SMALL INTESTINAL BACTERIAL OVERGROWTH (SIBO)

Small intestine is a large area of IECs, where absorption of nutrients occurs. To imagine the size for nutrients absorption; it is about tennis court area! 

The cause of small intestinal bacterial overgrowth is complex. There are many important host defence mechanisms against bacterial overgrowth. When these protective barriers fail, SIBO occurs.

There are four main reasons for SIBO to occur:

1) Digestive deficiency. 

Achlorhydria and hypochlorhydria can cause small intestine bacterial overgrowth as stomach acid is there to destroy any pathogen, which gets ingested. Conditions like H. Pylori infection is a cause of low HCL production, thus predisposing body for SIBO. Pancreatic enzymes and bile salt insufficiency is very commonly associated with SIBO.

Digestive enzymes with betaine HCL are a great way to deal with this insufficiencies. 

My favourite product is Super Enzymes from NOW.

2) Formation of a scar tissue.

After abdominal surgery of any sort, scar tissue is formed. This scar tissue can cause adhesion of the small bowel to the abdominal wall and cause obstruction for a free movement of small intestine for proper peristalsis and cleaning waves of MMC complex.

Visceral manipulation is great way to loosen up the adhesions causing bacterial overgrowth.

3) Medication which slows down transit time trough digestive tract, opiates use.

4) Motility problems due to food poisoning, hypothyroidism, diabetes mellitus, mould toxins affecting small intestine motility, autoimmune diseases like scleroderma.

Every 9th person recovering from food poisoning will develop SIBO due to creation of antibody against vinculin (protein important for muscle contraction in small intestine).

IBS smart can identify antivinculin antibodies. If you are positive for the antibodies, it is very important to use prokinetics to heal MMC and prevent SIBO relapse.

I am using two laboratories to identify small bacterial overgrowth. SIBO doctor and Nutripath.

Jason Hawrelak, leading expert in Microbiome field in Australia recommends fructose as a main substrate for SIBO testing.

IBS smart is available to be tested in SIBO doctor lab.

I would like to also point out, that in small bowel and large bowel could be other pathogens than bacteria (so we are not calling it SIBO) like parasites, fungus, archaea which are causing digestive problems. Archaea are mainly associated with constipation and can, in many cases go hand in hand with fungus overgrowth. Misuse of antibiotic use can cause yeast to overgrow and cause yeast infection as a result.