Is SIBO the cause of your bloating?

What is SIBO and could it be the reason you constantly experience bloating?

SIBO is an acronym standing for Small Intestinal Bacterial Overgrowth.  So an overgrowth of bacteria, but not necessarily “bad” bacteria, in your small intestine.   It is estimated that up to 84% of people with IBS (Irritable Bowel Syndrome) have SIBO as their underlying cause.

Ideally almost all our bacteria should be hanging out in the large intestine, and the small intestine should be relatively sterile. This displacement can wreak havoc on your health as it can lead to leaky gut syndrome, liver overload, immune issues and potentially brain toxicity. Cotton wool head anyone?

SIBO often goes on unchecked for years on end as it is still relatively new as a diagnosis in the medical community. Plus, even though it's annoying and uncomfortable, most people are still able to carry on their day to day lives. I often hear my clients say they have learnt to live with it over the years, “I just have a sensitive stomach”.

It doesn’t have to be that way.

The bloating is often occurring as a result of fermentation. Fermentation is a metabolic process that converts sugar to acids, gases, or alcohol. The gas build up leads to the bloat. Often you can feel so bloated that you feel six months pregnant, when all you are incubating is food, not a baby. The favourite food that the bacteria like to ferment are certain types of carbohydrates, namely fructose and sorbitol in fruits, lactose in dairy, and fructans in wheat or onions.

What are the main symptoms of SIBO?

(Could be one or all)

• Bloating, especially if it's happening 1-2 hours after meals
• Food intolerances or food allergies
• Constipation, diarrhoea or alternating between the two
• Abdominal pain
• Acid reflux, heartburn or indigestion
• Headaches
• Excessive gas or belching
• Fatigue
• Brain fog
• Morning stiffness
• Out of control cravings
• Eczema and other skin conditions
• You feel worse when taking probiotics or prebiotics
• Weight loss or weight gain

What causes small intestinal bacterial overgrowth / how do you get SIBO?

So many reasons, with the main ones being:

• Period of high stress
• Digestive diseases like Coeliac’s, Crohn’s, or Ulcerative colitis
• History of antibiotics (even as long ago as when you were two years old)
• Any episode of food poisoning
• Low levels of stomach acid (can be caused by PPIs)
• Pancreatic insufficiency
• Drugs, such as opiates
• Any disease that slows functioning of the digestive system, i.e. Diabetes, Hypothyroidism

You can test for SIBO at home with the Lactulose SIBO breath test

Currently, the best way to find out whether you may have SIBO is the 3 hour Lactulose SIBO Breath Test. Anyone, anywhere can order a SIBO test with video interpretation through me.  

Testing for SIBO is really important as it will determine your most appropriate treatment protocol.

What is the best diet for SIBO?

(These are as a treatment adjunct, diet alone is almost never enough to clear SIBO completely).

It is also important to note that many of these recommendations are quite restrictive and aren’t designed to be followed long term. Clear the SIBO, then begin re-introducing.

• SIBO Stages Food Guide (my guide to eating all the foods again)
• Bi-Phasic Diet
• FODMAP Diet
• SCD Diet
• SIBO Specific Food Guide
• GAPS Diet
• Dr Siebeckers Home Made Elemental Diet
• Avoid alcohol – if you must your best choices would be clear spirits and no more than 30ml 2x weekly
• Caution with pre and probiotics
• Caution with fermented foods such as sauerkraut and kimchi
• Aim to space meals 4 – 5 hours apart. This helps with your Migrating Motor Complex (the sweeping wave that goes through your small intestine every 90 minutes – and is stopped by eating).
• Avoid drinking with meals. This can dilute your stomach acid levels and digestive enzymes. Great to “flush” your body with one litre of water within the first hour of waking up – digestive system is at its emptiest and can help to clear your digestive tract.

How to treat SIBO naturally

If you're wondering how to treat SIBO naturally, you've come to the right spot. Treating SIBO with natural antimicrobials is usually safer, better tolerated and more effective than pharmaceutical antibiotics or the elemental diet. 

Which antibacterial and antimicrobial herbs to use to treat SIBO naturally

This depends on the type of SIBO you may have, i.e. hydrogen or methane dominant.  Another reason why testing is a great idea.

Some of my favourites include:

Allimax

Berberine

Neem

Oregano – enteric coated

Iberogast for motility and improving digestion.

A “round” of herbals would usually be 4 to 6 weeks. High doses are often needed to smash SIBO, so check in with your practitioner.

Can you treat SIBO with antibiotics eg Xifaxan?

This wouldn’t be my first recommendation as they nuke everything, good and bad, and the relapse rate tends to be quite high after antibiotics.
Knowledge is power though and can help you to make informed decisions, so here you go:

H2 (hydrogen) Predominant SIBO: Xifaxan
Methane Predominant SIBO Xifaxan plus neomycin or tindamax

How to stop SIBO from coming back

Once you’ve cleared your SIBO it is important to figure out how you might’ve got it in the first place, so that you can prevent it from coming back. Unfortunately “relapses” can occur if not addressed correctly.

Parting piece of advice would be to begin your own food journal. Noting down foods eaten and any symptoms which may be occurring. So much easier to make connections when it’s noted down. The one I have available for download on my website can help you get an idea of what to look out for. Sometimes food intolerances can take 2-3 days to show up so bear this in mind.

If your bloating is not resolving or comes back as soon as you deviate from your “safe foods”, it would be a great idea to book yourself in to see your health care practitioner. From there you can investigate further to come up with a personalised treatment protocol for you and your specific needs…don’t be scared to look for a second opinion if your current practitioner has not yet heard of SIBO.  It’ll be worth your time and effort to connect with one that has.

While I was busy clearing my own SIBO, I was also busy taking my practice wholly online.

You can work with me 100% online from anywhere in the world and be guided every step of the way through my online Fix Your SIBO do-it-yourself course or my SIBO Freedom Group Coaching Program

Life is so much better when your digestive system is happy.

SIBO-free Kirsten

x x x