Do you suffer from GAS and BLOATING after meals?
DIARRHEA or frequent loose stools?
Mysterious GI upset that diets don't improve?
SIBO:
What It Is and What You Can Do About it.
Small Intestinal
Bacterial Overgrowth(SIBO) is a
condition with an excess of varying types of non-pathogenic bacteria
within the small intestine. These types of bacteria may be beneficial in
the saliva, stomach or large intestine but overgrow and cause dysbiosis in
the small intestine. Common symptoms are abdominal pain, bloating, distention,
diarrhea, flatulence, restless leg syndrome and weakness. Other conditions
to consider along with SIBO are IBS/IBD, Lactose and Fructose Intolerance as
well as Celiac Disease. The microbial imbalance can lead to fat malabsorption,
a reduction of bile secretions that are antimicrobial and fermentation excess
leading to gas. Fat soluble vitamins(A, D, E, K) will be low as well as B's,
iron, zinc, selenium and amino acids. Long term the overgrowth will
affect intestinal permeability and nutritional status and leading to
systemic dysbiosis and infection.
Patients are at
risk who have had or experience:
- Long
term use of PPIs
or Antibiotics depleting
acids, enzymes and protein absorption along with many nutrients; Antibiotics
stripping the body of good bacteria.
- Hypochlorhydria, no to low stomach acid needed to act as an antimicrobial agent as
well as to bind, absorb and digest nutrients.
- Gastric Surgeries altering stomach acid levels and enzymes as well as peristalsis.
- Gall Bladder Removal eliminating bile acids secretions needed to digest fats and
act as antimicrobial agents.
- Crohn's Disease associated autoimmunity and inflammation severely affect nutrient,
mineral and protein absorption, intestinal permeability and can lead to overall
dysbiosis and infection.
- Celiac Disease or gluten sensitivity not improved with gluten free diets can be due to
SIBO. Inflammation in the gut lead to immune or autoimmune triggers.
- Hypothyroidism can lead to constipation, a motor dysfunction, and slower
small intestine metabolic transit time allowing bacteria to build up and
recirculate through the body.
- Diabetes affects
clearance time of excretion, the lack of motility due to neurological changes
in the periphery contribute to the build up of small intestinal bacteria.
Sugar imbalance also feeds yeast in the body that releases toxins into the
bloodstream creating gas and distention.
- Tetany and Restless Leg Syndrome(RLS) can be due to hypocalcemia and low mineral
absorption. RLS associated inflammation and autoimmune changes attack the
peripheral nerves.
- Night blindness can be exacerbated by malabsorption of fat soluble vitamins
specifically Vitamin A.
- Dermatitis. Rosacea and Skin Changes are affected by low selenium, low amino acids,
proteins and collagen as well as the related immune trigger response due to
inflammation.
TESTING can be done using a hydrogen breath test with
glucose or lactulose and upper gut respirate as the gold standard. Stool
testing is not diagnostic and can be of little value. Observation of symptoms
can be enough to start treatment and diet changes to look for alleviation of symptoms.
TREATMENT can include Rifaximin broad spectrum
antibiotic therapy and botanical antimicrobials like oil of oregano, allicin
and berberine. The FODMAPs
Diet is the most
recognized to change intake and alter microbial composition.
The Elemental Diets, Specific Carbohydrate Diet and Paleo Diet may
also be therapeutic options. Nutrient deficiencies are a hallmark of SIBO
so even if you eradicate the overgrowth you need to monitor repletion and
address the underlying cause. Serotonin receptor support and acid
restoration should be included. Micronutrient
Panel Information as well as Cardiometabolic
Panels to assess homocysteine
and Glycemic control are valuable tools as part of your treatment plan.
For more information or to get started on assessment and treatment contact Dr.Martin
--
CREATE HEALTH NATURALLY!
Dr. Hillary Martin, ND
Licensed Naturopathic Doctor
Dr. Hillary Martin, ND
Licensed Naturopathic Doctor
