If you commonly experience bloating, abdominal pain, feeling extremely full, or diarrhea after eating, SIBO may be to blame. SIBO stands for small intestinal bacterial overgrowth, and it occurs when there is an overgrowth of bacteria in the small intestine.
This can lead to a variety of symptoms that has you hunched over in pain. The good news is that SIBO can be fixed with the help of functional medicine approaches. With our patients, we address SIBO with a SIBO-specific diet, supplements, and lifestyle changes.
Read on to learn what is SIBO and how you can opt for a SIBO-specific diet to avoid unnecessary discomfort and SIBO fatigue.
What is SIBO?
Small intestinal bacterial overgrowth or SIBO is a condition characterized by an abundance of intestinal bacteria in your small intestine. Normally, a healthy amount of gut bacteria (around a whopping 100 trillion) is present in an adult and mostly stays in your large intestine. However, when there is an alteration in motility and balance of the GI system, the bacteria can travel from your large intestine up to the small intestine, leading to SIBO and its nagging and painful symptoms.
What happens is the bacteria in the small intestine begin to eat and digest the food you consume and produce excess volumes of gas. This gas byproduct accumulates and leads to your SIBO symptoms.
SIBO symptoms and severity can differ from person to person, but there are some common ones we see again and again that make us investigate whether it’s SIBO or not. Most of the symptoms are related to the gastrointestinal organs; however, SIBO can cause conditions like SIBO fatigue, and can even manifest into more serious gut-related systemic issues if left untreated.
Common SIBO symptoms include:
- Abdominal pain
- Acid Reflux
- Brain fog
These symptoms are usually due to the presence of undigested or poorly digested food particles in the small intestine, poor absorption of nutrients and activation of the immune response.
How does SIBO develop in the Gut?
You might be wondering how do you develop SIBO? Common causes/risk factors of SIBO include:
- Loss of gastric acid and bile acid – bacteria from the food are not killed and can travel to your small intestines and flourish.
- Impaired gut motility – peristalsis of the gut pushes the food and bacteria out of the intestines and keeps your intestines clean. When you struggle with slow digestion and constipation, for example, it can lead to harmful bacteria building up.
- Frequent antibiotic use- Antibiotics kill not only the bad bacteria but beneficial bacteria as well. If you don’t prioritize reintroducing healthy bacteria, the bad bugs can take over again.
- Digestive disorders such as Crohn’s disease, celiac disease, and irritable bowel syndrome (IBS) – These are signs of an unhealthy gut, which can lead to microbiome imbalances that can travel to the small intestine.
- Eating a diet high in processed foods and excess sugar – Harmful bacteria flourish with unhealthy foods.
SIBO Diagnosing and Testing
Due to the complexity of the disease, SIBO is slightly harder to diagnose and often gets misdiagnosed. SIBO is often confused with irritable bowel syndrome (IBS) because like SIBO, symptoms are bloating, diarrhea, and abdominal pain. In fact, up to 80% of IBS patients have SIBO. In fact, according to Mark Pimentel, MD we now believe we can explain 60% to 70% of IBS with SIBO. Therefore, many forms of IBS can be cured.
One commonly used method to diagnose SIBO is the SIBO breath test. A SIBO breath test is a simple and effective tool to approximate the number of bacteria in your gut. This breath test measures the gas, namely hydrogen and methane, in your breath. By measuring the amount of byproduct of bacteria, it can then be estimated, if you have a bacterial overgrowth in your small intestine.
If your doctor finds SIBO symptoms, additional laboratory tests may be recommended. Lab tests that look at vitamin and mineral levels may be useful, as well as stool tests to get to the root of your digestive issues.
If you are diagnosed with SIBO, the Functional Medicine approach looks at getting to the ROOT cause of SIBO. We don’t just prescribe antibiotics and send you on your way. Clinical management of SIBO involves diet recommendations, antimicrobial therapy, gut-supporting supplements, and gut-maintenance measures to prevent SIBO from coming back in the future.
Typically, a dietary modification will most likely be a large part of your healing protocol. Some practitioners also call it SIBO specific diet. A SIBO-specific diet is similar to a low FODMAP diet recommended by MONASH University.
The term ‘FODMAP’ stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These compounds are short-chain carbohydrates that are a great food source for the ‘excited’ bacteria in your gut. FODMAPs are found in many common foods, including wheat, dairy, onions, garlic, and legumes. The goal of a low FODMAP diet is to reduce your intake of these carbohydrates. This can help to relieve symptoms like bloating, gas, and abdominal pain.
But keep in mind, that this diet is only supposed to be used for a short time period. Once your SIBO is treated, it’s vital to eat a wide array of foods to keep your gut balanced and to avoid gut imbalances in the future.
Avoiding processed food is always a healthy option for intestinal health as well as for resolving SIBO.
Be aware that treatment for SIBO can sometimes cause SIBO die-off symptoms, so working with a Functional Medicine provider can help you manage those symptoms.
SIBO die off symptoms occur due to the killing of bacteria in huge amounts. The by-products of this massive killing may result in nausea, severe bloating, diarrhea, and abdominal pain. SIBO die off symptoms go away in a couple of days.
Other approaches to keep SIBO at bay include:
- Stress management
- Encouraging bowel movements with increased fiber and whole foods intake
- Avoiding antibiotics, artificial ingredients, and excess sugar
- Consuming a wide variety of whole organic foods
Treat SIBO with Arizona Functional Medicine Doctor, Cheri Dersam, MD
Want to know if your digestive pains and issues are connected to SIBO? Book a consultation with Dr. Dersam today. Please know there are answers even if you’ve been told you’d have to live with these symptoms forever. Let’s get to the root cause of your SIBO together.
Dr. Cheri Dersam
Dr. Dersam is board certified in both Integrative and Emergency Medicine and fellowship trained in Functional Medicine. Dr. Dersam focuses on a personalized approach that empowers each patient to achieve optimal health in mind, body and spirit.