SIBO otherwise known as small intestinal bacterial overgrowth is something I am seeing in my clients more frequently.
SIBO is a condition where the bacteria (even normal, healthy bacteria) migrate from the large intestine into the small intestine and make themselves home. The small intestine is the location of nutrient absorption and is not equipped to handle high levels of bacteria, giving them the opportunity to act on poorly-digested, fermentable carbohydrates which cause bloating, gas, abdominal pain, constipation and/or diarrhoea.
The effects of SIBO are not isolated to the gastrointestinal tract, these bacteria can release acids that can cause brain fog and fatigue, maldigestion of nutrients due to the inflammation and irritation these bacteria cause in the small intestine environment leading to nutritional deficiencies. SIBO has also been shown to directly alter immune function which in turn can result in an underactive immune system.
Normally, the body has precautions to prevent SIBO from occurring, but in SIBO these defensive factors have reduced which is what can originally cause SIBO to occur.
What does SIBO look like?
SIBO symptoms vary between individuals but can include:
· Loss of appetite
· Abdominal pain
· Nausea
· Bloating
· An uncomfortable feeling of fullness after eating
· Diarrhea and/or constipation
· Unintentional weight loss
· Malnutrition
The symptoms can look very similar to IBS or Irritable Bowel Syndrome and this is true, SIBO can be the cause of IBS in many cases.
What causes SIBO to occur?
The causative agents of SIBO vary between individuals:
- Mechanical damage to the digestive tract which could be scar tissue wrapping around the outside of the small bowel or pouches of tissue protruding through the wall of the small intestine.
- Certain medications that slow the transit time of food through the small intestine.
- Complications of abdominal surgery.
- Hypothyroidism. The thyroid slows the activity of every cell including those in the gastrointestinal tract, slowing the migrating motor complexes* that stimulate peristalsis through the digestive tract.
- Chronic stress. When the body is in the sympathetic nervous system, the fight or flight response, the gastric function is reduced and slowed. The enteric nervous system that controls the migrating motor complexes are also slowed.
- Diabetes. Diabetes can cause damage to the nerves of the body including those of the intestinal sphincters of the digestive system.
- Excess oestrogens. Excess oestrogens inhibit bile acids from being released from the liver into the intestine. Bile acids have an antimicrobial effect which then gives the bacteria a further chance to survive. Oestrogen also delays gastric emptying and motility of the digestive tract.
- Immune function. Low secretory IgA aids in an increase in bacterial overgrowth. Secretory IgA are immunoglobulins that are the first line of defence in protecting the intestinal epithelium from toxins and pathogenic microorganisms.
*Migrating motor complex is a cyclic, recurring motility pattern of the smooth muscle layers that occurs during fasting in the stomach, small intestine or colon. I think of it as a big propulsion of gastric content through the intestines to ensure there are no blockages and to move not only food particles but also bacteria along.
How does Naturopathy support SIBO?
A SIBO diagnosis is done through a breath test over a couple of days. The test results identify not only bacteria present, but which type of bacteria is in excess to direct treatment appropriately.
Herbal antimicrobials are used but are not the only treatment given. Depending on the individual, we may work on enhancing the migrating motor complexes, addressing the cause of the SIBO or the factors that can exacerbate the condition whilst also addressing the health of the digestive tract.
Diet and lifestyle play a prominent role in the healing process.
If you are interested in investigating SIBO or need support with what direction to turn, book a consult to discuss.
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