I work with a lot of clients that have SIBO, small intestinal bacterial overgrowth. We are supposed to have lots of bacteria in large intestine and colon. Sometimes this bacteria ends up in our small intestine in abnormally large amounts, and it certainly doesn't belong there.
There are 3 types of SIBO you may have heard of. Hydrogen, methane, and hydrogen sulfide SIBO.
The 2 better known types are hydrogen dominant and methane dominant SIBO. In our gut, bacteria produce hydrogen (as a byproduct of carbohydrate fermentation) and archaea produce methane. Hydrogen SIBO tends to cause diarrhea, and methane constipation. Archaea feed on hydrogen and make methane as a byproduct, and this can reduce levels of hydrogen, so this is why sometimes hydrogen breath tests are negative when SIBO is actually present.
Hydrogen sulfide is a third type of SIBO. Hydrogen sulfide is important for a variety of biochemical functions in the body, however its overgrowth can also cause SIBO, and it tends to affect the upper gut. Most with this issue also have methane dominant archaea overgrowth in the small intestine, and constipation is more common.
Hydrogen sulfide SIBO doesn’t show up on typical breath tests. So if you have symptoms of SIBO (such as IBS symptoms for example), and a negative breath test, using interventions for SIBO anyway may be helpful. In terms of the symptoms, this type of SIBO can cause rotten egg like breath, flatulence and stools.
When we have abnormally large amounts of bacteria in our small intestine as can occur with SIBO, we become unable to digest and absorb nutrients from the foods we eat. It is through the lining of our small intestine where many of our nutrients are absorbed so that our body can use them for fuel.
Because the bacteria that cause SIBO ferment carbs in the gut, starchy and sugary foods can feed the overgrowth. Therefore if you have strong carbohydrate and/or sugar cravings, it can be due to gut infections, like SIBO. The gases produced in this process result in some of the symptoms associated with SIBO, like gas, bloating, constipation, and diarrhea. SIBO also can be linked to skin conditions like eczema and other skin rashes (because SIBO leads to leaky gut, more on that below)!
When we have SIBO, finding the root cause is important. SIBO is very hard to eradicate, and one reason is because we neglect to address why it happened in the first place.
Two examples of underlying causes that can be addressed from a nutrition standpoint are motility of the gut, and appropriate digestion (there is often a lack of stomach acid and/or digestive enzymes, both of which are necessary for proper digestion of food and subsequent absorption of nutrients).
As the problem continues, inflammation in the gut causes the normally tight junctions holding the cells of our gut lining together to loosen. This results in leaky gut, allowing particles of food and toxins from bacteria to enter into the bloodstream. Our immune system mounts a response, and over time this can lead to autoimmune disease.
SIBO is most often addressed with specific antibiotics, and diet. There are natural anti-microbial agents that can help as well.
SIBO is stubborn. Many suffer for years. In order to resolve the problem we must address the underlying cause of it. This is often missed, which is why you can't get rid of your SIBO!
Protocols that are successful in eradicating SIBO take into account multiple interventions, and addressing the underlying cause.
Everyone is different. There is no one size fits all approach. Your plan will be unlike anyone else's. Working with a professional who can connect the dots between your biochemistry and best practices in SIBO eradication is essential if you want freedom from it once and for all.
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"Your nutritional needs are as unique as your fingerprint, and they are dictated by your individual biochemistry. As a functional and clinical nutritionist, I can help you interpret your body's nutrient needs and customize a plan to reach your health and wellness goals. This is personalized nutrition."
-Jennifer Caryn Brand, MPH, MS, CNS, Clinical Nutritionist
Wishing you a delicious weekend!
Functional and Clinical Nutritionist