What is SIBO?


The normal (beneficial) bacteria that are an essential part of the healthy large intestine also perform important functions. These beneficial microorganisms help protect against bad (i.e. pathogenic) bacteria and yeast that are ingested. They help the body absorb nutrients, and also produce several nutrients (such as short chain fatty acids) and vitamins like folate and vitamin K. These bacteria help maintain normal muscular activity, which creates peristaltic waves that move the intestinal contents, like food, through the gut.

What is SIBO?

Simply put, Small Intestinal Bacterial Overgrowth is a chronic bacterial infection of the small  Intestine. The bacteria that normally live in the large gastrointestinal tract have found their way into the small intestine by accident, a location not meant for so many bacteria, and overgrown.

The Problem:

The bacteria interfere with our normal digestion and absorption of food and are associated with damage to the lining or membrane of the Small Intestine (SI) (leaky gut syndrome).

They consume some of our food which over time leads to deficiencies in important nutrients such  as iron and B12, causing anemia.

They consume food unable to be absorbed due to SI lining damage, which creates more bacterial overgrowth (a vicious cycle).

After eating our food, they produce gas within our SI. The gas causes abdominal bloating, abdominal pain, constipation, diarrhoea or both (the symptoms of IBS). Excess gas can also cause belching and flatulence.

They decrease proper fat absorption by deconjugating bile leading to deficiencies of vitamins A & D and fatty stools.

Larger food particles may not be fully digested, and can slip through the damaged lining and enter into the body which the immune system reacts to. This can lead to food sensitivities.

Bacteria themselves can also enter the body/bloodstream.

Immune system reaction to bacteria and their cell walls (endotoxin) can cause chronic fatigue and body pain and burdens the liver.

The bacteria excrete acids which in high amounts can cause neurological and cognitive symptoms.

What causes SIBO?

The body has several different ways of preventing SIBO. These include gastric acid secretion (maintaining an acidic environment), waves of bowel wall muscular activity, immunoglobulins in the intestinal fluid, and a valve that normally allows the flow of contents into the large bowel but prevents them from refluxing back into the small bowel. (This is called the ileocecal valve because it’s located between the ileum, or terminal end of the small intestine, and the cecum, a pouch forming the first part of the large bowel.)

The onset of SIBO often coincides with a bout of gastroenteritis. Abnormalities in gut motility is recognized as one of the most common associations with SIBO. One study demonstrated that patients with SIBO do have significant delays in small bowel transit time (the amount of time it takes something to move through the small bowel).

Risk Factors:

  • Lower levels of stomach acid
  • High Antibiotic use
  • Diabetes
  • Bowel Surgery
  • Irritable bowel syndrome
  • Irritable bowel disease
  • Celiac Disease
  • Symptoms of SIBO are similar to IBS and include:
  • Abdominal pain/discomfort
  • Bloating and distention of the abdomen.
  • Diarrhea/constipation also gas and belching.
  • More severe cases can see weight loss and vitamin deficiencies.

As research into SIBO continues, we are increasingly understanding the complexity of this disease, and how treatment must be tailored to each individual to maximize success. The latest recommended treatment protocols for SIBO involve concurrent use of antibiotics and botanicals. TACGA works closely with GPs to ensure the most up to date and effective treatment is provided.

An additional piece of successful treatment must include addressing the underlying cause, or predisposing factor.