Small Intestinal Bacterial Overgrowth (SIBO) – The Elephant in the Room

SIBO occurs when the small intestine (the part of the digestive system that is designed to absorb nutrients from our food) is overgrown with bacteria that should not be there. The small intestine is effectively sterile. It is the colon that should harbour large populations of bacteria. When bacteria that should be in the colon decide to take up home in the small intestine, significant health issues may ensue, including nausea, bloating, vomiting, diarrhoea, malnutrition, weight loss, joint pain, fatigue, acne, eczema, asthma, depression and rosacea. SIBO might be best described as an infection of the small intestine.

SIBO is typically not considered in the standard assessment of an individual’s well being, but clinically it is highly prevalent. The latest data/studies suggest that IBS and SIBO often co-exist, with a 10-fold increase in SIBO if you are presenting with IBS. If SIBO is present it needs to be properly addressed, as without rebalancing the bacterial imbalances that drive this condition, the client has little chance of regaining long-term health and well-being. SIBO is highly correlated with nutritional deficiencies (even if supplementing), due to the bacteria in the small intestine interfering with absorption of nutrients. The malabsorption of nutrients is likely to eventually impact every major system in the body, if left unchecked.

Key triggers and drivers of SIBO include low stomach acid (including using Proton Pump Inhibitors such as omeprazole), poor bile flow/liver health, abdominal surgery (e.g. gall bladder removal and hysterectomy), radiotherapy, lack of pancreatic enzymes, diabetes, diverticulosis, coeliac disease, stress, ileocaecal valve dysfunction (the doorway between the small intestine and colon), food poisoning, regular alcohol and a dysfunctional Migrating Motor Complex (MMC) – The MMC makes cleansing/sweeping like motions between meals that cleans the small intestine, moving the contents of the small intestine and bacteria towards the colon. If the MMC is not working properly, then undigested food becomes a substrate for bacteria to thrive and ferment.

SIBO is typically treated with antibiotics, but reoccurrence rates are high and beneficial bacteria essential for digestive function are likely to also be harmed. Research and clinical experience show that certain herbal antimicrobials are just as effective at treating SIBO as antibiotics. Whichever route is decided upon, SIBO resolution requires a multi faceted approach to ensure that it is properly managed and prevented from reoccurring.