastrointestinal disorder characterized by an overgrowth of bacteria in the small intestine and is commonly overlooked among those with IBS.
People with SIBO often suffer for years from a variety of unpleasant digestive symptoms like bloating, abdominal pain, gas, constipation, diarrhea, nausea, heartburn, and nutrient insufficiencies.
Restaurant menus and grocery stores can look like a minefield of triggering foods, and chronic gastrointestinal pain and discomfort can feel socially isolating.
But with the right approach, SIBO is not something you have to suffer with forever.
Causes and Risk Factors
Two of the most common SIBO risk factors are low stomach acid or other digestive insufficiency and impaired gastric motility.
Without adequate stomach acid, bile, or digestive enzymes, the gut’s ability to fight against infections is compromised, undigested food begins to ferment, bacterial overgrowth occurs, and before you know it, you’ve got symptoms. Chronic use of certain medications like proton pump inhibitors, Helicobacter pylori infection, chronic pancreatitis, and excessive alcohol use contribute to digestive insufficiency.
Impaired gastric motility also encourages bacterial overgrowth by slowing the downward movement of food and bacteria through the gastrointestinal tract. I often talk about the migrating motor complex (MMC), also known as the gut’s janitorial service. The MMC is activated during periods of fasting to push food and other matter through the small intestine and into the colon where it will eventually be eliminated from the body in the form of a bowel movement. An impaired MMC can occur from eating too frequently, having a history of disordered eating behavior including anorexia or binge eating disorder, hypothyroidism, diabetes, chronic stress, or gastroparesis.
My Top Functional Nutrition Interventions for SIBO
My patients with SIBO tell me how much the condition affects their quality of life. Not only does it cause digestive issues, but it is connected to fatigue, brain fog, anxiety, depression, and can lead to very real fears around food and social events. My approaches are always tailored to individual patients’ needs, but there are basic strategies I use to provide effective, lasting relief.
Let’s Get You Feeling Better ASAP
I look for ways to help you immediately address symptoms that interfere with everyday life. We’ll review your health history, discover what your trigger foods and intolerances are, and identify your unique root causes. Therapeutic foods and supplements like ginger, artichoke, fennel, bitters, apple cider vinegar, magnesium, and digestive enzymes can be used to reduce a variety of symptoms.
Eating foods high in iron, vitamins A, D, E, B12, and thiamine reduce the risk of nutrient insufficiencies associated with SIBO while improving energy and mood.
Teach Your Gut It is Safe
Did you know that 40% of SIBO cases experience relapse? Did you also know that Vagus nerve stimulation greatly reduces relapse risk? Vagus nerve stimulation exercises, resources to helpful apps, developing mindfulness practices, stress reduction techniques, restful sleep, and joyful movement play crucial roles in teaching your gut it is safe.
Reduce Inflammation and Encourage Gut Healing
Foods that stoke intestinal fires like digestive bitters or adding bitter greens to recipes are relatively low-cost, easy ways to improve stomach acid and digestive wellness.
Limiting snacking between meals allows the MMC to move bacteria and food particles out of your body.
Quercetin, curcumin, NAC, omega 3 fatty acids, serum bovine immunoglobulins, binders, and biofilm disruptors help lessen inflammation in the gut.
Let’s Talk Microbiome
Because SIBO is notoriously stubborn, treatment options can involve a combination of antibiotics prescribed by your physician and herbal antimicrobials, followed later by the introduction of specific probiotics and prebiotic foods that do not induce symptoms to improve the gut microbiome.
Develop a Sustainable Long-Term Plan
Slow and deliberate reintroduction of foods while developing confidence in food and lifestyle choices support your gut and overall health. By understanding how different foods and habits impact your gut microbiota and symptoms, you can feel empowered to take an active role in your health journey and make informed choices that nurture your gut ecosystem. Through ongoing support and guidance, you will learn to recognize early warning signs and implement strategies to maintain your gut health to prevent relapse.
Click here to learn more about naturopathic SIBO treatments.
References:
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Efremova I, Maslennikov R, Poluektova E, Vasilieva E, Zharikov Y, Suslov A, Letyagina Y, Kozlov E, Levshina A, Ivashkin V. Epidemiology of small intestinal bacterial overgrowth. World J Gastroenterol. 2023 Jun 14;29(22):3400-3421. doi: 10.3748/wjg.v29.i22.3400. PMID: 37389240; PMCID: PMC10303511.
Norris ML, Harrison ME, Isserlin L, Robinson A, Feder S, Sampson M. Gastrointestinal complications associated with anorexia nervosa: A systematic review. Int J Eat Disord. 2016 Mar;49(3):216-37. doi: 10.1002/eat.22462. Epub 2015 Sep 26. PMID: 26407541.
Rigaud D, Bedig G, Merrouche M, Vulpillat M, Bonfils S, Apfelbaum M. Delayed gastric emptying in anorexia nervosa is improved by completion of a renutrition program. Dig Dis Sci. 1988 Aug;33(8):919-25. doi: 10.1007/BF01535985. PMID: 3391083.
Sachdeva S, Rawat AK, Reddy RS, Puri AS. Small intestinal bacterial overgrowth (SIBO) in irritable bowel syndrome: frequency and predictors. J Gastroenterol Hepatol. 2011 Apr;26 Suppl 3:135-8. doi: 10.1111/j.1440-1746.2011.06654.x. PMID: 21443727.
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