SMALL INTESTINAL BACTERIAL OVERGROWTH (SIBO) IS AN OFTEN OVERLOOKED TEST BY GPS AND HEALTHCARE PRACTITIONERS WHO OFTEN FOCUS FAR TOO MUCH ATTENTION ON THE LARGE BOWEL. WE OFTEN SEE CLIENTS WITH SIBO WHO HAVE BEEN UNDIAGNOSED AND/OR LABELLED WITH IBS (WHICH IS JUST A SYNDROME) FOR MANY YEARS BEFORE COMING TO SEE US.
The small intestine bacterial overgrowth test measures breath levels of hydrogen and methane to determine if a bacterial infection is present in the small intestine. The test differs from a stool test in that it tests for imbalance in the small intestine rather than the large. Small intestinal bacterial overgrowth occurs when bacteria from the large intestine travel to the small intestine, often the result of poor hydrochloric acid production in the stomach or an insufficient amount of pancreatic enzyme function. It is often found in conjunction with parasitic infections. Chronic pancreatitis, Crohn’s disease and lupus erythematosus can also cause small bowel overgrowth.
Symptoms of SIBO
What causes SIBO?
People with SIBO experience diarrhoea, bloating, poor nutrient absorption and weight loss Other people that may be affected are those with poor ileocecal valve function, poor intestinal motility, scleroderma, or recent gastric surgery. People with SIBO often have difficulty with digestion of fats, which come through undigested in the stool, called steatorrhea. They may also experience B12 deficiency, chronic diarrhoea and poor absorption of the fat soluble vitamins A, D, E, and K.
Breath testing provides a simple, non-invasive alternative to the more widely used method of obtaining a small bowel aspirate and is more accurate. To perform the test, you drink either a lactulose or a glucose drink and collect breath samples. Hydrogen is produced when lactulose or glucose come in contact with the gut flora. A significant rise in the Hydrogen levels indicates SIBO.
Q and A
What dietary measures are good for SIBO?
Low FODMAPS alongside SCD diet are a useful dietary measure for SIBO amongst other approaches but must be combined with bowel motility and anti-microbial programme.
Self help for SIBO prevention
What is the treatment for SIBO?
SIBO is treated using anti-microbials followed by bile and pancreatic support. This is then followed by a gut healing program and stress reduction techniques. Also it is necessary especially in methane based SIBO to improve the function of the Migrating Motor complex (MMC) For further info on testing see here
latest research shows herbal medicine as or more effective than antibiotics: Chedid V, Dhalla S, Clarke JO, et al. Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth. Global Adv Health
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