Introduction:

Small Intestinal Bacterial Overgrowth (SIBO) is a health condition characterized by an abnormal increase in bacteria in the small intestine. It affects a significant percentage of the population, with estimates suggesting that up to 15% of individuals may be affected by SIBO. 

This article aims to shed light on the symptoms associated with SIBO, explore potential root causes, highlight the doctor’s approach, and outline the step-by-step approach that we would take to support patients with this condition.

Symptoms of SIBO:

Someone with SIBO will most likely have some of the symptoms listed below, but they do not need to have all of them.

• Bloating and distention
• Abdominal pain or discomfort
• Diarrhea or constipation (or alternating between the two)
• Excessive gas and belching
• Fatigue and low energy levels
• Nutritional deficiencies
• Weight loss or difficulty gaining weight
• Nausea and acid reflux
• Brain fog and difficulty concentrating

Root Causes of SIBO:

SIBO can arise from various underlying factors, including:

Impaired Intestinal Motility: Conditions such as intestinal dysfunctions or structural abnormalities can disrupt the normal movement of the intestines, leading to bacterial overgrowth.

• Low Stomach Acid: Inadequate production of stomach acid can reduce the effectiveness of the body’s natural defence mechanisms against bacteria, allowing them to proliferate in the small intestine.
• Digestive System Disorders: Conditions like celiac disease, inflammatory bowel disease (IBD), and irritable bowel syndrome (IBS) or some food intolerances or sensitivities can contribute to SIBO.
• Previous Abdominal Surgery: Surgeries that alter the structure or function of the digestive system can disrupt the balance of bacteria in the small intestine.

Doctor’s Approach to SIBO:

A doctor’s approach to diagnosing and treating SIBO typically involves :

1. Clinical Assessment: The doctor will evaluate the patient’s medical history, symptoms, and conduct physical examinations to assess the possibility of SIBO.
2. Diagnostic Testing: Breath tests, such as the lactulose or glucose breath test, are commonly used to detect the presence of bacterial overgrowth in the small intestine.
3. Antibiotic Treatment as a first line therapy: Doctors may prescribe antibiotics to eradicate the overgrown bacteria and restore balance in the gut. Commonly used antibiotics include rifaximin and neomycin. Sometimes, Probiotics are prescribed but they have shown mixed results in studies and in some cases can even make the SIBO worse by adding more bacteria to the small bowel.   
4. Prokinetics: Medications that improve intestinal motility, such as prokinetics, may be prescribed to enhance the movement of food through the digestive system.
5. Follow-up Testing: After completing treatment, repeat breath tests may be conducted to assess the efficacy of the intervention and determine if further treatment is necessary.

But even with all this, SIBO may be very difficult to get rid of.

Our Approach to Supporting SIBO Patients:

As part of a comprehensive treatment plan, a nutritionist can play a critical role in supporting individuals with SIBO. Here is a step-by-step approach that we may follow:

Step 1: Comprehensive Assessment

We will conduct a thorough assessment of the patient’s medical history, symptoms, dietary habits, and lifestyle factors to gain a holistic understanding of their unique situation.

Step 2: Personalized Dietary Plan

Based on the patient’s specific needs and symptomatology, we will design a customized dietary plan. This plan may include a combination of a low-FODMAP diet (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), elimination of trigger foods, and specific recommendations to support gut healing.

Step 3: Nutritional Supplementation

We may recommend targeted nutritional supplements to address potential nutrient deficiencies and support overall gut health. These supplements could include selective probiotics, digestive enzymes, and specific vitamins and minerals.

Step 4: Lifestyle Modifications

We will assist the patient in implementing lifestyle modifications that can positively impact SIBO. This may involve stress management techniques, adequate sleep, regular exercise, and optimizing hydration.

Additionally, we can combine Kinesiology sessions to help in prioritising and minimising stress in patient’s daily life.

Step 5: Further testing

If required, we may further investigated the root cause to overrule other potential issues such as IBS through a stool test.

Step 6: Monitoring and Adjustments

Regular follow-up sessions will allow us to monitor the patient’s progress, make necessary adjustments to the dietary plan and supplementation, and provide ongoing support and guidance.

Conclusion:

SIBO is a complex health condition that requires a comprehensive approach for effective management. By understanding the associated symptoms, potential root causes, and implementing the nutritional & lifestyle changes, individuals with SIBO can take proactive steps toward improving their gut health. 

If you struggle with your SIBO and related symptoms, we can provide valuable guidance and support on your health journey to restore balance and your overall well-being.