Underlying Causes of Small Intestine Bacterial Overgrowth (SIBO)
Over the past year, I have seen and treated more cases of SIBO than I have in my entire tenure as a physician. Some might ask: “Is it becoming more prevalent?” or “Why are so many people suffering from this condition?” The truth is, there are a laundry list of reasons why a patient may develop SIBO – Small Intestinal Bacterial Overgrowth.
Small Intestinal Bacterial Overgrowth is defined as an increase in the number of bacteria that are present in the small intestine; bacteria that should not be there. Often times, bacteria from the large intestine migrate into the small intestine where they are not welcome, causing a plethora of digestive issues including gas, bloating, GI distress, constipation, diarrhea – and the list goes on.
Although the prevalence seems to be increasing, we are also dedicating more time and resources towards researching this chronic condition, which in turn, helps physicians like myself, give you the most impactful remedies possible. The more studied SIBO becomes, the more treatments and protocols become available as options to help you heal.
If you’re suffering from any of the following conditions, it may be time for you to meet with your physician to rule out SIBO:
- Bloating
- Gas
- Constipation
- Diarrhea
- Abdominal Pain
- Brain Fog
- Fatigue
- Food Sensitivities (increasing or worsening)
- Skin issues (Rosacea, rashes, eczema, dry skin)
- Headaches / Migraines
- Pain or Gas After Eating
- Pain Not Relieved with Passing Gas
Now that we know what some of the symptoms are, you may be wondering: “What are some of the underlying conditions that contribute to SIBO?” Let me preface this by saying that there are MANY, however, here are some of the most common underlying conditions that I’ve seen, contribute to a SIBO infection:
1. Leaky Gut
You know when naturopathic physicians say “everything starts with the gut?” Well, it’s true. Leaky gut is one of the biggest predispositions to SIBO, according to recent research. When you have a permeable gut wall, your body classifies certain foods as “foreign invaders.” Eventually, one can develop food sensitivities to foods that, at one point, never caused a reaction. I’ve seen many patients start to become sensitive to foods that aren’t common, in a healthy human being, such as lettuce, cucumbers, blueberries, cantaloupe, and even spices. The goal is to work with a physician in getting to the root cause of Leaky Gut (and SIBO), by running a delayed IgG and IgA food sensitivity panel.
2. Prior Use of Antibiotics
For years, people thought antibiotics were the only way to cure or treat a health condition – whether it be a cold, sinus infection, yeast infection or SIBO. However, in naturopathic medicine, we utilize a variety of other herbs, blends of herbs, foods and lifestyle changes to create an environment of “healing” in your body. If you’ve ever used antibiotics (which, most of us have), and have any of the associated SIBO symptoms, I would recommend working with a physician to test for a variety of bacterial overgrowths. (2)
3. Past Incidence of Food Poisoning
Who remembers that one time they ate questionable grocery store sushi, and ended up regretting it at 2:00 am in the morning? Most of us have experienced food poisoning in some capacity, but brush it off, after we’re feeling better, and move on with their lives? It’s common, but it doesn’t mean that it’s benign. Research presented by Dr. Mark Pimentel, and the Mount Cedar Sinai Center and Hospital, at the Annual SIBO Synopsium, suggests that types of harmful bacteria are released when a person experiences food poisoning, that can have long-lasting harmful effects on the gut. (6)
“(Except from Better Gut, Better Health) – At the third SIBO symposium in Portland, Oregon last month, the research presented indicated that E. Coli, Salmonella, Campylobacter Jejuni and Shigella all produce a toxin known as cytolethal distending toxin B (a neuro toxin). Sounds pretty threatening, and it is, if you are one of the 10 percent of people who don’t necessarily recover from the food poisoning.” (6)
4. Low Stomach Acid
According to this study by the Journal of Gastroenterology and Hepatology, “Diminished acid production (hypochlorhydria) is a risk factor for SIBO, and can develop after colonization with Helicobacter pylori…. Inhibition of acid secretion via histamine type 2 receptor blockers (H2RAs) or proton-pump inhibitors (PPIs) may predispose to SIBO.” (2) Stomach acid is essential to breaking down your food and properly digesting your meals. Many of my patients dealing with SIBO have, at one point in their life, been on a Protein Pump Inhibitor (PPI) such as Omeprazole, to inhibit their own hydrochloric acid (HCL) production. As we’ve learned, this often does more harm than good and allows infections like SIBO to manifest.
5. Slowed Bowel Motility
One study, of many, suggests that chronic constipation, a symptom of SIBO, is caused by excess methane gas, which is, therefore, causing by slowed bowel motility. According to the Journal of Neurogastroenterol Motility, “A patient with slow transit constipation [is] associated with high methane production both in fasting state and after ingestion of glucose, whose constipation improved after treatment with non-absorbable antibiotic, rifaximin, which reduced breath methane values.” (5)
In constipation-dominant patients, most aren’t having proper and frequent bowel movements, causing a back-up of food, bacteria, waste, and gas. This slow bowel motility must be addressed before resolving SIBO, or a relapse can be expected.
6. Underlying Co-Infections and Disease
More times than not, SIBO is never the root cause. Did you have SIBO when you were 2 years old? Probably not. SIBO is the effect of one, or more, underlying causes that have manifested in the gut. Many times, SIBO is present alongside another co-infection or disease such H. Pylori, EBV, parasites, autoimmune conditions, adrenal fatigue etc. It’s imperative that you, alongside your physician, dig deep to find the root cause(s), in order to successfully put SIBO in remission. Dr. Alison Sibecker has a list of associated co-infections and diseases on her website, SiboInfo.org, alongside a plethora of other informative material.
Don’t be discouraged if your SIBO relapses – It’s fairly common. The most important part of healing SIBO is keeping your “mind” right. It can be discouraging. It can be very challenging. But, when healing from any chronic disease or infection, it starts by getting your mindset right. Finding a physician (or “wellness team”) that is encouraging, supportive, knowledgable and ready to walk this journey with you, is invaluable to your success.
If you’re interested in a Part II of this topic, let us know by leaving us a comment, tweeting us, or leaving a comment on Facebook. How do you treat SIBO? How do you prevent a relapse? What else can I do to decrease my risk of developing SIBO? These are all fair, and valid questions, especially for those of you in the midst of treating an overgrowth.
If you’re interested in chatting with one of our physicians, call our office at 480-588-6856 for a FREE, 10-minute consultation, to learn how we can help you heal.
In health,
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