Do you suffer from symptoms of nausea, flatulence, post-meal bloating, cramping, diarrhoea and/or constipation? Have you tried all the go-to treatments and seen little improvement in your symptoms? Or perhaps your symptoms have even been made worse after common treatments like probiotics? If so, there is a chance you could be suffering from a surprisingly common, yet little known condition referred to as Small Intestine Bacterial Overgrowth, or SIBO.
What is SIBO?
As the name suggests, SIBO is an overgrowth of the bacteria in the small intestine. While we need bacteria in our small intestine, if too many bacteria are allowed to set up camp there, particularly those bacteria that are usually found in the colon, then they can start to cause a whole lot of chaos. Our small intestine houses roughly 100,000 bacteria per 1/4 teaspoon, in comparison to the large intestine which can house about 20 billion bacteria per 1/4 teaspoon. That’s a bit of a difference! If the bacteria from the large intestine migrate up towards the small intestine, SIBO can result and lead to debilitating IBS symptoms.
How do you get it?
Multiple factors can lead to SIBO, including:
- a previous gastrointestinal infection that develops into SIBO
- low stomach acid allowing survival of bad bacteria
- use of certain medications, such as proton pump inhibitors, immunosuppressants, narcotics, opiate medications, like morphine, and the oral contraceptive pill
- stress, which can lead to low stomach acid and stagnation of the digestive system, allowing bacteria to grow
- excessive alcohol consumption
- removal or structural damage to the ileo-cecal valve in the digestive system, allowing the back flow of bacteria from the large intestine into the small intestine
Malnutrition as a result of SIBO
Those suffering from longstanding SIBO will often have significant nutrient deficiencies, which can lead to fatigue and disruption to multiple body systems. Basically, too many bacteria in the small intestine begin to disturb the functioning of the vili. The vili, which line the wall of the small intestine, are mainly responsible for the absorption of our food, releasing enzymes which breakdown starches and proteins, so that they can be affectively absorbed. An overgrowth of bacteria from the colon causes fermentation of foods in our small intestine, producing hydrogen and/or methane gas. This gas is the main cause of the symptoms associated with SIBO (cramping, bloating, flatulence) and also causes damage to the vili and intestinal wall. Excess bacteria may also begin to breakdown the bile acids that are responsible for the absorption of fats and fat soluble vitamins. The result is significant malabsorption.
Common nutrient deficiencies that can occur as a result of SIBO;
- folic acid
- fat soluble vitamins A, D and E
- minerals including iron, magnesium, and calcium
In severe cases, damage to the intestinal wall can also lead to ‘leaky gut’, allowing larger than normal food particles to pass through the intestinal wall. This can then trigger an altered immune response, leading to complications, including food allergies and autoimmune disease.
If you have been suffering from IBS symptoms that don’t appear to be associated with other causes of IBS, such as a food intolerance, large intestine dysbiosis, reduced digestive enzymes and/or reduced gastric acid (to name a few!) then SIBO could be to blame. Chat to your health care professional about testing and personalised treatment options.