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person suffering a pain from digestive track infection or diarrheaIf you have abdominal swelling, pain, and diarrhea, then you may have small intestinal bacterial overgrowth or SIBO. People most likely affected include women, the elderly, and those suffering from digestive conditions like irritable bowel syndrome (IBS). Luckily, the availability of various SIBO remedies may address the issue.

What is SIBO?

SIBO occurs due to the overgrowth, or an imbalance in small intestinal bacteria. Your digestive microbiome plays a very important part in your immune system, bone, thyroid, and general health. Your digestive tract contains millions upon millions of various microorganisms and up to a thousand different types of bacteria. Most of these bacteria, found in the large intestine and colon, play a crucial role in vitamin synthesis, digesting food, and waste elimination. However, these bacteria colonize your small intestine, and result in an excess of bacteria that causes problems. The presence of excess bacteria in the small intestine is called SIBO. SIBO remedies address these additional bacteria and their accompanying symptoms.

How SIBO Symptoms Arise

The excess small intestinal bacteria start to feed on the undigested foods present in your small intestine, especially the sugars and carbohydrates. This results in carbohydrate fermentation and the formation of hydrogen. In turn, hydrogen becomes a food source for archaea. These single-cell organisms produce methane.

Someone with SIBO may thus contend with the possibility of excess hydrogen and/or methane in the digestive tract. High methane levels may result in constipation, while high hydrogen levels may result in diarrhea. Either way, the excess gas in your gastrointestinal tract may lead to bloating, belching, and flatulence.

SIBO remedies targeted at gut bacterial control may address these digestive issues.

Causes of Bacterial Overgrowth in the Digestive Tract

image of bacteria growing in the digestive systemSeveral factors could result in an overgrowth of bacteria in the digestive tract.

Under normal circumstances, enzymes break down your food while food movement through the digestive tract relies on various nerves, muscles, and neurotransmitters. In so doing, food is moved from the stomach to your small intestines and then the colon. Then the waste product passes out of your system. A healthy gut system sees bacteria passing along the digestive tract with your food until it reaches the final destination along with the waste products. Interference in this process may result in issues such as SIBO.

Causes of interference include:

  • Nerve or muscle damage that leads to an increase in small intestine bacteria.
  • Obstructions in the gut, e.g. from surgical scarring, or diverticula.
  • Certain medications like antacids, steroids, and antibiotics that may unbalance your gut flora composition.
  • A diet high in sugar and refined carbohydrates.
  • The aging process that sees a decline in stomach acid production.
  • High stress levels.

When considering SIBO remedies, you should consider all the possible causes of interference.

Symptoms Associated with SIBO

SIBO has a variety of symptoms, such as:

  • Flatulence
  • Bloating
  • Depression
  • Diarrhea
  • Constipation
  • Abdominal pains or cramps
  • IBS or inflammatory bowel disease (IBS)
  • Food intolerances
  • Chronic disorders (like diabetes and autoimmune disorders)
  • Vitamin and/or mineral deficiencies
  • Skin disorders like rosacea or rashes
  • Malabsorption of fat typified by large, pale, smelly stools

Some healthy people and most people with IBS may have SIBO. Please note that these symptoms may also indicate inflammation.

Testing for SIBO

If you suspect SIBO as the cause of your symptoms, a healthcare professional could confirm the condition. There are three lab tests and a symptoms checklist commonly used to do so.

The Breath Test

The breath test gives a clear sign as to the dominance of either hydrogen or methane.

First, you fast for twelve hours before breathing into a balloon. This measures your hydrogen and methane baseline levels. You are then given a certain amount of sugar to eat, which feeds the bacteria in the small intestine. Over the next three or more hours, you will provide breath samples every fifteen minutes. These will establish whether there is an increase in the levels of these two gases.

The Urine Test

This lab test is common with functional medicine practitioners. Your urine gets tested to find any small intestine yeast or bacterial by-products. Although a simple test needing on one urine specimen, it does not show the dominance of either hydrogen or methane.

The Stool Test

This test allows one to look at your intestinal flora composition. If you have the symptoms but all bacteria present in the stool are classified as ‘good’ bacteria, SIBO may be the cause. This test is also good at seeing whether you have parasites or a candida overgrowth as these could add to your list of symptoms.

Your Inflammatory Response

woman is in the bathroom having bowel problems holding her stomach in painSIBO is associated with your inflammatory response. It's a form of chronic inflammation in your small intestine resulting from bacterial overgrowth and your immune system’s aggressive response.  Adrenal fatigue is often overlooked as one of the possible causes of an inflammatory response with regards to the gut.

Stress is one of the main causes of inflammation. This stress may result due to psychological, physiological, environmental factors, or lifestyle issues. It has a far-reaching effect on all body systems, starting with the Hypothalamic-Pituitary-Adrenal (HPA) axis and your body’s NeuroEndoMetabolic (NEM) stress response. Here, the increased cortisol and its accompanying effect on your body, as well as your body’s actions to curb these effects, may often result in inflammation that leads to a host of seemingly unrelated symptoms.

Most inflammatory issues start in the gut and, from there, spread throughout your body. This is because your gut lining is permeable and allows substances to pass through, thereby entering your bloodstream. Infection in your gut lining causes this permeability to increase and allow unwanted elements to pass through. This action may trigger your immune response and the resulting inflammation.

