SMALL INTESTINAL BACTERIAL OVERGROWTH (SIBO)

Small Intestinal Bacterial Overgrowth (SIBO) is an underdiagnosed gut condition, due to an overgrowth of certain types of bacteria in the small intestines - a location not meant to be for so many bacteria, such as E. coli, Enterococcus spp., Lactobacilli, Streptococcus, Staphylococcus, Klebsiella, M. Smithii and several other species. This gut dysbiosis results in symptoms of IBS such as bloating, gas, diarrhea, constipation, abdominal pain and cramps, which can range from day to day, patient to patient, based on the diet and level of overgrowth.

SIBO can be mild, moderate or severe and the symptoms often correlate with the severity of the overgrowth.

SIBO was thought to be quite rare in the past and mostly in patients with rheumatic conditions and diabetes, however, there is much more awareness now, and has been seen in people without these conditions and much more prevalent than previously thought. Studies have found that SIBO is involved in more than 50% of the cases of IBS.

WHO IS AFFECTED BY SIBO?

Adults and children, including infants can have symptoms of SIBO.

WHAT ARE THE SYMPTOMS OF SIBO?

Digestive symptoms: abdominal pain and discomfort, diarrhea or constipation, nausea, flatulence, fat in the stools, nausea, heartburn, acid reflux, malabsorption, malnutrition, weight loss, anemia, and histamine intolerance.

Other symptoms: joint and muscle pain and inflammation, fatigue, weakness, neurological imbalances such as brain fog, OCD, ADD / ADHD, depression, anxiety, poor memory and concentration, nutritional deficiencies especially in Vitamin B12, fat soluble Vitamins A, D, E and K, and iron and osteoporosis.

WHAT CAUSES SIBO?

SIBO is a condition of overgrowth of bacteria in an area of the gut where they do not belong or should not be overgrowing, here are some of the contributing factors as to what may cause SIBO:

• A gut motility issue, where the muscle contractions that move the food along do not occur as they should, and the bacteria get stuck and they start to reproduce. Chronic conditions like diabetes or Crohn’s disease, previous bowel surgeries can also affect motility in the gut.


• In children, early antibiotic use along with a C-section birth and several interventions can cause SIBO down the road, due to immune dysfunction and immune suppression, along with a lack of healthy digestive flora, leading to an abundance of opportunistic bacteria and pathogens in the gut.


• Other risk factors for SIBO: taking medications that reduce the stomach acid causing hypochlorhydria or natural decline of gastric acid secretions with age and other factors including lifestyle and diet, age, overuse of antibiotics in general, metabolic disorders, celiac disease, chronic constipation and other organ dysfunction such as renal failure and pancreatitis.


• Alcohol, travel, stress, use of certain anti-inflammatory medications can also affect motility in the gut.

How your IBS symptoms may actually be related to SIBO

Bloating, abdominal discomfort and flatulence are some of the classic symptoms of irritable bowel syndrome or IBS, however, depending on what type of bacterial overgrowth you or your child has – you could also have additional symptoms of either constipation or diarrhea.

Gut dysbiosis including SIBO can cause IBS symptoms in up to 50% of the cases. Bacterial overgrowth of E. Coli, Enterococcus spp. and Klebsiella species were found in IBS patients complaining of diarrhea symptoms, versus M. Smithii which was found in higher amounts in IBS patients complaining of constipation symptoms. The toxins produced by some of these bacteria can also produce toxins, create biofilms leading to antibiotic resistance, that can damage the mucosa, and affect absorption as well, create inflammation which can mimic other gastrointestinal tract infections.

Babies and Colic

Researchers have found a link between colic and the gut, and the presence of certain types of bacterial overgrowth associated with gut inflammation in colicky infants. Babies with healthy bacteria and those born naturally, without interventions, also seem to have lower chances of colic. The inflammation seen in these babies also closely resembled the inflammation seen in patients with IBS later in life.

DIAGNOSING SIBO

If you suspect symptoms of SIBO, talk to your naturopathic doctor or gastrointestinal specialist and try not to self-diagnose. In clinic, I have found 2 tests to be extremely helpful for the diagnosis and identification of the bacteria contributing to the symptoms.

