Do I Have SIBO?

Are you suffering from bouts of bloating, diarrhea or constipation? 

Have you had abdominal surgery and now have a shortened bowel? How about narrowing or strictures in your bowel? Or intestinal adhesions from a previous surgery?

If you’ve been ruled out for other digestive diseases and still have unexplained and unresolved symptoms, you may be suffering from small intestinal bacterial overgrowth, also known as SIBO.

Living with SIBO can affect your overall health and may cause fatigue, stress, anxiety and mood disorders. I want YOU to know that you are not alone, I’m here to help!

What is SIBO?

In simple terms, SIBO happens when there is an overgrowth of bacteria in your small intestine. This bacteria typically migrates from in your colon. Your body works to help maintain the perfect balance of gut microbes in each section of the digestive system. But sometimes an altered anatomy or other medical condition prevents this homeostasis.

The small intestine is where your body mainly digests and absorbs nutrients from food. The majority of our gut microbiome actually lives lower down in our colon or large intestine, not in the small intestine. But when colonic bacteria exist in the more proximal small bowel, they ferment and produce gas that may interfere with the proper digestion process and result in uncomfortable digestive symptoms.

Symptoms of SIBO may include bloating, diarrhea, constipation, abdominal pain, changes in appetite, nausea, feeling uncomfortable after eating, unintentional weight loss, and even malnutrition and vitamin and nutrients deficiencies.

One of the risks of this bacterial overgrowth is that it can impede the proper digestion and absorption process of carbohydrates, fats and proteins in the small intestine causing dehydration, malnutrition, unexplained vitamin deficiencies, osteoporosis and kidney stones. 

These symptoms may leave you feeling fatigued and even scared of eating – you may find yourself avoiding foods. Additionally, you may have sought help from a medical professional only to be dismissed or given antibiotics only to find yourself right back where you started.

I hear you, and I see this happening way too often. 

Living with SIBO

SIBO is a challenging diagnosis for digestive specialists to manage. However, finding the root cause and addressing it with nutrition, lifestyle and complementary and traditional therapies can help you achieve lasting healing!

If this has been your experience, my first recommendation is to seek a second or third opinion. Find a gastroenterologist and book an appointment with a digestive disease specialized registered dietitian. 

How to find a provider to help

When choosing a medical provider, consider the following: 

1. Are they board certified in their field?
2. Do they listen to you? You don’t want a provider who dismisses your symptoms. You should feel seen and heard.
3. Are they trying to get to the underlying issue? Or are they only using medications (which may or may not act as a band aid)?

When SIBO is suspected we might order a variety of tests such as labs, endoscopy, and imaging to evaluate for different and more common conditions. IF these are negative and a suspicion of SIBO is still high, a breath test may be ordered. Once confirmed, we need to find the reason or reasons for your SIBO in order to treat it.

Initially your doctor might use several antibiotics to treat the bacterial overgrowth. The most efficient way to treat SIBO, however, is by treating the underlying cause. If they do not address the cause, SIBO will come and go and you will continue to struggle with the symptoms. 

The next obvious question in your mind is: what is the root cause of your SIBO?

What is causing your SIBO?

Inadequate movement of food through the digestive tract increases risks of SIBO, but there can be various reasons for slow motility, including:

• Medical conditions that cause the small intestine to slow down the movement of food and waste products such as Crohn’s disease, celiac disease, diabetes, radiation enteritis, intestinal lymphoma and scleroderma, hypothyroidism, Parkinson’s disease, amyloidosis, systemic sclerosis, chronic kidney failure, endometriosis and short bowel syndrome, among others.

• Abdominal surgery, such as a gastrectomy or gastric bypass. You might have had surgery recently or may be suffering from a disease that causes the digestive tract to slow down, causing the perfect breeding ground for bacteria.

• Small intestine structural differences such as fistulas, shortened bowel, intestinal adhesions and/or diverticulosis.

• Small intestine injury from medications like MSAIDS (non steroidal medications like ibuprofen, naproxen, Motrin, Advil etc)

• Irritable Bowel Syndrome (IBS) patients might be at higher risk of developing SIBO than others due to altered gut motility. Both conditions share symptoms and it is possible to have both at the same time.

There may be other reasons that contribute to create a bacteria-friendly environment such as:

• Low levels of stomach acid. The body is usually perfect at self-regulating. Yet an imbalance can cause an environment that is not acidic enough to kill unnecessary bacteria.

• Excessive alcohol consumption and/or smoking. Unhealthy habits can cause an imbalance in your digestive tract.

• Chronic stress and stress hormones have negative effects on our vagal nerve function, and therefore upset your normal gut movement.

• Medications that slow the motility of the digestive system or cause constipation such as frequent antibiotic use, proton-pump inhibitors, narcotics or opioids, antispasmodics and some antidepressants

Healing is possible 

There might be one or many contributing reasons for your SIBO. Ultimately, your personalized therapy plan will depend on what’s causing you to have developed SIBO in the first place. Treatment may take a long time and might take several trial and errors between you and your doctor to get to the root cause. 

What should you eat or avoid eating if diagnosed with SIBO? See a registered dietitian to create a personalized plan based on your nutritional needs and current food sensitivities. A dietitian can help you develop a varied diet with plenty of nutritious food to promote a healthy gut microbiome and get you on the path to healing.

And whether it’s SIBO or some other issue, Planted Forward can help!

You can always book an appointment with me or my amazing colleagues at Planted Forward. We offer Family Medicine, Gastroenterology, and Cardiology services, all provided by trained integrative physicians. We also have IBD and integrative registered dietitians and health coaching services to further support your health.

Do you need help managing your gastrointestinal symptoms? Or are you simply looking to be as healthy as possible? I’m here to help! If you want to maximize your gut health, you can purchase Doctor Méndez Introduction to Gut Health here or book an appointment with me today to get the support you deserve.