What is SIBO?

SIBO stands for small intestinal bacterial overgrowth. The symptoms of SIBO may include the following: gas, bloating, abdominal pain, nausea, diarrhea, GERD, constipation, anxiety, brain fog, fatigue, depression, weight changes and others. The most common symptom of SIBO is bloating, especially in the second half of the day.

Why does SIBO happen?

There are two major reasons why SIBO happens. The first major reason is there is a structural issue that decreases the flow of substances through the intestine. Basically things don’t move through as fast as normal. One example of this is a structural blockage which may occur as the result of adhesions (scars) in the abdomen that may arise in persons with history of abdominal surgery or with conditions such as endometriosis (yes, there is a connection between SIBO and endometriosis.)

The second major issue is there is a functional issue that decreases the flow rate of substances through the intestines. This is the case in SIBO caused by food poisoning, which is the most common underlying cause of abnormal motility in the intestines. Food poisoning accounts for about two-thirds of SIBO cases, and interestingly there is a connection between SIBO and IBS (irritable bowel syndrome). SIBO accounts for about two-thirds of IBS.

With food poisoning there is the potential to form antibodies to the system responsible for keeping the small intestine clear of large numbers of bacteria and other debris, which is called the migrating motor complex (MMC). The toxin that is released by food poisoning-causing microorganisms is called Cdtb. The immune system responds to the presence of Cdtb and makes antibodies to Cdtb. That is the appropriate response. However, because Cdtb looks like a protein in the MMC called vinculin, antibodies may also be made against vinculin mistakenly, thereby injuring the MMC. In that case the anti-vinculin antibodies injure the MMC which lowers the ability of the small intestine to “clean and clear” itself properly allowing colonization of bacteria.

How does SIBO happen?

Whether there is a functional or structural issue causing some degree of stagnation in the small intestine, normal bacteria of the large intestine take up residency in the small intestine.

The large intestine and the small intestine are two very different organs and have very different functions in the body. The large intestine is meant to be a place of final water absorption. It primarily functions to dehydrate the remains received from the small intestine to make stool. The large intestine is home to our microbiome which feeds on the leftovers from the small intestine and breaks down these leftovers to complete the digestive process. However, when our large intestinal bacteria make their home in our small intestine, we may experience gas, bloating, diarrhea, constipation, reflux, and many other issues.

Are there other risk factors for SIBO?

There are additional risk factors for SIBO that include the following: Ehlers Danlos Syndrome, Hashimoto’s thyroiditis, diabetes, pelvic inflammatory disease, appendicitis, endometriosis, traumatic brain injury, stress, gallbladder disease, systemic sclerosis, Parkinson’s disease, use of muscle relaxants or opioids, and history of abdominal radiation. What these risk factors all have in common is they either structurally or functionally impact the flow of substances through the intestines.

Does SIBO need to be treated?

Unfortunately, left untreated SIBO does not go away. Rather, it continues to fester and lead to more gastrointestinal issues and can cause issues that extend beyond the gastrointestinal tract. In the next segment on SIBO, I’ll be discussing how SIBO is diagnosed.

If you think you may have SIBO, take the next step to enhance your health and well-being-– Vytal Health is here to help.

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