The gut is one of the most important systems in the body. Unfortunately, a growing number of Americans suffer from gastrointestinal disorders. Perhaps one the most influential yet often overlooked contributors of gastrointestinal difficulty is small intestinal bacterial overgrowth or SIBO.
Chronic gastrointestinal problems can involve an underlying case of SIBO. As such, many individuals may benefit from having a better understanding of SIBO, its causes, and effective approaches to diagnosis and treatment.
A Brief Review of SIBO
SIBO is clinically described as excess bacteria in the small intestine. Typically, the small intestine maintains a relatively low level of bacteria. However, in the presence of SIBO, this region becomes overgrown with bacteria, which inhibits absorption of essential nutrients, proteins, carbohydrates, and fats. This is in part due to the fact that, when in excess, bacteria in the small intestine consume nutrients before the body is able to absorb them. If left untreated, SIBO can lead to nutrient deficiencies that promote the occurrence of symptoms such as severe weakness, fatigue, bloating, constipation, diarrhea, and even damage to the central nervous system.
What Causes SIBO?
Due to the gut’s high degree of interconnectivity, there are many factors that may contribute to the development of SIBO. Underlying health conditions, certain forms of medication, and individual patient factors can all contribute to SIBO development.
Many conditions are associated with bacterial imbalance and overgrowth in the gut. Some of the most common contributors or cohorts of SIBO include: dysmotility, chronic pancreatitis, diabetes, diverticulosis, fistula, intestinal lymphoma, rosacea, Lyme disease, autoimmune disease, and scleroderma. One condition that is frequently seen in conjunction with SIBO is celiac disease. The condition, wherein proteins found in grain aggravate and damage the intestine, promotes inflammation and limits gut motility, thereby contributing to the development of SIBO.
Although it may seem counterintuitive, antibiotic use is a major contributor to SIBO. Antibiotics destroy harmful bacteria as well as bacterial agents that protect against imbalances and overgrowth. Researchers believe this action may be why many SIBO patients experience a more severe return of SIBO after being treated with antibiotics.
Other medications including immunosuppressants and proton pump inhibitors can also increase the risk of SIBO.
Effects of Aging
Age is frequently a factor regarding the development of chronic health conditions. As the body progresses through the aging process, many functions begin to slow including digestion. This can contribute to bacteria overgrowth.
Dietary imbalances are a prominent factor regarding SIBO occurrence. Those who do not consume probiotic-rich foods and regularly miss out on essential nutrients are more likely to develop a bacterial imbalance. Furthermore, those who consume a high volume of sugar and complex carbs are more likely to have greater bacteria prevalence in the gut.
Recognizing and Diagnosing SIBO
As a gastrointestinal disorder, symptoms of SIBO can be exceptionally varied and may appear similar to other gut-related and even systemic conditions. Symptoms include nausea, diarrhea, joint pain, fatigue, skin issues, and others. Ideally, if these or other forms of gastrointestinal disruption appear, the gut is assessed with appropriate tests. The two methods below are common practices for diagnosing SIBO.
The SIBO Breath Test
SIBO is frequently diagnosed by measuring the amount of gas, specifically hydrogen and methane, expelled while breathing. Only certain bacteria located in the intestine produce these types of gas. Therefore, measuring the levels in an individual’s breath allows doctors to determine, with a certain degree of accuracy, the prevalence of bacteria in the small intestine. Elevated levels of hydrogen or methane suggest that SIBO is present – this can also suggest chronic infections.
Additionally, a urine test may be recommended to look for the presence of yeast or bacteria byproducts in the small intestine. If the small intestine is overgrown with yeast or bacteria, their byproducts are excreted through urine.
Resolving a bacterial imbalance requires lifestyle changes and multiple therapies. Ideally, SIBO patients are treated with a collection of patient-specific measures allowing for the most effective treatment possible. An individualized SIBO treatment protocol may include one or more of the following methods.
