As a Healthcare Practitioner, I’m seeing an increased prevalence of gut dysfunction, hence I felt the need to write about it. This is my first article on Small Intestinal Bacterial Overgrowth also known as SIBO and I would like to give you a snippet of what this is without overwhelming you with information. 

SIBO is defined as an increase in the number of bacteria, and/or changes in the types of bacteria present in the small intestine. In most people, it is usually an overgrowth of the various types of bacteria that should normally be found in the colon. 

Effect of SIBO:

The bacterial overgrowth causes fermentation of foods, especially starches and fibre. The gases produced by these bacteria could be hydrogen, methane or hydrogen sulfide. The gases produced by the bacteria then lead to the development of the symptoms in SIBO, most commonly occurring after meals. 

Common Symptoms includes:

  • Bloating and abdominal discomfort or pain
  • Gas and belching
  • Nausea
  • Constipation (generally associated with methane producing bacteria)
  • Diarrhoea (generally associated with hydrogen producing bacteria)
  • Altered between constipation and diarrhoea
  • Food sensitivities
  • Fatigue
  • Brain fog
  • Nutrient deficiencies
  • Weight loss or weight gain

Research suggests that up to 80% of irritable bowel syndrome presentations are actually SIBO-related.

SIBO has been shown to damage the structure and function of the small intestine. Due to the damage of the “gut architecture”, food digestion and nutrient absorption may be compromised.  Additionally, this damage to the small intestine lining can lead to impaired gut permeability which is known to have many potential complications including immune reactions that cause food allergies or intolerances, generalised inflammation and autoimmune diseases. These pathogenic bacteria can lead to nutritional deficiencies on top of those due to poor digestion or absorption. As they are situated in the small intestine, food that we consume also becomes a smorgasbord for these bacteria!

The bacteria may also decrease fat absorption through their effect on bile acids. Through a series of mechanisms, the body can no longer emulsify essential fatty acid such as Vitamin A, D, E and K.

The body has different ways of preventing SIBO. It attempts to maintain high enough levels of gastric acid, digestive enzymes and bile production, which discourages the bacterial overgrowth. It also maintains a healthy bacterial terrain and waves of bowel wall muscular activity also assist in further preventing over-growth. 

The cause of SIBO is usually complex. Some of the risk factors include structural disorders of the small or large intestine; IBS; motility disorders or medications which interfere with gut motility, such as codeine containing analgesics, proton pump inhibitors and antibiotics, surgery, fasting, over consumption of simple carbohydrate, stress, being elderly or a past history of Traveller’s diarrhoea (Giardia). 

SIBO test is available. It is a simple, non-invasive breath test. Speak to an integrative health practitioner who is familiar with SIBO. He or she could assess if the test is appropriate for you. If the test is positive for bacterial overgrowth, under the guidance of your practitioner, suitable treatment could then be commenced.  

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