What is SIBO (Small Intestinal Bacterial Overgrowth) and how can Functional Medicine help?
SIBO can have a wide variety of physical symptoms including bloating, abdominal discomfort, nutritional deficiencies, fatigue and weight loss.
We talked to Angie, one of the nutritional therapists at Surrey Center for Nutrition to find out what symptoms to look out for, the underlying causes of SIBO, identifying SIBO and how functional medicine would recommend you to manage your SIBO including supplements and diet suggestions.
Read on to find out how functional medicine could help with your SIBO.
What is SIBO (Small Intestinal Bacterial Overgrowth) and how does it affect the body?
SIBO, or Small Intestinal Bacterial Overgrowth, is a medical condition characterised by excessive growth of bacteria in the small intestine. Typically, the small intestine contains a relatively low number of bacteria, while the majority of the gut's bacteria reside in the large intestine. However, in individuals with SIBO, bacteria that are typically found in the colon end up thriving in the small intestine.
The small intestine is responsible for nutrient absorption and digestion. When SIBO occurs, the overgrowth of bacteria can interfere with the normal digestive processes and nutrient absorption. The bacteria in the small intestine can consume nutrients intended for the host, leading to various symptoms and potential complications. Some of the symptoms associated with SIBO include:
Gastrointestinal Symptoms: These may include bloating, abdominal discomfort, excessive gas, diarrhea, and/or constipation.
Nutritional Deficiencies: Due to the bacterial competition for nutrients, individuals with SIBO might experience malabsorption of nutrients like vitamins (especially B12 and D), minerals, and other essential nutrients.
Weight Loss: The malabsorption of nutrients can lead to unintended weight loss.
Fatigue: Nutrient deficiencies and disrupted gut function can contribute to fatigue and overall decreased energy levels.
Joint Pain and Skin Issues: Some people with SIBO may experience joint pain, skin rashes, and other inflammatory symptoms.
Increased Intolerance to Certain Foods: SIBO can lead to increased sensitivity to certain types of carbohydrates, known as FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols).
Complications: If left untreated, SIBO can lead to more severe complications, such as damage to the lining of the small intestine further affecting it’s ability to absorb nutrients and an increased risk of developing other gastrointestinal disorders. Autoimmune conditions and several other chronic health conditions have been linked to SIBO
Fatigue: Nutrient deficiencies and disrupted gut function can contribute to fatigue and overall decreased energy levels.
Joint Pain and Skin Issues: Some people with SIBO may experience joint pain, skin rashes, and other inflammatory symptoms.
Increased Intolerance to Certain Foods: SIBO can lead to increased sensitivity to certain types of carbohydrates, known as FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols).
Complications: If left untreated, SIBO can lead to more severe complications, such as damage to the lining of the small intestine further affecting it’s ability to absorb nutrients and an increased risk of developing other gastrointestinal disorders. Autoimmune conditions and several other chronic health conditions have been linked to SIBO
What are the underlying causes of SIBO that Functional Medicine considers?
The causes of SIBO can be diverse and might include a range of underlying factors that can vary from person to person. Functional medicine takes a holistic approach to understanding and treating SIBO just as it does with other health conditions. As a result, Functional Medicine considers a range of underlying factors that might contribute to the development of SIBO, these factors include:
Impaired Gut Motility: Slow or impaired movement of the digestive contents through the small intestine can allow bacteria to accumulate and overgrow in the area. Conditions that affect gut motility, such as irritable bowel syndrome (IBS), which has a strong association with SIBO.
Structural Abnormalities: Anatomical issues like strictures, adhesions, or diverticula in the gastrointestinal tract can create pockets where bacteria can accumulate and proliferate.
Low Stomach Acid: Stomach acid plays a crucial role in killing off potentially harmful bacteria that enter the digestive system. Low stomach acid levels can contribute to the survival and growth of bacteria in the small intestine.
Disrupted Digestive Enzymes: Enzymes are responsible for breaking down food in the digestive tract. Insufficient enzyme production can lead to undigested food particles reaching the small intestine, providing a food source for bacteria.
