SIBO is a clinical syndrome of gastrointestinal symptoms (e.g. abdominal pain, bloating, gas, distention, diarrhoea and constipation) due to the presence of an excessive number of bacteria within the small intestine (>105 – 106 organisms/mL).

Fungal and bacterial micro-organisms are part of the normal intestinal ecosystem, however they are normally regulated and kept in balance by the body’s immune system and mix of beneficial bacteria. For patients with SIBO, fungal/bacterial microbes migrate back into the small intestine from the large intestine.

Normally the small intestine contains relatively low amounts of bacteria and fungi/yeasts, but it’s only when the protective immune and/or GI mechanisms fail that SIBO/SIFO can occur. This overgrowth of micro-organisms in the small intestine causes production of large amounts of gases from premature fermentation of carbohydrates. This results in bloating, discomfort, and gases such as hydrogen and methane created, when partially digested food matter is fermented.

Symptoms of SIBO may include:

• Chronic abdominal pain
• Nausea
• Bloating and/or gas
• Pain and/or GI discomfort
• Diarrhea and/or constipation
• Fatigue
• Brain fog
• Fibromyalgia

There are several potential drivers of SIBO, the most common of which is irritable bowel syndrome (IBS). Meta-analyses indicate that as many as 78% of IBS sufferers also have SIBO. This is further validated by the efficacy of antibiotics in the management of IBS. When there are motility disorders in the gut, the reduced elimination of wastes and toxicity can prmote bacterial overgrowth.

Testing

Testing for the presence of SIBO is most commonly completed via a hydrogen-methane lactulose breath test. This method is relatively inexpensive, non-invasive, simple and widely available. It is important to test prior to treatment because testing identifies the type and extent of the overgrowth, both of which influence treatment.

Treatment

Approximately 44% of patients with small intestinal bacterial overgrowth (SIBO) relapse within 9 months of initial treatment. While the cause for relapse may be multifaceted, it is often largely attributed to failure to properly identify and address the underlying cause.

Naturopathic management of SIBO will involve the use of herbal antimicrobials (e.g. oregano oil, Phellodendron), prokinetic agents (e.g. partially hydrolysed guar gum), and a low fermentation diet, i.e. low FODMAP.

There are many antimicrobial herbal medicines that can be utilised to treat SIBO:

Allium sativum (Garlic) • Origanum vulgare (Oregano) • Punica granatum (Pomegranate) • Nigella sativa (Black Cumin) • Cinnamomum cassia (Cinnamon) • Berberine containing herbs such as Phellodendron amurense (Phellodendron)

If you suspect you may have SIBO; schedule a time with your naturopath to talk through functional testing options, as well as a tailored treatment plan.

The above listed antimicrobials will only work on SOME of the bacteria strains. ie all bacteria are sensitive to different types of antimicrobials, which is why a blanket approach doesn’t work.

You need a treatment plan tailored specifically to you and YOUR bacteria.

Yvette is a qualified Naturopath and Nutritionist, MINDD Practitioner, member of the Naturopaths and Herbalists Association of Australia.

Yvette specialises in the treatment of gut health and digestive complaints, skin issues, mood disorders, hormonal concerns, fatigue, and more.

 

 

 

 

 

 

 

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