An Integrative Approach to SIBO

Small Intestinal Bacterial Overgrowth (SIBO) is a condition that occurs when there is an excessive amount of bacteria in the small intestine. While it's normal to have bacteria in the gut, an overgrowth can lead to various digestive issues and discomfort. At Texas Center for Lifestyle Medicine, we understand the importance of addressing SIBO for optimal gut health and overall well-being.

What is SIBO? SIBO is a condition characterized by an abnormal increase in the number of bacteria in the small intestine. Typically, the majority of gut bacteria reside in the large intestine (colon), while the small intestine contains a much smaller number. When the bacterial population in the small intestine becomes excessive, it can lead to symptoms such as bloating, abdominal pain, constipation or diarrhea, and malabsorption of nutrients.

Causes of SIBO Several factors can contribute to the development of SIBO, including:

1. Reduced motility: When the muscles of the small intestine don't contract properly, it can slow down the movement of food and allow bacteria to accumulate.
2. Anatomical abnormalities: Certain physical conditions, such as intestinal strictures, diverticula, or surgery that alters the gut anatomy, can create an environment that promotes bacterial overgrowth.
3. Decreased stomach acid: Stomach acid plays a crucial role in controlling bacterial growth. Low stomach acid production can allow bacteria to survive and migrate to the small intestine.
4. Compromised immune system: A weakened immune system can make it harder for the body to keep bacterial growth in check.

Symptoms of SIBO The symptoms of SIBO can vary from person to person but often include:

• Bloating and abdominal distension
• Abdominal pain or discomfort
• Diarrhea or constipation
• Gas and flatulence
• Fatigue
• Malnutrition due to impaired nutrient absorption

Typically, assessing the symptoms alone is sufficient, but the typical diagnostic test used to determine SIBO is a breath test. These tests measure the levels of hydrogen and methane gases produced by bacteria or archaea species in the small intestine. High levels of these gases indicate the presence of SIBO.

Treatment Options Treatment for SIBO typically involves a combination of approaches:

1. Antibiotics or herbal compounds: Specific antibiotics or herbal compounds can be prescribed to target and reduce the overgrowth of bacteria in the small intestine. At TCLM, we always lean on the conservative side when it comes prescriptions for antibiotics, as many patients can experience worsening of bacterial overgrowth. This is especially the case if probiotics are not tolerable to reinoculate the gut with healthy microbes. Certain herbs and supplements in tandem with lifestyle changes are sufficient to restore balance to the gut flora.
2. Dietary modifications: A low FODMAP diet, which restricts fermentable carbohydrates, can help alleviate symptoms and starve the excess bacteria. While this is not sustainable long term, it may be helpful initially to get symptoms under control. It is important to not create additional stress by adhering to a strict "diet." At TCLM, we know food is medicine, but any diet can be detrimental if it is a source of extreme additional stress and rigidity. Work with a health coach on our team to help navigate this process.
3. Probiotics: Certain probiotic strains can help restore the balance of beneficial bacteria in the gut.
4. Prokinetics: Medications that improve gut motility may be recommended to prevent the recurrence of SIBO. Hydration, specific types of fiber, and movement are all natural ways to help the gut motility.
5. Addressing underlying causes: Identifying and treating any underlying conditions that contribute to SIBO is crucial for long-term management. Often, SIBO accompanies underlying nervous system disorders, such as Dysautonomia and POTS, autoimmune disorders, or other immune system disorders. It is important to address root causes and have a whole-body assessment and roadmap to healing.

At Texas Center for Lifestyle Medicine, we take a comprehensive approach to treating SIBO. Our experienced healthcare professionals work closely with patients to develop personalized treatment plans that address their unique needs and promote optimal gut health. When necessary, we will even refer to GI Specialists who share our values and have an integrative approach to wellness. We take pride in collaborating with a team of experts who share our mission and vision for health. Contact us to start your healing journey today!