Is SIBO The Cause of Your Gut Problems?

SIBO (Small Intestinal Bacterial Overgrowth) has been a major contributor of digestive issues, causing a range of digestive symptoms, such as nausea, bloating, gas, diarrhea/constipation, and/or abdominal pain. SIBO is exactly as it sounds, it is an overgrowth of bacteria (can be good bacteria too) or archaea in the small intestine, where they cause excessive gas production (hydrogen and methane specifically) which leads to the variety of symptoms listed above.

Known causes:

  • Impaired gastric acid barrier
  • Impaired intestinal clearance
  • Impaired immune response
  • Impaired structural integrity of the gastrointestinal tract
  • Impaired thyroid function

Things that will impair the gastric acid barrier will impair acid secretions in the stomach. This lack of stomach acid production will allow for improper food digestion. Thus this provides a great food source for any bacteria located in the small intestine which can then ferment such foods thereby causing an overgrowth. Medications such as proton pump inhibitors (PPI) that reduce or stop acid production have been shown to cause SIBO. As well as gastrectomy, which is a surgical intervention involving the stomach.

Impaired intestinal clearance can be caused by diabetes, which negatively impacts the nerves in the gut, thus leading to gastroparesis (intestinal paralysis). In additional many surgical procedures in the area (especially with relation to the colon) can cause a large amount of scar tissue in the area. This scar tissue will essentially pull on all the surrounding tissues causing impingement (or tightening effect) in the area thus preventing from foods to move down through the intestines. By preventing the movement of food down through the intestines, there is a risk of causing fermentation of the food higher up in the gastrointestinal tract, thereby allowing for an overgrowth to occur.

Impairment of the immune response related to any medical suppression, such as steroid based medications and immune impairing medications (example: methotrexate) have also been shown to cause SIBO. Obviously as you suppress the immune system you suppress your body’s ability to function normally, thus allowing for overgrowth.

Loss of the structural integrity of the gastrointestinal tract (or leaky gut) can also contribute to SIBO. As the gut becomes more leaky it allows for bacteria and their toxins to leave the large intestine and migrate towards the small intestine.

Altered thyroid function, such as hypothyroidism (including Hashimoto’s thyroiditis) has been linked with SIBO. But an even bigger link was found with those individuals who were being treated with levothyroxine (aka Synthroid). There is a theory that this condition leads to decreased intestinal clearance, but there is no clear mechanism for why Synthroid causes SIBO.

Diagnosis:

The number one way to test for SIBO is through a surgical removal of fluid (aka aspirate) from the jejunum and then measure amount of SIBO containing bacteria in the aspirate. Because of the obvious constraints of this technique, it is rarely performed. Thus we now test for SIBO using a lactulose breath test to measure both hydrogen and methane, the gases that the bacteria (or archaea) are producing in the small intestine. Please note that this breath test is not the same as the urea breath test used for H. pylori testing. Once measures we are able to determine the presence of SIBO and set up the proper course of treatment based on the underlying cause and the type of SIBO present.

If you feel that SIBO could be the cause of your digestive issues, please book in and ask to be tested. If you are taking any of the medications mentioned or have any of the conditions listed above and have digestive concerns, SIBO must be ruled out as a potential cause for your digestive concerns.

Call either Wellness Within (780-651-7365) or West Edmonton Naturopathic Wellness Centre (780-761-2889) to set up your visit with Dr. V to determine if SIBO is the cause of your digestive concerns.

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