SIBO the new kid on the block as being the possible causes of your digestive symptoms.
Ok so with this blog, I'm about to get a bit science-y on you, so I hope you don't mind. I have attended several conferences this year and participated in heaps of webinars on gut health and besides the exciting news about the gut microbiome, SIBO has become a leading contender for many of your current digestive symptoms, including Irritable Bowel Syndrome (IBS), reflux, abdominal bloating and altered bowel movements, but the main IBS and bloating.
So what is SIBO?
SIBO is an acronym that stands for Small Intestinal Bacterial Overgrowth. This means that until recently, everyone though that the small intestine had no bacteria residing in it and all the bacteria was in the large intestine. We now know this be incorrect, yes at least 90% of bacteria does reside in the large intestine but there is also a smaller population in our small intestine.
So with SIBO, the bacteria that would normally reside in the large intestine, sneaks up into the small intestine and creates havoc . The symptoms of SIBO mimic those that we see in IBS, with bloating being the most troubling complaint. Research has proven that a whopping 80% of people who are diagnosed with IBS are also said to have SIBO.
If SIBO is left untreated, long term health issues can result. As I mentioned, under normal circumstances , the majority of your gut bacteria is found in the large intestine where it helps to break down food, synthesize certain vitamins and eliminate waste from digestion. When we have excessive amounts of the wrong bacteria in the small intestine it can interfere with digestion and absorption of nutrients which results in poor health, It can also contribute to inflammation of the gut lining, negatively affecting out gut immunity and contribution to other more serious diseases.
I'll briefly delve into the workings of the small intestines, this will help give you an understanding of why some of you may have developed SIBO.
As I have mentioned, Overall the small intestine is a pretty clean space and the intelligence of our human body never ceases to amaze me.
Digestive fluids such as bile, enzymes, valves, intestinal muscle movement and contractions are all components that help keep things moving along and keeping the bacteria in the large intestine where it belongs. There is a mechanism called the migrating motor complex - a cleansing wave that sweeps away bacteria, food, debris and left over cells between meals. Whilst we sleep, research indicates that the failure of this complex is one of the major reasons for developing SBIO.
How do you get SIBO?
It's near impossible to pinpoint the exact causes of SIBO because everyone's internal environment is so different. However, studies suggest that SIBO is causes by structural change in the gastro-intestinal tract, it could also be caused by a disruption of the rhythmic wave like motion of the (peristalsis) stomach and small intestine, Or a disruption of the normal mucosal defences of the small intestine.
SIBO is still in the early staged of being studies as a medical condition, so there could be more that we are unaware of.
7 Common causes of SIBO.
1. Low Stomach Acid
Stomach acid activates digestive enzymes and kills pathogenic bacteria, low stomach acid which can be caused by frequent antibiotic use, drugs that treat reflux known as PPI'S , processed foods or natural decline with age can all lead to microbial overgrowth.
2. Pre-existing Medical Conditions
Any condition that affects the gut muscle function can lead to SIBO. Including type 2 diabetes, prior bowel surgery or abdominal surgery, coeliac disease and increased inflammation of the gut lining.
3. Dietary factors
These all damage the gut lining, disrupt gut flora and contribute to inflammation of the gut lining known as 'leaky gut'.
4. Small Intestine Dysmotility
This means that your small intestine moves a lot slower than normal, possibly caused by genetics, auto-immune disorders or any illness that causes inflammation of the gut.
5. Decrease in Digestive Enzymes and Bile
If you don't digest your food adequately or produce enough bile to emulsify food, this will allow bacteria to grow where they feed of the undigested food.
Stress has the ability to decrease motility of the intestine again, allowing overgrowth of unhealthy bacteria.
7. Prescription Medication
Anyone on long-term prescription medications will have altered gut bacteria. The main culprits are antibiotics, antidepressants, the birth control pill, anti-inflammatory and proton pump inhibitor drugs.
The most common symptoms are
Chronic bloating - Often starting the day with a nice flat stomach and ending up looking like you are 6 months pregnant every evening
Gas and flatulence - But also belching
Altered bowel movements - Diarrhoea, constipation or both
All sounds a lot like IBS doesn't it?
There are also some systemicsymptoms that you may not associate with SIBO
Skin issues - Acne, Psoriasis, Eczema, Rosacea
Mood disorders - Depression and Anxiety
Wow right - So how do you test for SIBO?
You shouldn't diagnose on symptoms alone. The only way to be sure is by using a SIBO test method.
SIBO is tricky - Usual test such as stool samples and even endoscopies are unable to detect SIBO. The only real test that's available at this point is a breath test. The most effective test at this point is the Hydrogen Breath Test.
This test detects 2 gases that are produced by certain bacteria in your gut, Hydrogen and Methane.
As I mentioned, these gases are not produced by us humans but are produced by bacteria in the small intestine as they ferment the sugar from carbohydrates. These gases are released into the blood, sent to the lungs and exhaled through the breath.
Just to re-cap a bit, Food is not supposed to be fermented in the small intestine, this is the large intestines job. So if your breath test shows elevated levels of hydrogen and methane, this means there's bacteria present in the small intestine that break down carbs before they can make it to your large intestine.
So that's my take on SIBO. If you would like to know more about this issue or suspect it may be possible that you have SIBO, Please give us a call.
In the next blog, I will discuss how to treat SIBO because this is a biggy.