Do you “suck at digestion” no matter what you eat?
You might have SIBO…
This is the first of two articles all about Small Intestinal Bacterial Overgrowth (SIBO), so also check out the second article: SIBO Diagnosis & Treatment.
What is SIBO?
While fun to say (it sounds cute!), it is NOT so fun to have!
SIBO stands for Small Intestinal Bacterial Overgrowth and occurs when bacteria is in the wrong place at the wrong time because it is not correctly moved by muscular contractions into the large intestine. This causes overgrowth in the small intestine which can cause chronic digestive upset.
SIBO is more common than you might think, particularly in patients with IBS (irritable bowel syndrome).
What is the root cause of SIBO?
The root cause of SIBO is thought to be dysfunction of the migrating motor complex (MMC) which sends waves of electrical signals through the intestines which trigger peristalsis, transporting food and other substances (including bacteria!) through the body and keeping the digestive system healthy.
MMC problems can arise due to:
- Gastroenteritis (including food poisoning, gastrointestinal virus, parasitic infections, traveller’s diarrhea)
- Celiac disease
- Inflammatory bowel disease (Crohn’s and ulcerative colitis)
- Ulcerations in the digestive tract
- Traumatic brain injury (causing changes to intestinal function)
Secondary causes include:
- Hypochlorhydria (low stomach acid)
- Bile insufficiency (due to gallbladder removal or dysfunction)
- Pancreatic enzyme insufficiency
- Small intestinal inflammation/damage
- Intestinal strictures
- Ileocecal valve disorders
Not everyone with the health concerns listed here will have SIBO, but if you suffer from chronic digestive problems that have not responded to treatment, you should test for SIBO to rule it in or out.
How do I know if I have SIBO?
Symptoms of SIBO typically include one or more of the following:
- Bloating and/or discomfort/pain after meals
- Excessive gas (burping, flatulence)
- Heartburn and/or regurgitation
- Feeling of fullness/heaviness or “slow digestion”
- Chronic constipation
- Chronic loose stool/diarrhea
These issues also point strongly toward SIBO:
- Onset or worse since a case of gastroenteritis (or multiple cases of gastroenteritis in the past)
- Onset or worse since a traumatic brain injury
- May be aggravated from probiotics
- Worse from eating foods such as apples, pears, mangos, avocados, asparagus, cauliflower, sweet potatoes, lactose containing dairy products, and fibrous grains
- History of heavy or frequent antibiotic use
- History of taking proton pump inhibitor medications (which suppress stomach acid)
- History of gallbladder removal or dysfunction
SIBO is also associated with:
- Heartburn/acid reflux/GERD
- Fat malabsorption and steatorrhea (fat in the stool)
- Chronic iron deficiency (despite adequate intake or supplementation)
- Vitamin B12 deficiency (despite adequate intake or supplementation)
- Skin conditions (acne, eczema, rosacea)
Do you recognize yourself in these symptoms or conditions?
Stay tuned for the second article: SIBO Diagnosis & Treatment!