What is SIBO?
SIBO also is known as Small Intestinal Bacterial Overgrowth is found in the small intestine and presents as large numbers of bacteria that mimic the bacteria found in the colon. People who have been diagnosed with IBS (Irritable bowel syndrome) may also present with SIBO. SIBO is a sign of dysbiosis which is a microbial imbalance.
Some of the causes could be medications, gastrectomy, advanced age, PPIs, gastritis, small bowel diverticulosis, celiac and, chronic pancreatitis. A healthy small intestine has very few bacterial populations, so when the bacteria is present in large numbers then the symptoms start to appear.
Symptoms may include:
Gas and bloating
Diarrhea or constipation
Is there a test for SIBO? One test that is ordered is called the Hydrogen Breath Test. The patient ingests lactulose or glucose and then exhales into a bag. The test measures the exhaled hydrogen and methane which are produced by bacterial fermentation of carbohydrates. In addition, methane may be measured.
The test, unfortunately, can give a false positive so it’s important to work with a functional medicine practitioner to help determine if you have SIBO.
SIBO can be either methane or hydrogen-producing. If it is hydrogen dominant, then a person usually has diarrhea. If it is methane dominate then you see more constipation.
SIBO Diet Plan
If one follows a low FODMAP diet many symptoms can improve. If they add some natural antimicrobials the results can be even better. When following the low FODMAP diet one should commit to at least six weeks to see optimal results. If they can add some antimicrobials it would be important to work with a registered dietitian who is familiar with the SIBO protocol and follow the program for 2-4 weeks. This is important so they can eventually add back pre and probiotic foods.
The goal with SIBO in functional medicine is to treat the root cause, contain the bacterial overgrowth and replace nutrients that are depleted. In some case’s antibiotic therapy may be recommended if a person is having severe side effects from SIBO, however changing the diet alone will make symptoms better.
FODMAP stands for (F) Fermentable (O) Oligosaccharides, (D) Disaccharides, (M) Monosaccharides, and (P) Polyols. The objective is to remove foods high in lactose (dairy), fructose (apples), polyols (avocado), fructans (broccoli), galactans (chickpeas) among other foods that are high in any of these short-chain carbohydrates.
It’s important to decrease the bacteria in the stomach and to eventually go back on the foods that you removed. Some of these foods are pre and probiotics and it’s important to eat prebiotics to make short-chain fatty acids which in turn can produce probiotics.
The goal is to return to a healthy balanced normal diet with a variety of vegetables and fruit, healthy fats and lean protein.
Until next time…eat healthily and move.