Recent research shows that a peptide substance called Body Protection Compound-157 (BPC-157) may be a powerful tool for treating SIBO. Benefits associated with BPC-157 include, modulating the gut-brain-axis, gastrointestinal rejuvenation and repair, and neuroprotection. Additionally, multiple studies show that BPC-157 can significantly lower gut inflammation. Furthermore, studies show that proper use of BPC-157 is more effective than common SIBO medications such H2-blockers, proton pump inhibitors, and gastric coating agents. Incorporating BPC-157 into a SIBO treatment protocol may produce exceptional results.
Adopting a SIBO Diet
Optimizing diet is a vital component of an effective SIBO treatment. The main goal of a SIBO diet is to support intestinal repair, reduce inflammation, and eliminate excess bacteria. Avoiding foods that are either difficult to digest or ferment easily reduces the risk of rapid bacteria growth. Conversely, consuming whole foods and gut-supporting substances can improve gastrointestinal wellness and bacteria balance.
Supplements may prove to be useful in resolving common nutrient deficiencies found in SIBO patients including, vitamin B12, vitamin D, vitamin K, probiotics, digestive enzymes, iron, and zinc. In addition to replenishing nutrients, SIBO patients may also benefit from certain gut-supporting supplements. We recommend HoltraCeuticals’ Gut Feeling Max.
Eliminating SIBO and Protecting the Gut
SIBO is a common condition that can contribute to the development of many other gastrointestinal disorders. This cascade of dysfunction can only be resolved by correctly identifying and treating all underlying issues including bacteria imbalances and potential systemic conditions. Individually crafted treatment protocols are the only way to effectively eliminate SIBO and restore gut health.
At Holtorf Medical Group, our physicians are trained to utilize cutting-edge testing and innovative treatments to uncover and address SIBO. Additionally, our Certified Health and Nutrition Coach will work with you and your HMG physician to develop a diet that addresses your unique needs. If you are experiencing chronic gastrointestinal disruption and suspect you may have SIBO or if you’ve been diagnosed with SIBO, but aren’t getting the treatment you need, call us at 877-508-1177 to see how we can help you!
1. Dukowicz, Andrew C et al. “Small intestinal bacterial overgrowth: a comprehensive review.” Gastroenterology & hepatology vol. 3,2 (2007): 112-22.
2. Kathleen McCoy, BS. “Do You Have SIBO Symptoms? Here Is ALL You Need to Know!” Dr. Axe.
3. Antonio Tursi. “Gastrointestinal Motility Disturbances in Celiac Disease.” Journal of Clinical Gastroenterology vol. 38, 8 (2004):642-645.
4. Parlesak, Alexandr et al. “Prevalence of Small Bowel Bacterial Overgrowth and Its Association with Nutrition Intake in Nonhospitalized Older Adults.” https://doi.org/10.1046/j.1365-2389.2003.51259.x
5. Richard J. Saad and William D. Chey. “Breath Testing for Small Intestinal Bacterial Overgrowth: Maximizing Test Accuracy.” Clinical Gastroenterology and Hepatology vol 12 (2014):1964–1972.
6. Sikiric P et al. “Stable gastric pentadecapeptide BPC 157: novel therapy in gastrointestinal tract.” Current pharmaceutical design. 2011 Jun 1;17(16):1612-32.
7. Boban-Blagaic A et al. “The influence of gastric pentadecapeptide BPC 157 on acute and chronic ethanol administration in mice. The effect of N (G)-nitro-L-arginine methylester and L-arginine.” Medical science monitor. 2005 Dec 22;12(1):BR36-45.
8. Vuksic T et al. “Stable gastric pentadecapeptide BPC 157 in trials for inflammatory bowel disease (PL-10, PLD-116, PL14736, Pliva, Croatia) heals ileoileal anastomosis in the rat.” Surgery today. 2007 Sep 1;37(9):768-77.
9. Patrick J. Skerrett. “Vitamin B12 deficiency can be sneaky, harmful.” Harvard Health Publishing.
10. M. F. Murphy et al. “Megaloblastic anaemia due to vitamin B12 deficiency caused by small intestinal bacterial overgrowth: possible role of vitamin B12 analogues.” https://doi.org/10.1111/j.1365-2141.1986.tb02894.x