Millions of Americans suffer from IBS, but very few doctors talk about what could be the underlying cause. IBS is a symptom that can point to other potential problems in the body that need to be dealt with.
In fact, IBS is so common that Chris Kresser, author of The Paleo Cure said it is second only to the common cold in causing people to miss work.
One of these potential problems could be SIBO, or Small Intestine Bacterial Overgrowth. There are bacteria all through your digestive tract but only a small amount live in the small intestine.
In a healthy digestive system, the number of bacteria in the large intestine outnumber the small intestine by 100,000-1,000,000x (https://scdlifestyle.com/2014/01/everything-you-need-to-know-about-sibo-small-intestinal-bacterial-overgrowth/)
If you’re serious about optimal health and weight loss you’ll want to understand SIBO. I will explain why this overgrowth happens, what damage it may be causing you, and most importantly what steps you can take to stop SIBO for good.
Hold On…I Thought Gut Bacteria Was A Good Thing?
If you’re keeping up with modern health trends you may have heard that recolonizing your gut bacteria with probiotics is the greatest thing since Betty White (she is older and much cooler than sliced bread). It is true …eating probiotics regularly is one of the best things you can do to maintain overall digestive health. It blows sliced bread out of the water as far as I’m concerned, and comes a close second to Betty White.
Hippocrates, the father of modern medicine himself, was certainly onto something when he famously said: “All disease begins in the gut.” The most recent data just keeps proving him right.
We have over 100 trillion bacterial organisms living in our gut and they are important for immune health and proper digestion. However, when a larger amount of bacteria, including good bacteria, end up in the small intestine, terrible things start to happen.
Leaky Gut
SIBO has been known to lead to something the experts call “leaky gut”, which is basically when the lining of your small intestine isn’t keeping food particles and toxins within the intestinal wall and instead lets them escape into the bloodstream.
It is also quite possibly the most disgusting name for a medical condition I’ve ever seen.
Leaky gut is a serious issue that can lead to a weakened immune system, autoimmune disease, ulcers, inflammation, and it can even exacerbate obesity. If your small intestine lining is permeable due to SIBO, you will want to take steps to clear up SIBO. I will talk about that shortly. Keep reading.
Luckily much of the effort you take to clear up SIBO can also aid in clearing up issues with leaky gut.
Vitamin Deficiencies
SIBO can leave you malnourished. Chances are good that if you’re wrestling with SIBO you will have a hard time absorbing all of the proteins, carbs, fats, vitamins, and minerals your body needs to stay healthy.
Vitamin B12 and iron deficiencies are particularly common and can lead to weakness, fatigue, and tingling in arms and legs. Symptoms of vitamin B12 deficiency may appear gradually but you should take them seriously.
Left untreated, a vitamin B12 deficiency could lead to anemia and permanent nerve damage. (https://www.health.harvard.edu/blog/vitamin-b12-deficiency-can-be-sneaky-harmful-201301105780)
Deficiencies in vitamins A, D, and E could lead to poor immune system health, hormonal problems, vision problems, and muscle weakness.
I could go on quite a bit longer listing all the side-effects of SIBO that range from irritating things like bloating and gas, unsightly and itchy things like skin rashes, and life-changing and mood altering things like depression.
However, I have a feeling most readers by now already understand they don’t want to have SIBO and if they already have it they want it gone ASAP.
The first step is to find out if you are one of the lucky ones who will just have to keep it away or the ones who will have to work harder to get rid of it. Don’t worry, this isn’t irreversible and there are multiple paths you can go down to restore your bacteria count back to normal.
What Causes SIBO?
Our body is hyper-intelligent… it can heal wounds and automatically digest food without a single conscious thought on your end. However, even the most beautifully designed machines can have maintenance issues.
The most common reason people develop SIBO is due to being overstressed. Fascinating research has been done on gut bacteria that has led to some scientists calling the gut and its bacterial tenets “a second brain”. http://dana.org/Cerebrum/2013/Gut_Feelings__Bacteria_and_the_Brain/)
The gut-brain axis goes both ways. Severe hunger could cause a stress or depression response, or in this case being chronically overstressed could lead to SIBO.
The Dark Side Of Good Medicine
I’m in no way anti-science or anti-doctor. Most medical professionals have your best interest in mind. Unfortunately, that doesn’t prevent the overprescription of antibiotics from happening which could be another major cause of SIBO. In a two year study involving 238,000 doctor visits, researchers have found that doctors prescribe the strongest form of antibiotic available 60% of the time.
Antibiotics are used to destroy bacteria in the body, but they do not just target the bad bacteria. They kill off good bacteria, too, causing a major imbalance in gut flora. This imbalance can cause a growth in bacteria in your small intestine.
Perhaps the biggest tragedy in all of this is that in one-quarter of these cases the antibiotics serve no purpose because the patient had a virus. (https://www.medicinenet.com/script/main/art.asp?articlekey=172470)
A Broken Digestive (Dis)Assembly Line
The last cause to talk about is digestive dysmotility. That’s just a fancy word for you digestive muscles not contracting and moving things along like they are supposed to. Think of it like an assembly line in reverse, where things are supposed to be taken apart as they go along but the conveyor belt gets broken. That broken conveyor belt is dysmotility.
Now if you think about that in terms of your gut, you have a whole bunch of food that is not being properly digested. It’s just hanging out in the small intestine it is only a matter of time before bacteria starts showing up to gorge on the feast.