A Bacterial Overgrowth Test or SIBO Breath test – for 2 or 3 hours to measure hydrogen and methane levels produced by the bacteria after the ingestion of lactulose, which your body cannot digest however the SIBO bacteria can metabolize producing high levels of methane and hydrogen. The amount produced at different times will identify the severity of SIBO.

A Comprehensive Digestive Stool Test to identify the pathogens involved in SIBO, as well, look at how well digestion, absorption, elimination is of the digestive system, and also culture bacteria, yeast, fungi, parasites and other pathogens that may be present in the large and small intestine.

WHAT TO EXPECT AT OUR NATUROPATHIC CLINIC?

The naturopathic approach includes identifying what the root cause of the problem is using various testing methods such as the bacterial overgrowth test, comprehensive stool testing and blood testing to identify any deficiencies, and also doing an extensive intake of your symptoms.

At our clinic, during your initial 1 hour one – on – one consult with our Naturopathic Doctor, Dr. Sushma Shah, you will undergo a comprehensive symptom intake in detail, and at the end of the visit, you will be required to do some blood and urine testing. Her assessment is oriented toward determining what is impeding your body's ability to function normally. She will determine which assessment tools are most helpful in establishing a treatment strategy specific to your health needs.

Naturopathic Doctor Sushma Shah may order some specialized testing, if need be in order to get all the necessary physiological information and to get a more complete picture of your symptoms – to get to the root cause of your symptoms. Following this visit, you will be coming in for your second visit, in which she will be doing a full physical check-up, a traditional Chinese medicine tongue and pulse diagnosis, body fat analysis and blood glucose testing. After having gone through your case, she will be giving you an INDIVIDUAL TREATMENT PLAN, that is specific to the symptoms you have.

NATUROPATHIC TREATMENTS FOR SIBO

PREVENTION IS KEY

The naturopathic treatments for SIBO at our naturopathic clinic for adults and children are based with the following goals in mind:

1. Eradication of the harmful bacteria and their biofilms causing the SIBO symptoms with natural and effective herbal remedies, and natural supplements. A short-term diet change may be recommended based on the individual especially avoidance of high carbohydrate diets that are high in sugar and refined carbohydrates.
2. Decrease and eliminate inflammation in the digestive tract, especially in the intestines and reinforce a healthy immune function.
3. Address and treat symptoms of diarrhea, constipation, bloating, and all the other symptoms associated with SIBO.
4. Create a healthy gut environment and educate the client on how to prevent reoccurrence of SIBO and other digestion related issues, such as leaky gut and suggest a maintenance plan once SIBO issues have been resolved.
5. Addressing any underlying nutritional deficiencies caused by SIBO. Optimize the overall health of the client.

TIPS FOR ADDRESSING SIBO SYMPTOMS FROM DR. SUSHMA SHAH, ND

1. Talk to your naturopathic physician for the best approach for your specific case as even though you may think you are suffering from SIBO, your naturopath can properly diagnose you and suggest an individualised treatment plan that suits your lifestyle. If you do not have a naturopathic doctor, you can call our clinic to schedule an initial consultation with Dr. Sushma Shah, ND in Toronto, who has been treating various digestive issues successfully for over 15 years.
2. Maintain a healthy digestive tract with nourishing nutritious and fermented foods if tolerated. Avoid processed refined foods and foods that are high in sugar, additives and colorings.
3. Drinking filtered water can be beneficial as well, as it will reduce chlorine consumption which can harm gut flora.
4. Handwashing is important before preparing and eating food.
5. Adequate rest and sleep for immune support is key.

Please ask your doctor or naturopath before starting on any supplements. Its is better to first identify the cause and then treat it with the right remedies, even though those mentioned above have minimal side effects.

For any questions, concerns or to schedule an appointment, please contact us at 416 913 4325 (HEAL) or email us at [email protected]

* DISCLAIMER: The information on this article is the property of Dr. Sushma Shah, Naturopathic Doctor, and is not intended to treat, diagnose or cure any diseases or promote any services or products mentioned on the website.