SIBO, what’s that – a new app for my phone? If only, no SIBO stands for Small Intestine Bacterial Overload, and it is becoming a serious problem for us. Last week I wrote about bloating. At the end of the article I talked about a bloating pattern that happens 3 to 4 hours after you eat a meal. This is the amount of time it takes for the food you eat to travel down to the middle of the intestines. Once it gets there the bacteria that live there start eating the sugars and fibers in the food. This is normal and is what is supposed to happen, but this only happens when you have normal amounts of bacteria living there.
SIBO is the condition of having too many bacteria living in your gut – up to a 1000 times too many. The amount of bacteria living in your gut normally goes up and down every day depending upon what you eat. The more food you eat that contains the things the bacteria also like to eat, the more bacteria you grow. Different foods feed different bacteria. The average person has over 500 different kinds of bacteria in their gut at any one moment. All these different bacteria live in balance with each other normally. When that balance is working it keeps us healthy. A balanced diet produces balanced populations of gut bacteria normally. That is the way it is supposed to work anyway.
But what happens when you don’t eat a diet that supports a proper balance of gut bacteria? Certain bacteria will grow way out of proportion to the other bacteria, creating imbalance.
Here is a key point to understand. Good bacteria in excess become bad bacteria. Each bacteria has different needs and they shape their environment to meet those needs – just like people do. And just like people, the balance of the bacterial society requires a balance of the different needs all affecting the same overall environment. A good example is the yeast candida. A healthy gut has a certain percentage of the gut population made of candida. The candida are necessary for health. But if you eat too many simple sugars, the candida grows out of control and makes us very ill. Too many candida alter the gut environment into a state that is good for them, but bad for us.
The same thing happens with other common infections like MRSA and H.pylori. MRSA is really the normal skin bacteria called staph aureus. In the right amounts, staph actually protects our skin from infection. But when the population gets too big, the gene expression of the staph changes and it becomes an invader. The same thing is true of the stomach bug H pylori. In human populations the same thing happens. Whenever you get too many people focused on one outcome, respecting the needs of individuals is ignored. Life depends on diversity to function. Sameness is disease – in the body and out of the body.
This is one way SIBO begins and the results it causes. Eating too many of the wrong foods feeds just a small portion of the gut bacteria biome or society. That portion overgrows and creates intestinal disease. The most obvious symptom of this bacteria overgrowth is gas formation. When these bacteria digest these foods, they release gas which builds up in our gut and makes it swell up rapidly. We fill up like a balloon. While the gas is uncomfortable and the huge swelling is the main reason we want to stop the process, the real problem is the gut tissue destruction that also happens with too many of these bacteria in the wrong place.
I say “in the wrong place” because our colon is designed to accommodate high concentrations of these “bad” bacteria. Often the simple cause of SIBO is the concentration of these bacteria in the colon gets so large that the gas they form literally shoves fecal matter backwards along the digestive tract and up into the small intestine. The colon normally has 100 to 1000 times the concentration of bacteria the small intestine has. Shoving that huge a concentration of bacteria backwards into the small intestine creates an infection that punches holes in the gut, blocks protein absorption, impairs fatty acid and vitamin absorption, and leads to full systemic inflammation.
Other things that lead to SIBO include using acid blocking drugs for heartburn. Stomach acid is not an option for the body. You have to have it to absorb your minerals and digest your proteins. It also exists to sterilize your food so you don’t let bad bacteria into your system. When you block your acid production with drugs, you create all these problems.
Other causes for SIBO include anything that messes with the mechanical motility of the gut, such as brain issues and stress that decrease the parasympathetic nerve supply to the gut as well as anything that suppresses the natural immune system function to the gut.
So what feeds these bacteria? They eat carbohydrates – sugars, starches, and soluble fibers. If you get abdominal discomfort after ingesting these kinds of foods, you have to consider that you may have SIBO, particularly if you get bloating 3 to 4 hours after the meal. As I mentioned last week, swelling immediately after eating these foods is more likely to be a food sensitivity or a digestion failure. But both of these can help set you up for SIBO.
So much for the bad news, now what can we do about it?
Step 1. If the valve between the colon and the intestine is stuck open, the ileocecal valve, it needs to be adjusted to release the spasm so it can close properly. If not, then you will keep getting fecal matter from the colon backing up into the intestine.
Step 2. If your stomach acid levels are low, that needs to be corrected. If that is because you are on acid blocker drugs, then you need to revisit your choice to use them. Most “excess” acid symptoms in the stomach are actually from not enough acid, not too much acid. That is a story for another day. The most common reason for low acid is actually low zinc levels. But you have to have acid to absorb zinc, so just taking zinc tablets is worthless. We can test your zinc levels in the office with a simple taste test and the remedy is children’s sublingual zinc lozenges.
Step 3. Resolve brain/nervous system issues – there are many techniques for increasing vagus nerve function – the parasympathetic nerve supply to the gut.
Step 4. Starve out the existing overgrowth of bacteria. Stop eating the foods that feed them for several months – Starches, sugars, fructans, oligosaccharides, galactans, soluble fibers, and polyols.
Step 5. After starving out the “bad” guys for a while, it is time to start adding in the right “good” guy bacteria to rebalance the gut biome/society.
Step 6. If necessary there are certain herbs that are effective in killing off the stubborn bad bacteria. There is also a specific antibiotic that stays in the gut that is about 49% effective, but it is very expensive and the herbs actually have a higher effectiveness.
Step 7. As the bad bacterial overgrowth comes under control it is time to repair the damage to the gut lining caused by the excess bacteria. For this purpose we use the herbs and amino acids in Repairvite from the office. Proper enzyme replacement may be necessary to support healthy digestion as well as acid support and bile production support.
If your gut is not happy, you are not happy. More than just discomfort, overgrowth of the wrong bacteria actually suppresses the feel-good neurotransmitters in your brain. A bad gut will literally make you depressed. Your health begins in your gut, and no matter what symptoms you have on any level, if your gut is bad it makes recovery harder.
So “Are you ever bloated?” is actually a very important question. If your answer is yes, then the time is now to do something about it.
Take care,
David