SIBO- Overlooked Cause of GI Issues

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

What is SIBO?

SIBO, small intestinal bacterial overgrowth, is an increase in the number of bacteria, and/or changes in the types of bacteria present in the small bowel according to  Amy Nett, MD. In most patients, SIBO is not caused by a single type of bacteria, but is an overgrowth of the various types of bacteria that should normally be found in the colon. Less commonly, SIBO results from an increase in the otherwise normal bacteria of the small bowel. 

SIBO has been shown to negatively affect both the structure and function of the small bowel. It may significantly interfere with digestion of food and absorption of nutrients, primarily by damaging the cells lining the small bowel (the mucosa). Additionally, this damage to the small bowel mucosa can lead to leaky gut (when the intestinal barrier becomes permeable, allowing large protein molecules to escape into the bloodstream), which is known to have a number of potential complications including immune reactions that cause food allergies or sensitivities, generalized inflammation, and autoimmune diseases.

A 47-year woman named Kristina was seen with the following symptoms:  Chronic bloating, gas and belching, abdominal distention, intermittent diarrhea/constipation, and abdominal pain/discomfort.

Based on the review of the patient’s symptoms and review of her medical records from her primary physician I was suspicious of a condition called SIBO (Small Intestine Bowel Overgrowth).

SIBO, small intestinal bacterial overgrowth, is defined as an increase in the number of bacteria, and/or changes in the types of bacteria present in the small bowel.

The normal small bowel, which connects the stomach to the large bowel, is approximately 20 feet long. Bacteria are normally present throughout the entire gastrointestinal tract but in varying amounts. Relatively few bacteria normally live in the small bowel. In most patients, SIBO is not caused by a single type of bacteria but is an overgrowth of the various types of bacteria that should normally be found in the large bowel.

The most accepted test to diagnosis SIBO is called the hydrogen/methane breath test. 

Here are the results of Kristina’s SIBO breath test:

SIBO Results– order from https://www.biohealthlab.com/test-menu/sibo/

Antibiotics are often used to treat SIBO. However, studies show that despite treatment with antibiotics, recurrence develops in almost half of all patients within one year. The most commonly used antibiotic for SIBO is rifaximin. The treatment I decided to recommend included the following natural botanicals: Biotics FC Cidal with Biotics Dysbiocide at a dose of 2 caps 2 x day x 4 weeks, for each formula. I worked the patient up to this dose over a two week period to minimize die-off symptoms.

In addition to the botanicals I recommended a SIBO diet. The SIBO diet is a temporary elimination diet that incorporates lowFODMAP foods to decrease bacterial overgrowth. Click Here for a food guide for SIBO.

Kristina followed the above treatment protocol for six weeks with excellent results. Her follow-up breath test was negative. It has been 8 months and she is still doing quite well.

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