There are many things that can lead to dysmotility but a common preventable reason is inflammation. Inflammation can be managed well by controlling your stress levels and upgrading a poor diet.
So to wrap up, some good ways to make sure you never have to deal with SIBO include limiting stress, maintaining a clean eating diet, and only taking antibiotics when absolutely necessary.
Diagnosing SIBO
There are many different tests you can use to determine if you have small intestinal bacterial overgrowth. Most of them have enough drawbacks for me to not recommend them. These drawbacks range from invasive and ineffective to downright inaccurate.
If you want to know for sure if you have SIBO then the breath test is the best bang for your buck. The bacteria in your gut give of certain gases as they break down food, and by measuring the amount of these gases the doctor can determine if you have SIBO
The basic idea of the test is as follows:
You fast for 12 hours before the test. A tube will be provided for you to breathe into. This initial breath will read your fasted levels of hydrogen and methane. You will then drink a solution containing lactulose or glucose and afterward will be directed to breathe into new tubes every 20 minutes over a period of a few hours. When your doctor looks at the hydrogen and methane levels for your test they should be able to determine if you have SIBO.
It is important to test for both hydrogen and methane because some bacteria gives off high levels of hydrogen, while others produce higher levels of methane.
Okay…I Have SIBO. What Now?
First of all, don’t be alarmed. Many people have had SIBO and effectively reversed the number of bacteria in their small intestine to normal levels using the methods I’m about to share with you.
If you go to a conventional doctor about this chances are they might prescribe an antibiotic. On the surface an antibiotic makes sense…you have an overgrowth of bacteria and antibiotics kill bacteria. However, as I mentioned earlier, antibiotics can actually CAUSE SIBO because it’s killing off the good guys and creating an imbalance.
So as a permanent solution antibiotics by themselves are not a great option.
Probiotics, on the other hand, have been shown in a study from the center for education and clinical research to provide a clinical improvement in 82% of their test group versus only 52% improvement from SIBO in the antibiotic group. (https://www.ncbi.nlm.nih.gov/pubmed/21381407)
The probiotics also create a balance within the gut so the overgrowth is less likely to come back. Since the antibiotics do nothing to attack the root cause, the SIBO may return.
In addition to probiotics and avoiding stress, as I mentioned earlier, adjusting your diet can help you clear out SIBO.
SIBO Diets
There are a surprisingly vast amount of diets out there created for the sole purpose of eliminating excess critters from your small intestine. Navigating them all can be overwhelming but the important thing to remember is that they all share a single goal: Starving the bacteria to death.
Okay, maybe that was a bit dramatic but bear with me because notice I said starve the bacteria not starve yourself. While it is true that you will have to cut a few things back there are still quite a few good options to keep you well fed.
FODMAP Elimination
FODMAPS are foods that don’t fully digest in intestines and are left to be eaten up by the bacteria. These foods feed the bacteria and thus work against our goal of starving the little critters.
What to avoid: Lactose (conventional dairy), fructose (most sugar, syrups, fruits, and juices), fructans (wheat, onion, garlic, broccoli), and galactans (legumes, brussel sprouts)
What to consume: Meats, eggs, raw/hard cheeses, tomatoes, carrots, grapes, bananas, and leafy greens
This one may seem limiting but this doesn’t have to be for the rest of your life. It works well as the first part of a two-phase plan along with the GAPS diet.
Gut and Psychology (GAPS) Diet
This diet works well as a phase two after a complete FODMAP elimination. After about two weeks of FODMAP elimination sub for the following guidelines:
What to avoid: Grains, refined carbs, sugar, dairy, starchy vegetables
What to eat: Meats, non-starchy vegetables, nuts, and healthy fats. Also drink lots and lots of bone broth
The full diet consists of six separate stages (seven if you include the introductory phase). Each stage lasts a few weeks, and afterward more food varieties are added. That means the GAPS diet gets easier over time.
Specific Carbohydrate Diet (SCD)
The Specific Carbohydrate Diet is actually quite similar to the GAPS diet. That is no coincidence, the GAPS diet was actually inspired by SCD. As the name suggests this diet limits complex carbs and only allows for specific kinds of carbs.
What to avoid: Grains, refined sugar, conventional dairy products, starchy vegetables, most legumes, and processed meat
What to eat: Leafy vegetables, most meat, peas, and mushrooms
Cedars-Sinai Diet
This diet isn’t nearly as restrictive as those above. For this reason, it isn’t the greatest for eliminating a current SIBO condition and instead could be effective for preventing SIBO in the first place. If it’s easier, chances are it’s not as effective.
What to avoid: Sweeteners, conventional dairy
What to eat: Meat, eggs, vegetables (especially non-starchy), and a sensible amount of fruit and legumes
What Is The Best Diet For SIBO
The best diet is always the one that you can follow. That being said some of the diets above work better for fighting off SIBO than others.
For particularly severe cases of SIBO two weeks of FODMAP elimination followed by all the stages of the GAPS diet should work perfectly.
For less severe cases or basic prevention, a lower fodmap diet combined with SCD or Cedars-Sinai should serve you well.
Whatever you choose, remember to keep your stress levels in check and add probiotics when appropriate.
If you are battling SIBO you CAN win. There are plenty of options you can choose from, and day by day your digestive system will begin to feel better than it has in years. It may feel intimidating at first but if you take it one step at a time you can eliminate SIBO for good.
