You have just been told that the abdominal pain, bloating and discomfort you have been experiencing for some time now is due to small intestinal bacterial overgrowth or SIBO, as it is often referred to. You are relieved that you have a diagnosis and want to do whatever you can to recover from SIBO as quickly as possible. But you are confused and have a couple of questions like what is SIBO? What causes SIBO? And what can you do to cure SIBO naturally? These questions are the right approach to understanding and treating SIBO so you can get rid of the unpleasant symptoms and get back to feeling normal again. So let's get started by answering these questions and figure out how to treat SIBO naturally.
Small intestinal bacterial overgrowth (SIBO), as the name indicates, is when there is excessive growth of bacteria in the small intestine. The human gastrointestinal (GI) tract is home to many microorganisms and while there are some bacteria present in the small intestine, most of them reside in the large intestine or colon. These microorganisms, also known as microflora or microbiota, play a vital role in your health such as fermenting fiber and other foods not digested in the small intestine. They also help in the absorption of some minerals, production of some vitamins, and supporting the immune system. (1) Any change in GI microbiota has a negative impact on overall health, but especially on the health of the GI tract. One such change in the gut microflora causes SIBO, which is an overgrowth of the bacteria in the small intestine. Which brings us to the next questions, how and why did this happen?
There are several antibacterial measures in place in the digestive system that prevent growth of bacteria in the small intestine starting with the acidic gastric juices in the stomach that destroy bacteria from ingested food and drink. If any bacteria survive the acidic conditions of the stomach and they move on into the small intestine, they are killed by any one of the antibacterial mechanisms in place in the small intestine. These include actions of pancreatic enzymes, bile, and the intestinal immune system. In addition, normal movement of the small intestine called peristalsis prevents bacteria from sticking to the intestinal walls, while the ileocecal valve allows the passage of undigested foods into the large intestine but prevents the contents of the large intestine from reentering the small intestine.
As you can see, there is a whole system in place to keep GI microflora in their respective place. However, this also means that if any of these processes fails, it can result in microbial dysbiosis or an imbalance of microorganisms in the intestines, which can cause bacteria from the large intestine to move into the small intestine. (2,3)
There are also some other ways that SIBO can develop. This includes regular intake of antacids that decrease production of gastric acids in the stomach and create an environment that encourages growth of bacteria. Use of antibiotics can also disrupt the natural balance of beneficial bacteria in the GI tract. Furthermore, risk of developing SIBO may increase in people who have diabetes, Crohn's disease, celiac, diverticulosis, lupus, or HIV. (4)
With any one of these reasons, what you end up with is having the wrong kind of bacteria in the wrong place. While these bacteria are helpful in the large intestine, they can create havoc when they start growing in the small intestine. Overgrowth of these bacteria in the small intestine results in the development of SIBO and a wide range of symptoms linked to gastrointestinal disturbances.
Now that bacteria are in the small intestine, they feed off the nutrients that are supposed to be available for use in the body. This allows unchecked growth of unwanted bacteria in the small intestine. Here, they can damage intestinal walls and affect production of digestive enzymes that can lead to malabsorption and loss of nutrients such as carbohydrates, proteins, fats and vitamins. (2) Additionally, bacteria ferment short chain carbohydrates in the small intestine producing gases like hydrogen, methane and carbon dioxide, which are responsible for some of the most common symptoms associated with SIBO – bloating, flatulence, abdominal pain and distension. (3) But symptoms of SIBO are not limited and some are similar to those experienced by patients suffering from irritable bowel syndrome (IBS). (3,4,5)
SIBO is a complex condition to be completely free of. That is not to say it cannot be done but be prepared that it will take time, patience, and a can-do attitude. There are several steps that you need to take that will not only help treat SIBO but may also prevent a relapse. These include proper measures to eliminate bad bacteria, restore proper gut flora, and making lifestyle as well as dietary changes to help you treat SIBO naturally.
One of the best ways to eliminate overgrown bacteria in the small intestine is to starve them by not eating foods that encourage their growth. This means staying away from foods rich in fermentable carbohydrates that the bacteria thrive on. The overgrown bacteria ferment these carbohydrates in the small intestine, releasing gases such as hydrogen and methane in the process that cause bloating and abdominal distension.
A low-FODMAP diet, meaning a diet low in Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols may be helpful in decreasing symptoms of SIBO by starving the bacteria. The low-FODMAP diet is carried out in three phases.
In the first phase, try to eliminate all fermentable carbohydrates from your diet for 2 to 6 weeks, after which, in the second phase, you can slowly reintroduce these foods in the following 6 to 8 weeks.
It is important to make note of foods that do not cause any of the adverse effects associated with SIBO. In the third and last phase, you can include foods that were well-tolerated in phase two as part of your daily diet. Foods to avoid on the low-FODMAP diet include all-time favorites like bread, cookies, cakes, milk, legumes and sweet fruits. It is best to eat lean meats, non-starchy vegetables, and green leafy vegetables that are low in total carbohydrates. (6)
Next, you need to restore your gut with good bacteria so that they can carry out functions that support digestion, nutrient absorption and a strong immune system from their rightful place, the large intestine. While taking probiotics is widely believed to help restore healthy gut bacteria, it is critical that you do not aggravate symptoms of SIBO as certain probiotics can do that. This is why we specifically use a probiotic designed without prebiotics, perfect for those with SIBO.
Dr. Zyrowski has put together a kit containing natural ingredients for the treatment of SIBO. The kit includes the same nutrients he used to reverse SIBO naturally in his own life. The natural SIBO solution includes herbs and botanicals such as oregano, olive leaf extract, ginger and turmeric in Microbe Cleanse that are natural antimicrobial agents that help inhibit growth of bacteria and reduce inflammation. Gastro pH helps restore the acidic environment in the stomach, while GI Repair aids in reducing inflammation of the gut through the action of aloe vera leaf extract, l-glutamine, licorice and arabinogalactan. Excessive bacteria in the small intestine can also cause nutrient deficiencies because they consume nutrients that were to be absorbed and used by the body. To make up for any nutrient deficiencies that can occur if you have SIBO, the SIBO Kitcontains supplements of essential vitamins and minerals to help meet needs of these nutrients.
It is great that you have taken the first step to learn more about SIBO. I hope you found this post helpful and that it has addressed some common questions about SIBO, its causes, and treatment options. Remember that healing SIBO is a journey that you need to start by making small changes at a time to get your gut microflora back in balance. To learn more about SIBO, you can watch Dr. Zyrowski' s video and if you would like to consult him about your struggle with SIBO, you can consult him through his Precision Nutrition program.