I’ve talked about Irritable Bowel Syndrome, or IBS on this blog — a lot. Many of the people who come to me for help with their digestive issues have been diagnosed with IBS. But very few people know about Irritable Bowel Syndrome’s sidekick, SIBO.
If IBS is Batman, SIBO is Robin. Yes, they can exist separately. But you find them together often. But most people who have SIBO — whether or not they have IBS — don’t know they have it.
Of course I can’t diagnose anybody in an article. But we’re going to dig into SIBO over the next few weeks. And if you suspect it might be an issue for you, then you might want to reach out to me or talk with another knowledgeable practitioner.
SIBO stands for small intestinal bacterial overgrowth. But in order to explain what’s happening there, let’s start with the large intestine.
Your large intestine is home to colonies of bacteria. Don’t panic! This isn’t a bad thing. This bacteria makes up your microbiome. And in a healthy microbiome, the vast majority of this bacteria is friendly. The microbiome is an essential part of your digestive system — but it helps with more than just digestion.
✔ Aids digestion — Some species of gut bacteria digest fiber and produce gut-friendly short-chain fatty acids
✔ Supports immunity — The gut bacteria communicate with immune cells, affecting how your body responds to infection
✔ Affects brain health — Recent studies suggest the gut microbiome may impact the central nervous system, which controls brain function
✔ Impacts your weight — Studies on identical twins (and mice) have shown that even in the presence of identical DNA and similar diets, body weight varies when the microbiome varies.
You want billions of bacteria to live in your large intestine. It’s a good thing. But your small intestine is a different story. These bacteria that we call friends in the large intestine, aren’t so friendly when they migrate into the small intestine.
Your small intestine should be virtually bacteria-free. And in a perfectly healthy digestive system, it is. But sometimes your small intestine uninvited guests come knocking. And if conditions are right, any bacteria that migrates up into the small intestine can grow rapidly.
SIBO stands for small intestinal bacterial overgrowth. This means that you have bacteria growing where it doesn’t belong — in the small intestine. And the bacteria has multiplied enough to cause problems.
SIBO can occur when the bacteria travel north from the large intestine into the small intestine, or when the small intestine doesn’t move food along quickly enough.
The small intestine is where most of the nutrients you consume are digested and absorbed. But when there is uninvited bacteria, these processes can be disrupted. And when that happens you can end up with symptoms including diarrhea, abdominal pain, bloating, and weight loss.
? A disruption of the normal muscular contractions that move food through the digestive tract is a common factor in SIBO. When these contractions — known as peristalsis — don’t work properly, food hangs out in the small intestine for too long. And when this happens, you end up with a breeding ground where bacteria can grow.
? Low stomach acid, which allows bacteria to survive in the stomach and move into the small intestine can also contribute to SIBO. Ideally, your stomach acid should kill any harmful bacteria before it moves on down the digestive tract. But when you’re low on stomach acid (or taking medications designed to reduce stomach acid), sometimes bacteria can sneak through and make it all the way to the small intestine.
? Excessive use of antibiotics. These medications can disrupt the balance of bacteria in the gut. And sometimes the unhealthy bacteria can migrate up through your digestive system and cause problems in the small intestine.
? A weakened immune system can allow bacteria to proliferate unchecked. Part of your immune function is dedicated to destroying harmful bacteria. But if your immune function is compromised, sometimes this bacteria can end up in your small intestine and grow.
? Abdominal surgery can result in complications that create the right condition for SIBO. Surgeries including gastric bypass and gastrectomy (for peptic ulcers and stomach cancer) can result in these complications.
? Structural problems and scar tissue can cause problems when they wrap around the outside of the small intestine or protruding pouches of tissue push through the wall of the small intestine (intestinal diverticulosis).
? Certain medical conditions, including Crohn’s disease, celiac disease, and diabetes can slow the movement of food and waste products through the small intestine, giving bacteria the opportunity to take hold.
This is where things get a bit tricky. Symptoms of SIBO include:
? Stomach pain
? Unintentional weight loss
I know what you’re probably thinking. These are the SAME symptoms as almost every other digestive problem, including IBS. That’s why I said it’s tricky. These symptoms are present in everything from SIBO, to IBS, to lactose intolerance, and more. So you can’t diagnose SIBO — or anything else really — just by looking at symptoms.
If you think you may have SIBO, it’s important to get in touch with a practitioner with experience working with SIBO patients. And that’s probably not your regular doctor, or even your gastroenterologist.
Your best bet is to see a practitioner that works with their patients on a functional level. This means they look at the body as a whole and find the root cause of your symptoms. Medications can put a band-aid on digestive symptoms. But if you want a long-term solution, you need to figure out what’s going on and address that core issue.
If you’re tired of dealing with your digestive symptoms — whether you have a diagnosis or not — I’m here for you. Click the button below to book your consultation. Let’s work together to figure out what’s going on so you can feel better.