SMALL INTESTINAL BACTERIAL OVERGROWTH (SIBO)
What is SIBO? Small Intestine Bacterial Overgrowth. To best understand SIBO, you first need a basic understanding of the human microbiome. The human microbiome is the term used to describe all of the microbes that live in and on our bodies, both good and bad. A microbe is a tiny microorganism that can be bacteria, yeasts, molds, fungus, virus and parasites. I apologize if this may be news to you, but you are literally covered with tons of these bugs.
It is best estimated there are about 100 trillion microbes that live in and on our bodies, but there are only about 37 trillion cells that make up our entire bodies. This means that these bugs outnumber your cells by a startling factor of 3 to 1. This tells us that microbes have a huge influence on almost every function of our bodies. Your entire microbiome of these bugs is even considered another organ, just as important as your liver, or your lungs.
What is the purpose of these bugs? Like I mentioned, some of these microbes are simply the “bad” bugs you have heard about that carry pathogenic viruses, yeasts and parasites and can make us sick. However, the vast majority of these bugs are actually beneficial. Here is just some of what we know the beneficial microbes help us with:
- Digesting food
- Fostering a healthy immune system
- Regulating inflammation
- Boosting overall mood and happiness
- Creating healthy poop
- Making vitamins like B & K
So if our entire microbiome of all these bugs is healthy, we are also healthy.
Now let’s pull away from the entire microbiome and just focus on the good bugs that live along our digestive tract. Most of the microbes in our body live and flourish in our large intestine, specifically the last 4-5 feet of our digestive tract (see diagram). We need these microbes in order to be healthy. But when these good bugs migrate from the large intestine into the small intestine and stay there, we develop SIBO.
SIBO is not necessarily the presence of harmful bugs, but the presence of microbes in the wrong section of the digestive tract. It is when our good bugs live in the small intestine, rather than the large intestine, and that becomes harmful. Also the higher up along the small intestine (toward the stomach) these bugs travel and exist, the more issues people tend to have.
What Causes SIBO?
SIBO can have many causes but the most common are:
- Low stomach acid (sometimes caused by acid-reducing medications)
- Stomach infections
- Celiac disease (long-standing)
- Crohn’s disease
- Prior bowel surgery
- Loss of Ileocecal valve function
- Multiple courses of antibiotics
- Organ system dysfunction, such as liver cirrhosis, chronic pancreatitis, or renal failure
How Do I Know If I Have SIBO?
The common SIBO symptoms are:
- Acid reflux
- Skin conditions i.e., eczema, rosacea, acne
- Brain Fog
- Joint aches
Here’s an example of how issues with your microbiome affect your digestive system (gut) and your brain. Imagine three roommates are happily sharing an apartment. Now imagine that one roommate is grumpy and moody and complains about everything. Obviously, that will affect the other two roommates. To take it a step further, imagine that now two of the roommates are no longer happy. Now we’ve got a serious issue in the house. However, the three roommates don’t have the option to break the lease and leave the apartment so they are stuck together. They either have to work out their issues or simply suffer together.
I know these can seem like outwardly unrelated symptoms in regards to an intestinal issue. To understand why this happens, we explain this with something called the gut-brain axis. The gut-brain axis is the communication that occurs between your microbiome, your enteric nervous system (ENS) and your brain. The ENS is the mass of nerves that supply your gut (intestines) that is often referred to as your “second brain.” The reason why it deserves such an important title is because the ENS can function independently from your brain. The term, “listen to your gut,” derives from this very fact that your ENS has a “mind” of its own.
In the same way, your enteric nervous system (ENS), your microbiome, and your brain can act like those roommates. They are in constant communication with and affect each other just like the roommates. Based on the combination of how these three interact in the gut-brain axis, different symptoms will arise. So you can develop many different kinds of symptoms based upon your individual circumstances. However, the most common symptom associated with SIBO is a simple one, and it is when people bloat easily, especially after high fiber or high carbohydrate meals.
How Does SIBO Affect My Overall Health?
Besides the symptoms listed above, SIBO is also linked to “leaky gut” (intestinal hyperpermeability) and chronic inflammation. When you factor in these conditions, it becomes clear that SIBO can lead to a wide range of other health issues if left unaddressed. Chronic inflammation and leaky gut can also lead to issues pertaining to the brain, such as anxiety, depression, memory loss, and even loss of balance and coordination. Need I mention heart disease, autoimmune disease, arthritis, and anything else harmful. This is why the health of your gut is so important.
Can You Test For SIBO?
Yes, there is a test for SIBO. Like all tests, it isn’t perfect. There are false positives and false negatives based on many factors. The best practitioners to help you diagnose and get you healthy are those who are familiar with the most common test result scenarios and know how to interpret these results. The test consists of a series of breath collections after drinking a solution that can cause an acute increase in SIBO.
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