People who are in the latter stages of Adrenal Fatigue Syndrome (AFS) may be at particular risk of SIBO symptoms. This is because your metabolism slows down in a bid to conserve energy. The gut activity also slows down. Food, therefore, moves through your body much more slowly, allowing for more particle movement through a compromised gut lining or an increase in bacterial overgrowth. This only worsens the symptoms of SIBO.

Besides the possible symptoms already mentioned, gut dysbiosis may be linked to various neurological conditions, including Parkinson’s, multiple sclerosis, and autism. This is because the majority of neurotransmitters are made in the gut. Autoimmune disorders and psychological issues like anxiety and depression may also result because of chronic inflammation.

SIBO Remedies

Although stress plays a role in SIBO development, when it comes to SIBO remedies you need to take a three-pronged approach: make dietary changes, get rid of any unfriendly bacteria that worsens the situation, and try to balance your gut flora.

Conventional medicine often uses antibiotics as SIBO remedies. But here one needs to take care because SIBO may result from either high methane or hydrogen levels. Certain antibiotics are more effective in addressing the one than the other while getting rid of any ‘bad’ bacteria.

Diet

Your diet, to a large extent, causes SIBO. Yet it is one of the easiest SIBO remedies to implement. Foods high in sugar content and complex carbohydrates feed the excess bacteria in your small intestine, thereby worsening the problem. Regarding food, rather focus on high fiber foods, leafy green vegetables, fruit high in antioxidants like blueberries, fish, and beef. Do remember, everything in moderation and organic, if possible.

Also, remember the importance of hydration. In people with SIBO, water helps combat some SIBO symptoms.

Supplements as a Part of SIBO Remedies

Many functional healthcare specialists find certain herbal supplements just as effective as antibiotics in addressing SIBO. Amongst these we find:

Peppermint oil

Peppermint oil is one of the SIBO remedies that address SIBO overgrowth. Side effects noted with peppermint oil include heartburn, burping, and burning in the anal area.

Grapefruit seed extract

This is a natural antibiotic that helps to prevent the growth of any ‘bad’ gut bacteria without lowering healthy gut flora levels.

Oil of oregano

Oil of oregano capsules have antioxidant properties and contains phytochemicals that suppress your body’s resistance to bacteria, and polyphenols that support a healthy microbiome and immune function.

Garlic capsules

image of a capsule generated from herbs that serves as supplementThe allicin in garlic capsules helps with bacterial control and don't have the irritation sometimes found when eating raw or cooked garlic.

Berberine

Berberine (or Oregon grape or goldenseal) has antibiotic and antimicrobial properties help balance gut bacterial levels. It also helps support healthy digestive processes.

Olive leaf extract

Olive leaf extract has antifungal, antioxidant, and antibacterial properties that may offer digest tract support.

Thyme

Thyme is known for its benefits when it comes to upper respiratory tract conditions. Yet the herb’s antiseptic, antispasmodic, and carminative (flatulence-relieving) properties make it a part of the SIBO remedies list.

Pau d'arco

The antibacterial and antibiotic properties found in Pau d’arco may inhibit the growth of ‘bad’ bacteria in your digestive tract. It also supports the health of your intestinal lining.

Probiotics

Considered by many a staple when considering SIBO remedies, rather consider soil-based probiotics when dealing with the condition. This is because many probiotics may worsen your symptoms even although considered ‘good’ bacteria. Soil-based probiotics are encapsulated in a structure protecting them from stomach acids and various digestive enzymes. These probiotics only start their action in your large intestine and colon once it is safe for them to do so. They do not act in your small intestine.

Vitamins and minerals

Vitamin and mineral supplements are excellent SIBO remedies because many people suffering from a bacterial overgrowth have a shortage in certain minerals and trace elements. These include vitamin A, B12, D, E, and K, as well as calcium, zinc, iron, copper, and magnesium.

Digestive enzymes

Digestive enzyme supplements may help support digestive function until the issue is resolved.

Medium-chain glycerides

Medium-chain glycerides refer to easily digestible oils that do not need the action of digestive enzymes for absorption. Coconut oil is an example of a medium-chain triglyceride often recommended to people with SIBO.

Conclusion

While conventional medicine addresses SIBO via various antibiotics, functional medicine offers various SIBO remedies that may be beneficial. Most of these remedies are safe to use and have no negative side effects. However, you should always consult a qualified healthcare professional before embarking on a course of supplements. They are better able to suggest the right supplement for your specific needs as well as the correct dosage.

Having read up about SIBO and different SIBO remedies, how about learning how your inflammatory response works and possible solutions to chronic inflammation? The Dr. Lam site has many relevant pages that will help you gain a better understanding as to how your body works, and the different options available for reaching and maintaining optimum health.

© Copyright 2021 Michael Lam, M.D. All Rights Reserved.


Dr. Lam's Key Question

There are many factors that play a role in adrenal fatigue and many different symptoms. Remember, SIBO is an inflammatory condition, and inflammation is a result of your body’s NEM stress response. However, SIBO remedies, due to their action in addressing SIBO, may also supply adrenal support.

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