Approximately 11% of the population suffer from Irritable Bowel Syndrome (IBS). Studies have shown that of these people, 60-80% of them have a condition called Small Intestinal Bacterial Overgrowth or SIBO. This is where the trillions of friendly bugs in our large intestine, migrate up into our small intestine (where they should not be) and wreak havoc by consuming the food in the small intestine which then leads to a production of gasses, mainly methane and/or hydrogen.
In SIBO the normal cleansing wave of the small intestine is disrupted or stopped. This cleansing wave is called the Migrating Motor Complex (MMC), and occurs approximately every 90 minutes, typically between meals (this is the grumbling often heard in our tummy). The function of the MMC is to clean the digestive tract and wash out accumulated bacteria and propel them towards the colon. When the MMC is interrupted, the result is the bacteria are allowed to grow and proliferate throughout the small intestine which is a little over 6 metres in length.
Symptoms of SIBO include;
- Digestive pain and discomfort
- Bloating and/or wind
- Alternating diarrhoea and constipation
- Burping and/or reflux
- Food sensitivities
- Joint Pain
- Skin rashes, acne rosacea
SIBO can result in;
- Malabsorption of carbohydrates and proteins
- Fermentation of sugars by bacteria causing hydrogen, methane and hydrogen sulphate gasses
- These gasses themselves are damaging to the gut wall
- Malabsorption of vitamins (especially B12 and folate)
- Malabsorption of minerals (especially magnesium, iron and calcium)
- SIBO can cause leaky gut, with a damaged wall, allowing larger particles to pass through, causing an immune response
There are several identified causes of SIBO with the most common being post-infectious SIBO after an episode of gastroenteritis. Ask yourself, did all your gut troubles start after a bout of gastro? Long term use of medications such as proton pump inhibitors (for acid reflux) can also be a contributing factor. Chronic stress can also decrease stomach acid output which is important as normal stomach acid levels are required to kill off the bacteria. Stress can also change the motility of the small intestine causing stagnation which allows for bacterial overgrowth.
Testing for SIBO can be done via a simple breath test to assess how much gas the bugs are producing. By assessing the type of gas being produced and the amount of gas, treatment can be tailored to your specific results. If you think you may have SIBO take the quiz at www.sibotest.com to see if you should pursue further testing with your Naturopath.