Small Intestinal Bacteria Overgrowth

What is it?

SIBO refers to an excessive growth of bacteria in the small intestine, distinct from the colon. Typically, the majority of bacteria, fungi, and other microorganisms in our gastrointestinal tract are meant to inhabit the colon (large intestine). But they don’t always stay there.

How can SIBO develop?

Gut microbes can migrate outside the colon for several reasons:

• Slow gastric or intestinal motility (common with EDS and POTS)
• Weakened ileocecal valve (valve between the small intestine and the colon)
• Low stomach acid or prolonged PPI use
• Prolonged low-fiber diet
• Associated with IBS C/D but this may not be the cause

How is it diagnosed and managed?

There is a variety of testing available for SIBO that can be completed by a gastroenterologist. Breath tests and stool tests are the most common. A list of symptoms are also collected to help narrow down SIBO as a possibility.

Doctors might prescribe a short course antibiotic to kill off the overgrowth. That is a decision you can make with your GI physician.

But the medical management doesn’t need to stop there.

What else can be done?

Your first thought might be to take a probiotic to treat it, recover from it or prevent it. There might be some evidence to show that probiotics can make SIBO worse, especially if you have other factors at play. The data is mixed.

The ultimate goal is to rebuild the beneficial bacteria and reintroduce a variety of plant-foods.

“Where do I start?”

Nutrition interventions are tailored to individual needs, so a customized approach is essential for effectively managing your unique case of SIBO.

Collaborate with your doctor and registered dietitian (or Certified Nutrition Specialist) to create a nutrition plan that suits you best.

What worked for a member of the SIBO Facebook group may not work for you.

Key Points

• The awareness of SIBO and the gut microbiome is growing.
• SIBO can develop for a variety of reasons.
• Work with your doctor to rule out other potential root causes behind your symptoms.
• Management doesn’t end with prescriptions.
• Think twice before loading up on probiotics.
• Find a nutrition provider to support you with nutrition interventions to get your gut health back on track.

Thanks for reading! And remember, that this information does not substitute personalized medical advice. If you’d like support with your nutrition, feel free to book a free discovery call to learn more about my services – I’d be happy to help!

Crystal McLean, MS RD LDN

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Sources:

PMID: 28267052

PMID: 23239918

PMID: 29915215