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Underlying Causes of Small Intestine Bacterial Overgrowth (SIBO)

September 26, 2017

Over the past year, I have seen and treated more cases of SIBO (Small Intestinal Bacterial Overgrowth) 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 is a laundry list of reasons why a patient may develop SIBO.

SIBO is defined as an increase in the number of bacteria present in the small intestine, that is, an increase in the number of bacteria that should not be there. Often, bacteria from the large intestine migrate into the small intestine where they are not welcome, causing many digestive issues including gas, bloating, GI distress, constipation, and 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 can help naturopathic physicians like myself give you the most impactful remedies possible. The more studied SIBO is, the more natural 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

Capsules

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 underlying conditions. However, here are some of the most common 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 most significant 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 become sensitive to foods that aren’t commonly causes of sensitivity 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 associated SIBO symptoms, I would recommend working with a physician to test for various 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 at some point but brushed it off after we’ve felt better. We move on with our 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 Symposium suggests that types of harmful bacteria are released when a person experiences food poisoning. These bacteria can have long-lasting detrimental effects on the gut. (6) 

(Excerpt 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 neurotoxin). 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 lives, been on a Protein Pump Inhibitor (PPI), such as Omeprazole, to inhibit their hydrochloric acid (HCL) production. As we’ve learned, this often does more harm than good, and it 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. 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 don’t have proper and frequent bowel movements, which causes 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 two 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 as 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) to put SIBO in remission successfully. 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 relatively common. The most crucial part of healing SIBO is keeping your mind right. It can be discouraging. It can be very challenging. But healing from any chronic disease or infection starts by getting your mindset right. Finding a naturopathic physician (or “wellness team”) that is encouraging, supportive, knowledgeable, and ready to walk this journey with you is invaluable to your success.

If you’re interested in a Part II on this topic, let us know by leaving us a comment, tweeting us, or posting 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 important 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 480-588-6856 to schedule a FREE brief meet and greet with a naturopathic doctor, to learn how we can help you heal.

In health,


Sources:

(1)

(2)

(3)

(4)

(5)

(6)

Filed Under: Blogs, Digestion

Jill Mapstead
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2022-03-22
Can’t say enough about Dr. Marianne Marchese! Her commitment to women’s wellness, calm, knowledgeable, non-judgemental guidance and insightful diagnoses / treatment has me turn to her for all my wellness needs. She takes the time to really listen. I feel heard and valued in her care.
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We had a great first visit with Dr. Turner and we look forward to continuing to work with her. She provides true support and guidance to better health. Alexandra Cohn
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I'm writing my review for Dr. Sarv Varta Khalsa. I met with her a few months ago to receive treatment for a condition I'd been dealing with for an extensive amount of time. She was incredibly kind and took the time to listen to all the details of the symptoms I was experiencing. The office had the prescriptions I needed on-hand so I didn't need to go off-site to find them. All natural remedies, and at comparatively good prices (I don't remember how much exactly, but if they were up-charging, which I doubt, I didn't notice nor would I have minded for the convenience). I'm still symptom-free now after following her recommendations, so I wanted to write a review to express my gratitude. Even though the appointment was pricey, it was worth every single penny to finally be able to live my life feeling normal again. Thank you so much!!
Irene Nicholas
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2021-12-15
What's better than a Naturopathic Dr.... Dr. Olivia Watkins!!! I have been working with her for over a year and have learned so much about myself, she is truly a team partner in my journey. She is experienced in ANYTHING you may be experiencing. I consider her my primary physician... you should too!!!
Stephanie Llamas
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2021-11-29
Dr. Watkins is nothing short of incredible. She is kind and personable, while extremely smart and results driven. I have suffered from digestive and hormonal issues my whole life and it wasn't until I met Dr. Watkins that I finally felt heard by a Dr and saw a difference in my health. I can confidently say that my body has never felt this good and we are still working to be even better. If you are ready to feel better and feel heard from your doctor, then run, don't walk to Living Wellness.
D Bach
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2021-11-10
Dr Olivia Watkins offers a beautiful aura of sincere loving support that I will forever cherish, as she exudes and radiates a beautiful light towards her patients' health care needs. Also, her staff, Joslyn and Ariana are as sweet as they come and have been as helpful as can be to me. One issue I had (and have had a few) was a lack of nutrient absorption and it was Dr Olivia who helped me change that status (thank God!) which I'm already seeing immediate results from and I've had this issue for years which my nails and hair loss were severely revealing! I've also experienced so much stress in the last year and a half, that having Dr Olivia as part of my healing process has made all the difference in my recovery to a more whole being! At this point, I seriously don't know what I'd do without her, as she is now my go-to health advocate and will be to my end days. Dr Olivia is a GodSend! Don't hesitate to call her office. High fives for the brightest healing light you could ever pray for in life! After eight long years, Dr Olivia just recently finished her GM residency and once again, I must congratulate her on such discipline and hard work as it has obviously paid off in spades! Long live Dr Olivia!
Kristin A
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2021-09-19
I love Dr. Marchese and so glad I found her last year. She has helped me so much with my health. I have recommended her to several people and they love her too.
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2021-07-28
Dr. Watkins is life changing! I am so grateful that I was referred to Living Wellness and her specifically. I’ve been dealing with severe stomach issues for 10 years and have gone through the ringer with the test, labs, and over-the-counter medicine suggested by other doctors. Dr. Watkins is so smart, thoughtful, and attentive to every detail so that she can really get down to the bottom of your problems. She feels like a teammate and a very strong coach and a friend all in one. I’m finally on my way to feeling better and I couldn’t have done this without her. If you’re struggling don’t even hesitate to see her or any of the staff at living wellness. I promise you won’t regret it!
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I began to see Dr. Watkins for some general Women's Health issues and she was incredible to work with. She helped my body become more balanced, pain was relieved naturally, and my body was prepared for a healthy pregnancy. She is kind, knowledgable, and very supportive!
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