Do You Have SIBO?: Symtpoms, Therapeutic Options, & Healing

Small intestinal bacterial overgrowth, or SIBO, is a condition in which the small intestine becomes overrun with harmful bacteria. These bacteria can contribute to a range of symptoms, including digestive issues, fatigue, hormone imbalances, skin issues, histamine intolerance, appetite changes, and weight changes. If you have ever struggled with SIBO in the past or are currently struggling, you know the bloating and discomfort are very real!

SIBO occurs when microbes that would typically exist in the large intestines, make their way to the small intestines where they do not belong. Here they feed on food particles that are not efficiently moving through to the large intestines, causing the production of either hydrogen or methane gas, as a byproduct of the fermentation process. The gas produced by these microbes has an annoying ability to slow down digestive motility.. This is why SIBO sufferers experience bloating and often extreme stomach distention from trapped gas and constipation. But fear not! There are indeed steps we can take to heal this condition and work toward a lifestyle that promotes long-term gut health.

Before we can understand the steps we may take in order to heal from SIBO, we have to understand why we developed pathogenic microbe overgrowth in the first place.

SIBO typically develops through a combination of any of the following factors:

• Low stomach acid (due to eating in a rush/while stressed)
• Trauma and unresolved emotional pain 
• Low immune function
• Poor gut motility
• Poor diet/eating foods that do not suit your constitution
• Surgery 
• Hidden infections (dental, sinus, food poisoning, and others)
• Unaddressed food allergies (caused by histamine/stress) and IBS
• Imbalanced diet/food triggers 
• Poor digestive hardware (more on this later)
• Excessive use of antibiotics without gut healing interventions

Fortunately, there are many different tools and strategies that can be used to help heal from SIBO and improve overall health. How do we eradicate it for good? We often wish there was a quick fix or magic pill to eliminate the uncomfortable symptoms.  However, as with most chronic conditions, we know there is no such pill or one size fits all approach.. It is SO important to address all of the contributing factors that have led YOU to develop SIBO.  Often those who have SIBO have had gut issues in the past. Maybe digestive issues are your weak point or propensity. Many notice experiencing a flare-up after a stressful event and a period of indulging in excess junk food. Through teaching others how to recover from SIBO, we have noticed that potentially the most important piece is addressing stress.

Stress impacts the gut in the following ways:

When we are under stress the body:

1. Is not able to easily produce the stomach acid/enzymes required to break down food, combat pathogenic microbes (bacteria, viruses, parasites, etc)
2. Is unable to have efficient motility, leading to excess gas production, bloating, increased bacteria fermentation of food 
3. Has poor circulation, further contributing to poor digestion 
4. Causes excess cortisol production, resulting in irregular blood sugars and irregular hunger cues (i.e poor appetite, increased appetite, cravings, etc) 
5. Experiences a microbiome shift, especially if losing sleep (i.e bacteria dysbiosis - less good bugs, more bad bugs in the gut

So what can we do about our stress? We have to be intentional about checking in with ourselves when we are feeling burnt out and asses what we need in order to restore balance. Ask yourself if you are engaging more time in activities that are creating resentment vs. joy and if you are in need of a mindset shift, or potentially a change in priorities and boundaries. In order to better manage stress, we also recommend engaging in mind-body tools such as prayer, meditation, breathing exercises, tai-chi, expressive writing, movement, and more. Community and having a loving support system with people whom you trust are so important in the healing process as well.

In order to address digestive hardware, or how the food is moving through the body, we have to address the WAY we eat vs. just what we eat. Nutrition is important, but we must also focus on how we are eating. Some key principles to consider when healing from SIBO include: Making sure to eat slowly and mindfully, eating until about 80% full, taking time to chew food thoroughly, and giving your body the time it needs to produce enzymes. This can help prevent pathogenic microbes from proliferating in the small intestine. This is why breathing before meals can be so beneficial, as it activates the parasympathetic state of the nervous system, known as the rest and digest state of the autonomic nervous system. When we are in this state of the nervous system, we are able to produce the acids and enzymes needed in order to efficiently break down food, absorb nutrients, and prevent the need for microbes to assist in this process (causing fermentation). So before you take your first bite, allow the senses to engage and wait til your mouth is salivating, signifying that the body is actually prepared to receive food, with the enzymes and acids produced prior to the meal. This means that we should allow ourselves to enjoy our food!

Meal timing is important as well for reducing the development of SIBO by optimizing the way in which our digestive system moves food and digested material through efficiently. There is a complex called the Migrating Motor Complex (MMC) that acts as a microscopic vacuum, propelling undigested food and cells into the large intestine. However, this complex stops doing its job whenever we are eating. In order to complete a full cleanout of the small intestines, about 3.5 hours are needed. This is why snacking is typically not recommended when eliminating SIBO. It is also important to check in with stress/tension throughout the day, as the body will not be concerned about expending energy on the MMC if it perceives the body is under attack/stress. Our natural bodily functions will operate best if we are in a state of balance within ourselves.

To prevent the dilution of enzymes and stomach acid during meals, it is best to avoid drinking water with meals. This may seem odd at first, but your digestion and bloating may improve! Wait a few minutes after your meal to drink beverages, and if possible aim for room temperature or even warm water/tea. In Traditional Chinese Medicine, when the digestive tract is weakened, warm soothing meals/beverarges such as ginger tea, and cooked foods are recommended over cold foods such as salads and smoothies. We know that raw foods also require more digestive capacity to break down, so it may be best to ditch the smoothie bowls and salads for a season and opt for cooked vegetable stir fries, steamed greens, and soups!

In order to address the best way of eating in order to resolve SIBO, we have to understand why certain foods create an increase in symptoms related to SIBO. Most people who have symptoms notice that they are unable to tolerate certain carbohydrates. These are typically short chain carbohydrates, called Fructooligosaccharides (FOS). Typically foods rich in (FOS) are healthy sources of fiber that pass through the small intestines and provide nutrients for probiotics, encouraging them to proliferate. However, when the microbes are replicating in the small intestine where they do not belong, FOS consumption can cause increased bloating, nausea, and constipation. This is why a low fodmap diet is typically recommended to follow, only for a few weeks while addressing the underlying causes of SIBO and taking botanicals to kill off the harmful microbes. Check in with one of our providers to discuss a protocol tailored to you. There are so many low fodmap resources on the internet to weed through, but each person is so unique. It may be helpful to keep a food journal while working with a dietician/nutritionist/coach and medical provider.

While there are many lifestyle modifications, and integrtive healing protocols, conventional treatment options are also available, which usually consist of specific antibiotics and other medications. It is necessary that you meet with your specific provider in order to discuss the right treatment options available for you. With the use of healing protocols tailored to your unique needs, lifestyle changes, and tools to manage stress, healing is definitely possible!

For more information, check out our gut healing masterclass!

Schedule a consult with one of our providers if you resonate with the content in this article, and start your healing journey today!

Resources:

J;, Deloose E;Janssen P;Depoortere I;Tack. “The Migrating Motor Complex: Control Mechanisms and Its Role in Health and Disease.” Nature Reviews. Gastroenterology & Hepatology, U.S. National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/22450306/.