What is Small Intestinal Bacterial Overgrowth (SIBO)?

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The-Main-Symptoms-of-SIBO

Are you the kind of person who can’t eat anything without bloating so badly you look 3 months pregnant? Do you suffer from chronic constipation, diarrhea or abdominal cramping and pain? These symptoms may suggest Small Intestinal Bacterial Overgrowth (SIBO).

What is Small Intestinal Bacterial Overgrowth (SIBO)?

SIBO is an overgrowth of bacteria or the migration of commensal bacterial from the large intestine (colon) into the small intestine (SI). But isn’t it normal to have bacteria in the gut? Yes absolutely, but the “right” kinds of bacteria and the number of them is critical when it comes to the small intestine. The small intestine has only 10,000 bacteria per milliliter of fluid when compared with the large intestine, which has at least 1,000,000,000 bacteria per milliliter of fluid. When the migration of this microbiota occurs it causes functional and structural effectsibo-signs-symptoms-chart-drawings on the small intestine. The bacteria interfere with digestion and absorption of nutrients due to the damage of the lining of the small intestine. Damage to the lining of the SI is commonly referred to as “leaky gut”. Because the bacteria will consume some of our food, this leads to nutrient deficiencies such as iron and vitamin B12, which can result in anemia. Fat mal-absorption can lead to vitamin A and D deficiency. Through the damaged wall lining, large food particles enter the bloodstream causing food allergies, autoimmune disease and chronic fatigue and pain. Finally, the bacteria excrete acids causing neurological and cognitive symptoms like brain fog and migraines.

The gut is often referred to as “the second brain” because of the high concentration of neurotransmitters (the gut actually has the highest concentration of serotonin in the body) and the direct link it has to the brain and overall health. If gut microflora is imbalanced, dysbiosis ensues and no other system in the body can be in balance. This is why we believe so strongly in gastrointestinal integrity and we are excited to have a way of clinically measuring small intestinal bacterial overgrowth in patients who present with SIBO symptoms.

So what causes the gastrointestinal symptoms?

The bacterium, when overgrown in the small intestine, produces gases as byproducts, particularly hydrogen and methane. These gases cause bloating. Hydrogen gas production often results in diarrhea, as hydrogen attaches to another hydrogen and an oxygen molecule to make water…hence loose stools. Methane producing bacteria more often lend to constipation, though people can often have an over-abundance of both hydrogen and methane producing bacterium. These symptoms sound very similar to IBS right?  It turns out that 84 % of IBS/IBD patients test positive for SIBO. (1) While 66% of children diagnosed with IBS actually have SIBO. (2)   

What causes Small Intestinal Bacterial Overgrowth? (SIBO)

Our amazing bodies have built in mechanisms to control against the migration of bacteria from the large intestine to the small intestine. A few such mechanisms include:

  • Gastric acid secretion (Maintaining an acidic stomach pH is very important)
  • Peristalsis: Wave-like contractions of the muscles in the gastrointestinal tract that ensure timely and efficient movement of digested food particles through the gut for excrement.
  • Immunoglobulins in the intestinal fluid.
  • Ileocecal valve: Prevents the refluxing back of digested food into the small intestine. (A valve that separates the small intestine from the colon)

Who is at risk?

  • Low stomach acid
  • Irritable bowel syndrome
  • Celiac disease (long-standing)
  • Crohn’s disease
  • Prior bowel surgery
  • Diabetes mellitus (type I and type II)
  • Multiple courses of antibiotics
  • Organ system dysfunction, such as liver cirrhosis, chronic pancreatitis, or renal failure.
  • Not being breast fed
  • Traumatic brain or head traumas
  • Being born via cesarean section or having a C-section
  • Stress/PTSD (Sympathetic dominance which can lead to decreased vagal tone)
  • Decreased nerve motility from nerve damage (i.e. Lyme’s disease)
  • Chronic constipation (i.e. hypothyroidism)

Testing and treating SIBO

Utah has been one of the most under-served states when it comes to testing and treating SIBO because no clinic or hospital in Utah had the equipment until the Cameron Wellness Center acquired it. We are so excited to provide the only SIBO testing center in Utah! Testing for SIBO is done via a breath test. Breathing into 10 separate vials at 20- minute increments, will measure hydrogen and methane gas levels over a 3-hour period after consuming either glucose or lactulose. This kit can be taken home and performed. A positive test will show elevated levels of one or both of these gases. Patients testing positive for SIBO will then discuss the treatment plan of choice with the doctor, which includes an anti-microbial regime, initiation of a carbohydrate specific diet and a pro-kinetic to ensure proper peristalsis for the removal of bacterial die off. Patients will then have the option of re-testing methane and hydrogen levels post-treatment and repeat treatment if needed.

Fees

Initial breath Test: $180.00 (Which includes the breath test kit and analysis. Follow up appointment to discuss results and treatment plan not included.)

Retesting fee: $150.00

For more information on small intestinal bacterial overgrowth go to: www.siboinfo.com of visit our website at www.cameronwellnesscenter.net

References:

  1. Lin, H.C. Small intestinal bacterial overgrowth: a framework for understanding irritable bowel syndrome. JAMA. 2004 Aug 18;292(7):852-8.
  2. Scarpellini, E. et. al. Rifaximin treatment for small intestinal bacterial overgrowth in children with irritable bowel syndrome. Eur Rev Med Pharmacol Sci. 2013 May;17(10):1314-20.
  3. www.siboinfo.com