Immune System Dysfunction: An impaired immune response in the gastrointestinal tract might not effectively control bacterial overgrowth, allowing bacteria to proliferate unchecked.
Lifestyle Factors: A range of lifestyle influences can disrupt the normal functioning of the gut and trigger SIBO.
Antibiotic Use: The use of broad-spectrum antibiotics can disrupt the balance of gut bacteria, potentially leading to an overgrowth of certain bacteria in the small intestine.
Underlying Medical Conditions: Conditions such as diabetes, hypothyroidism, scleroderma, and other autoimmune or systemic disorders can affect gut motility and increase the risk of SIBO.
Stress: Chronic stress can influence gut motility, immune function, and the balance of gut bacteria, potentially contributing to the development of SIBO.
Dysfunction of the Migrating Motor Complex (MMC): The MMC is a series of contractions that sweep through the digestive tract between meals, helping to clear out residual food and bacteria. Dysfunction of the MMC can lead to bacterial accumulation.
Gastric Surgery: Surgical procedures that alter the anatomy of the stomach or small intestine can disrupt the normal flow of digestive contents and contribute to SIBO.
In functional medicine, the emphasis is on identifying and addressing the root causes of health issues rather than just treating symptoms. Therefore, a functional medicine approach to SIBO might involve comprehensive testing, dietary modifications, lifestyle changes, addressing gut health imbalances, supporting digestive function, and individualised plans that aim to restore gut health and prevent bacterial overgrowth.
Are there specific diagnostic tests used in functional medicine to identify SIBO?
Specific diagnostic tests are used to identify SIBO which help to assess bacterial overgrowth in the small intestine and guide targeted strategies. Some of the common diagnostic tests used in Functional Medicine to identify SIBO include:
Breath Tests: Breath tests are commonly used to diagnose SIBO. These tests measure the gasses produced by bacteria as they ferment carbohydrates in the small intestine. The most commonly used breath tests for SIBO include lactulose breath test and glucose breath test. During these tests, the patient drinks a solution containing lactulose or glucose, and then breath samples are collected at regular intervals over a few hours. Elevated levels of hydrogen and/or methane gasses in the breath can indicate bacterial overgrowth.
Stool Testing: Comprehensive stool tests can provide insights into the overall balance of gut bacteria and potential imbalances that might contribute to SIBO. These tests analyse the composition of the gut microbiota and can also identify markers of inflammation, digestive enzyme activity, and the presence of harmful bacteria.
Small Intestine Aspiration or Culture: This is a more invasive method and is less commonly used. It involves collecting a sample of fluid from the small intestine and culturing it to determine bacterial counts and types of bacteria present.
Blood Tests: Blood tests may be used to identify underlying conditions that could contribute to SIBO, such as celiac disease, autoimmune disorders, and nutritional deficiencies.
Clinical Evaluation and Symptom Assessment: Functional medicine practitioners often consider the patient's medical history, symptoms, and other relevant factors in diagnosing SIBO. Symptoms such as bloating, abdominal discomfort, altered bowel habits, and nutrient deficiencies can provide valuable clues. It’s important to consider ‘silent’ SIBO where the symptoms are systemic rather than gut-based.
Can functional medicine help with the long-term management and recovery from SIBO?
Functional Medicine takes a holistic approach that focuses on identifying and addressing the underlying factors contributing to the condition. This approach can be particularly beneficial in managing SIBO, which often involves a complex interplay of factors.
Here's how Functional Medicine can help with the long-term management and recovery from SIBO:
Identifying Root Causes: Functional Medicine practitioners delve into a patient's medical history, lifestyle, diet, stress levels, gut health, and other factors to identify the root causes of SIBO. By addressing these underlying factors, such as impaired gut motility, low stomach acid, dietary habits, and more, functional medicine can help prevent SIBO recurrence.
Personalised Support Plans: Functional Medicine practitioners create individualised plans based on the specific needs of each patient. These plans might include dietary modifications, targeted supplements, herbal therapies, lifestyle changes, and strategies to address gut dysbiosis and support overall gut health.
Dietary Guidance: Functional Medicine places significant emphasis on nutrition. Practitioners may recommend specific diets, such as the Low FODMAP diet, to help manage symptoms and prevent SIBO relapse. They might also provide guidance on gradually reintroducing certain foods and determining which ones trigger symptoms.
