What is SIBO?
Small Intestinal Bacterial Overgrowth, also known as “SIBO,” is a condition where excessive amounts of bacteria are present in your small intestine rather than the large intestine where they are normally found. The human gut flora has 10 times more bacteria in the body than cells (crazy, right?) and the majority of these bacteria are usually located in the colon. These bacteria ferment carbohydrates which can cause various digestive symptoms and even nutritional deficiencies in some cases.
What causes SIBO?
SIBO can be the result of several underlying conditions including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), celiac disease and a variety of other conditions. It can also result from a reduction of naturally occurring stomach acid or from an immune system that isn’t functioning properly. The truth is, SIBO is not yet well understood, but trends in associated conditions, symptoms and treatment have been identified.
The signs and symptoms of SIBO can be caused by the malabsorption of nutrients and/or the inflammation that can arise from the fermentation occurring in the small intestine. The digestive symptoms result from the gas produced by the fermentation going on in the small intestine. Studies show that the most common symptoms of SIBO are bloating, gas, abdominal distension, diarrhea and abdominal pain (1).
How do you know if the symptoms you are experiencing are due to SIBO?
See your practitioner if you have any symptoms of SIBO. Doctors often diagnose with a breath test. The premise of the breath test is that since SIBO causes your small intestine to produce methane/hydrogen gas from breaking down sugar in your small intestine, measuring levels of these gases in the breath can help diagnose. (Breath is measured after you are given a highly fermentable drink).
How can you treat SIBO?
Once diagnosed, it’s important to work with your practitioner to get the right treatment for SIBO. SIBO can be treated with a combination of antibiotics and diet changes. Antibiotic treatment is meant to directly kill the bacteria in the small intestine and introducing diet changes can help to indirectly starve the bacteria to death. It’s also important to treat any nutritional deficiencies that may have occurred.
Foods containing FODMAPs are often removed as a dietary approach to managing SIBO. These are a group of carbohydrates that your gut has a harder time absorbing properly. Studies have shown that a Low FODMAP diet can help to alleviate GI symptoms and reduce gas production. (2) It’s important to stress that low FODMAP is meant to be followed short-term (typically 4 to 8 weeks) to manage SIBO symptoms and decrease bacterial overgrowth. Long term is not recommend because it can restrict important and beneficial nutrients.
FODMAP stands for:
Examples of foods you may eliminate on a low FODMAP diet include:
- Fructose (high-fructose corn syrup, agave syrup, honey, apples, pears)
- Lactose (milk and yogurt)
- Fructans (wheat, barley, rye, onions, garlic)
- Galactans (legumes)
- Polyols (sugar alcohols, mushrooms, cauliflower, avocados, stone fruits)
Adding a digestive enzyme into your supplementation routine can help to break down the fat, carbohydrates, and protein that you eat and helps ease bloating associated with SIBO. Our Happy Gut Formula contains Digestive Enzymes and Peppermint Plus to help with bloating and improve digestion. Want to support your digestive health custom-tailored supplements? Take our free assessment for personalized recommendations based on your unique needs.
- Pimentel M, Saad RJ, Long MD, Rao SSC. ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth. Am J Gastroenterol. 2020 Feb;115(2):165-178.
- Bellini M, Tonarelli S, Nagy AG, Pancetti A, Costa F, Ricchiuti A, de Bortoli N, Mosca M, Marchi S, Rossi A. Low FODMAP Diet: Evidence, Doubts, and Hopes. Nutrients. 2020 Jan 4;12(1). pii: E148.