Understanding and Treating SIBO (Small Intestinal Bacterial Overgrowth)
Everyone has experienced the discomfort of bloating at one time or another, but when it becomes a constant and painful problem, there may be an underlying cause, known as SIBO. SIBO, or small intestinal bacterial overgrowth, is a relatively common problem, especially in those who suffer from IBS, hypothyroidism, fibromyalgia, acne rosacea, celiac disease, and nonalcoholic fatty liver disease. If you frequently experience painful bloating after meals and/or bloating that tends to worsen throughout the day, you may have SIBO.
What is SIBO? Imagine your small intestine as a peaceful village, suddenly overrun by invaders from the large intestine (AKA, bacteria). These invaders take over, feeding hungrily on all the carbohydrates in their path and upsetting the small intestine’s delicate ecosystem by fermenting these sugars and creating a buildup of hydrogen and methane gases characterized by that painful all-day bloating. The havoc they wreak can also lead to gas, heartburn, nausea, and fatty stool.
How Do You Get SIBO? What allows these invaders to get in? While there is no one surefire cause, there are a few theories. Anything that interrupts your digestive system’s natural movement process, known as the migrating motor complex or MMC, can allow bacteria to build up in your small intestine—such as a bout of food poisoning or long-term stress. Another theory suggests that antacid or antibiotic overuse can lower your stomach acid to a point where it can no long prevent the gut from infection by fungi, bacteria, and parasites. Still other theories suggest a connection to problems with the colon’s microbiome or mechanical issues between the large and small intestines, though more research is still needed.
I Think This May Be My Problem—What Do I Do? SIBO can be tricky to accurately diagnose as the standard tests, such as the breath test can yield inconsistent results—either inaccurately diagnosing or missing the existence of the problem. However, a review of your history and symptoms can provide insight. Very specific medications and supplements can be effective measures, though diet plays a significant role in combatting bacterial overgrowth. By adopting a low-FODMAP diet under the guidance of a nutrition professional, you can heal your body through food—perhaps the most effective long-term solution for SIBO prevention and management.
What Is a Low-FODMAP Diet? FODMAP is an easy way of categorizing “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols”—AKA, foods containing both simple and complex sugars that ferment when they come in contact with bacteria in the bowel. When these foods ferment, they naturally release gas which causes painful, telltale bloating, and fructose (found in fruit and high fructose corn syrup), lactose (found in dairy), and polyols (artificial sweeteners such as erythritol, xylitol, and sorbitol) can also trigger or worsen diarrhea by pulling water into the intestines. When you limit your intake of these foods, you can find drastic relief from both IBS and SIBO.
Some high-FODMAP foods include wheat, dairy, artificial sweeteners and high fructose corn syrup, garlic, onions, Brussels sprouts, mushrooms, peaches, plums and more. As you can see, some otherwise perfectly healthy foods make this list, which is why it’s so important to work with a nutritionist who can provide the support and guidance needed to successfully complete the process.
Like any elimination diet, a low-FODMAP diet is not intended to be a long-term lifestyle change. In the initial two to four weeks of the program, you’ll eliminate all high-FODMAP foods from your diet to help determine which you have a sensitivity to and which you don’t. During the second, longer phase, you’ll slowly reintroduce specific FODMAP foods to see which your body tolerates well. Because it can be a slow, and sometimes frustrating, process, the support of a nutritionist can be an enormous help in completing the diet successfully. And, the difficulty is worth it—in one study, a low-FODMAP diet was shown to significantly reduce abdominal pain in more than 50 percent of participants in just six weeks.
If you suspect SIBO might be an issue for you, contact me to find out how you can heal your body through diet and lifestyle changes for lasting wellness.