Small intestinal bacterial overgrowth (SIBO) is an increasingly recognized condition in which there is an elevated number of bacteria in the small intestines. The small intestine normally contains relatively few bacteria, but with SIBO, bacteria that are normally found in the colon---Escherichia coli, species of Enterococcus, Klebsiella pneumonia and Proteus mirabilis---abnormally expand into the small intestine.
These bacteria are notorious for fermenting carbohydrates into gas and their overgrowth is responsible for classic SIBO symptoms like gas and bloating. The good news is that SIBO treatment with either conventional or natural antibiotics is proven effective, especially if a SIBO diet is followed simultaneously.
SIBO symptoms
The main symptoms of SIBO are digestive in nature, although some people with SIBO have no gastrointestinal-related symptoms at all. Digestion-related SIBO symptoms include:
- bloating
- flatulence
- abdominal discomfort and pain
Because SIBO is associated with malabsorption of nutrients, many subtle and not-so-subtle symptoms of vitamin and mineral deficiencies may occur, including:
- joint and muscle pain
- fatigue
- neuropathy (tingling, numbness, or pain in the extremities).
In extreme SIBO cases, there may be obvious signs of malabsorption, including weight loss and excessive fat in the stool (steatorrhea).
Health conditions related to SIBO
A number of diseases are associated with SIBO, including the following:
- Irritable bowel syndrome
- Rosacea
- Restless leg syndrome
- Macrocytic anemia (due to vitamin B12 deficiency)
- Microcytic anemia (due to bleeding ulcers)
- Liver diseases (cirrhosis and nonalcoholic hepatitis)
- Celiac disease
- Fibromyalgia
- Parkinson's disease
- Hypothyroidism
- Inflammatory bowel disease (ulcerative colitis and Crohn's disease)
- Chronic pancreatitis
- Autoimmune disease (rheumatoid arthritis)
- Chronic prostatitis
What causes SIBO?
SIBO develops when the normal mechanisms that control balance among the gut bacteria are disrupted. One of the most common processes that leads to bacterial overgrowth is decreased gastric acid (hydrochloric acid) secretion. Many people, especially as they get older, don't make enough hydrochloric acid to properly digest food in the stomach. Heartburn sufferers who regularly use antacids or proton pump inhibiting drugs (purple pill) are also at increased risk of SIBO. Another common cause of bacterial overgrowth is statis (dysmotility) in the gut, which allows the bacteria to proliferate because the contents of the gut do not get pushed through quickly enough. Irritable bowel syndrome and certain medications like pain killers (narcotics) and proton pump inhibitors are common causes of stasis, as are many of the conditions listed above. Once present, bacterial overgrowth may cause inflammation in the mucus lining of the intestine, further exacerbating SIBO and its typical symptoms.
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Let's look into this deeper. What's typically blown off by most MD's won't go pasted the one who is trained in functional medicine. The above analysis is a stool analysis through Genova labs which I use on many of my colitis based patients. Small Intestinal Bacterial Overgrowth is very easily detected with this analysis. The real nice thing about this test is that it gives you the nutraceuticals that it will respond best to which are the ones with the higher inhibition and show you which medications are resistant (R) or sensitive (S) to the specific bacteria. Colitis can be very complex today and hard to manage if you just treat the symptoms and ignore the cause.
Dr. J