Gut Health Support: Promoting a healthy gut environment is crucial for long-term recovery from SIBO. Functional Medicine practitioners may recommend probiotics, prebiotics, and other supplements to restore a balanced gut microbiome and improve gut integrity.
Stress Management: Chronic stress can impact gut function and contribute to SIBO. Functional Medicine practitioners often incorporate stress management techniques, such as mindfulness, relaxation exercises, and lifestyle changes, to support recovery and prevent relapse.
Follow-Up and Monitoring: Functional Medicine practitioners typically conduct regular follow-up appointments to monitor progress, assess symptom improvements, and adjust plans as needed. This approach allows for ongoing guidance and adjustments to optimise recovery.
Collaborative Approach: Functional Medicine often involves collaboration between the practitioner and the patient. Education and empowerment are important aspects of Functional Medicine, as patients are encouraged to actively participate in their healing journey and make informed decisions about their health.
Preventive Strategies: Functional Medicine aims to address the root causes and contributing factors of SIBO, which can help prevent the recurrence of the condition. By identifying and addressing these factors, patients can reduce the risk of SIBO relapse and maintain long-term gut health.
Are any specific dietary protocols or supplements recommended for individuals with SIBO in functional medicine?
Functional Medicine often recommends specific dietary protocols and supplements for individuals with SIBO to help manage symptoms, support gut healing, and prevent bacterial overgrowth. Keep in mind that recommendations can vary based on the patient's individual needs, severity of SIBO, and other factors. It's important to work with a qualified healthcare practitioner who can tailor the recommendations to your specific situation. Here are some dietary protocols and supplements commonly recommended in functional medicine for SIBO:
Dietary Protocols:
Low FODMAP Diet: The Low Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (FODMAP) diet restricts certain types of carbohydrates that can exacerbate SIBO symptoms. It aims to reduce the food sources that bacteria in the small intestine feed on. This diet is typically followed under the guidance of a healthcare provider and is often used as an initial approach to symptom management.
Specific Carbohydrate Diet (SCD): The SCD restricts complex carbohydrates and focuses on easily digestible foods. It aims to reduce the intake of sugars that might contribute to bacterial overgrowth.
SIBO-Specific Food Plans: Some practitioners may develop individualised food plans that combine principles from various diets to address SIBO symptoms and promote gut healing.
Supplements:
Probiotics: Certain strains of probiotics can support a balanced gut microbiome. However, the use of probiotics in SIBO protocols can be complex, as some strains might exacerbate symptoms. Working with a knowledgeable practitioner is crucial to select the appropriate strains and dosages.
Digestive Enzymes: Digestive enzyme supplements can aid in the breakdown of food, reducing the availability of substrates for bacterial growth in the small intestine.
Herbal Antimicrobials: Herbal supplements like berberine, oregano oil, neem, and garlic have been used to help reduce bacterial overgrowth in the small intestine. These antimicrobial agents can be incorporated into protocols for SIBO.
Gut-Healing Supplements: Nutrients like glutamine, zinc carnosine, and aloe vera can support gut lining integrity and help repair damage caused by bacterial overgrowth.
Motility Agents: Certain supplements like ginger, and prokinetics can help improve gut motility, reducing the risk of bacterial accumulation.
Nutritional Support: Supplements targeting nutritional deficiencies caused by SIBO, such as vitamin B12, vitamin D, iron, and other essential nutrients, might be recommended.
Do you think you could be struggling with SIBO?
Book a FREE discovery call with us at the Surrey Centre for Nutrition to opt for a natural and holistic approach to your condition. We integrate Nutritional Therapy with Functional Medicine to ensure that you have a treatment plan completely suited to you and your needs.
Written by Angie, Functional Medicine Practitioner & registered Nutritional Therapist
It is important to note that functional medicine and nutrition are complementary to conventional medical treatments. If you are experiencing SIBO issues or related health concerns, it is advisable to work with a qualified healthcare professional who can provide guidance, monitor your progress, and collaborate with you to develop an individualised treatment plan.