Do you suffer from digestive distress? Gas & bloating, belching, & flatulence are sure signs that digestion is not functioning up to par. Monitoring your bowel movements can also be an indicator that digestion has gone awry. Diarrhea, constipation, and the shape, size, color, and smell of your stool can tell all. As well, disorders such as IBS, IBD, chronic illnesses, and food intolerances can indicate your digestive system is out of balance. If any of these symptoms ring true, then you may be suffering from SIBO (Small Intestinal Bacterial Overgrowth).
What is SIBO?
Small Intestinal Bacterial Overgrowth can occur when the ratio of good to bad bacteria in our gut becomes imbalanced. The proper ratio for good to bad should be approximately 85:15. However, many factors can upset this very delicate microbiome. Our microbiome is our body’s ecosystem. It is the bacterial balance within the human body; which outnumbers our human microbes 10:1! SIBO occurs when the antagonistic bacteria, like Candida Albicans, which are usually kept in check by the “good” bacteria, flourish. Dysbiosis is another term used to describe an imbalance in this bacterial ratio.
Causes of Dysbiosis
Diets high in sugar, alcohol, gluten, and refined carbohydrates, such as breads and pastas, can greatly contribute to SIBO as these bacteria feed on sugars.
Genetically Modified foods (GMOs), stress, pollution, chlorinated water, smoking, and heavy metals, such as mercury exposure, have been shown to be contributing factors, as well. Certain medications, such as antibiotics, the Birth Control Pill, and Acid Blockers all contribute to an overgrowth in the antagonistic gut bacteria.
Digestion is a very intricate process. Our gut depends on proper nerve supply, muscle function, enzymes, bacteria, and neurotransmitters to properly digest food. While enzymes mainly break down our food, the nerves, muscles, and neurotransmitters physically move the food through our digestive tract from the stomach to the small intestine and finally, to the colon. Many factors can affect improper digestion:
- Digestion begins in the brain; just think of your favorite food – what it smells like, how it looks, and imagine the taste. What happens? You salivate and begin a chemical reaction in the body that readies the GI, like priming an engine.
- Stress: The Nervous System regulates whether you will “Rest & Digest” (Parasympathetic) or be ready to “Fight & Flight” (Sympathetic). The catch is that you cannot do both at the same time. If your body perceives stress, whether finances, emotions, relationships, chronic illness, etc, you will be unable to digest. If you eat while you are stressed, more than likely you will be fermenting that meal instead of digesting it.
- Chewing: Your stomach does not have teeth. Food must be chewed, masticated, and thoroughly mixed with saliva to begin carbohydrate breakdown.
- Stomach Acid: Sufficient Hydrochloric Acid (HCl) is required to continue digestion. HCl is the only acid made by the body and is required in sufficient levels to activate all protein digestion and mineral absorption. Acid Blocking medication will shut this process down, allowing fermentation to continue.
- Pancreas: Bicarbonate from the pancreas activates enzymes needed to digest food and also helps break down carbohydrates (sugars) sufficiently, as well as proteins and fats.
How to Test for SIBO
SIBO Breath Test
Breath testing measures the hydrogen (H) & methane (M) gases produced by bacteria in the small intestine that has diffused into the blood, then lungs, for expiration. H & M are gases produced by bacteria, not by humans. The gas is graphed over the SI transit time of 2 or 3 hours & compared to baseline. Patients drink a sugar solution of glucose or lactulose after a 1 or 2 day preparatory diet. The diet removes much of the food that would feed the bacteria, allowing for a clear reaction to the sugar drink. Abnormal breath tests can also signify H pylori infection, carbohydrate malabsorption, pancreatic insufficiency, and celiac disease.
Urine Indican Test: This functional medicine lab test will test the urine for by-products of yeast or bacteria in the small intestine. This test is looking at quantitative and qualitative evaluation of urine for indicans and detection of an elevated level of serum d‑lactic acid which will be present in SIBO.
Comprehensive Stool Test: This is also a functional medicine lab test looking at the flora of the large intestines. This test is determining levels of bacterial balance.
Symptomatology: Signs and symptoms are the body’s language. They are how the body speaks. Based on symptoms, information from the client’s health history and dietary intake, we can quickly and accurately determine root causes and/or what we need to do to get to the root causes.
What to do if you suspect SIBO…
There are natural therapies which can eliminate and rebalance the delicate balance of flora in the gut.
Recommendations for SIBO could include:
- 4 R Strategy to digestive healing: Remove, Replace, Re-inoculate, Repair
- Dietary: Simple Carbohydrate or Paleolithic Diet is most recommended
- Herbal: Demulcent herbs, such as Marshmallow Root and Globe Artichoke, as examples
- Supplementary: Anti-Infective compounds; such as, Garlic, Grapefruit Seed Extract, or Pau D’Arco will remove the unfriendly bacteria
- Nutrients: Healing formulas including Vitamins A, C, E and Zinc + L‑Glutamine
- Probiotics: in a therapeutic dose will help replenish and heal the intestinal lining
Working with a Holistic Practitioner to assess SIBO and implement a strategy to address the associated symptoms and to re balance the Small Intestinal Bacteria is recommended. Holistic Nutritionists can guide you through the dietary changes as well as offer you a supplement protocol for lasting solutions.
By: Jennifer Papaconstantinou CNP, NNCP, RNT
Edison Institute Student Liaison
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