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Do you have gas, bloating, diarrhea, constipation, IBS…or maybe all of the above? Then you may have SIBO, or small intestinal bacterial overgrowth.

Doctors have long blamed stubborn gut problems on stress. For the person whose life is dictated by the cruel whims of their digestive system, this can feel like shame and blame. Thanks to new research, these days we know many things cause gut problems. They include food sensitivities (especially to gluten and dairy), leaky gut, gut inflammation, autoimmunity, poor brain function, and SIBO.

SIBO results from too much bacteria that belong in the large intestine migrating into the small intestine. When these bacteria consume sugars and carbohydrates, they produce large amounts of gas that causes not only bloating, belching, and flatulence, but also constipation or diarrhea (depending on the type of gas produced).

These bacteria also inflame and damage the lining of the intestinal tract, causing leaky gut. Leaky gut allows undigested foods, bacteria, yeast, and other antigens into the bloodstream, triggering inflammation, autoimmunity, and chronic disease.

Many different lab tests, stringent dietary strategies (managing SIBO often requires a diet that restricts most everything but meats and a limited variety vegetables), and treatment protocols exist to treat SIBO, and sometimes it’s a matter of trial and error to land on an approach that works.

But if you don’t want a relapse, it’s important to ask why you have SIBO in the first place.

The causes include:

  • Food poisoning
  • Poor diet and excess sugar
  • Low stomach acid
  • Repeated antibiotic use
  • Chronic stress
  • Problems with brain function or health

Brain function is one of the most overlooked and unaddressed causes of SIBO. The digestive system maintains close communication with the brain. Poor brain function leads to poor gut function (this explains why people often suffer from gut problems after a head injury). Digestive juices and hormones are not sufficiently released, motility slows so that food sits longer in the intestines, giving rise to bacterial overgrowth, and the valve between the small and large intestine does not stay shut, allowing bacteria from the colon to escape into the small intestine where it does not belong. All of these are examples of how poor brain function leads to SIBO.

This explains how childhood brain development disorders, brain injuries, brain inflammation, brain degeneration, and brain aging all contribute to SIBO.

The elderly are especially vulnerable to malnutrition caused by SIBO, as are the increasing numbers of children born with autism and other brain development disorders. Fortunately, you can improve gut function through simple exercises that help tone the digestive system and prevent relapses of SIBO.

Managing SIBO does not have a one-size-fits-all solution, and there are various ways to approach it that include both nutraceutical and/or pharmaceutical approaches. Diet is always an important strategy. For more information, contact my office.

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SIBO in elderly copy

Do you have an older loved one in your life who seems to be wasting away no matter what you do to keep them nourished and healthy? This may be due to a condition called SIBO, or small intestinal bacterial overgrowth. SIBO happens when bacteria that normally belong in the large intestine travel backwards to colonize the small intestine. The small intestine is where we absorb the majority of our nutrients. Because SIBO inflames and damages the small intestine, this prevents these vital nutrients from being absorbed. As a result, the body and brain cannot function efficiently and it is difficult to maintain weight.

Symptoms of SIBO

For most people, symptoms of SIBO are straightforward. One of the most common symptoms is bloating after eating, particularly after eating grains, desserts, or other starchy foods. Other SIBO symptoms include gas, belching, indigestion, heartburn, nausea, abdominal pain and cramping, and either constipation, diarrhea, or both.

Doctors often misdiagnose SIBO as irritable bowel syndrome (IBS), as the symptoms are so similar. In fact, SIBO has been found in more than 80 percent of patients diagnosed with IBS.

Wasting away in elderly is usually SIBO symptom

Most doctors and patients haven’t heard of SIBO and blame such a rapid decline in the elderly on aging. However, researchers have identified SIBO, which is treatable, as the leading cause of malabsorption, and thus wasting away, in older adults.

SIBO doesn’t always result in malabsorption and wasting away. People can fall anywhere along a range of symptoms, from asymptomatic to the severe. But those who fall in the middle of the spectrum can become progressively worse. That’s why complaints of bloating and gas after meals should be taken seriously and not thought of as normal.

As SIBO and malabsorption worsen, nutrition status can plummet. Levels of B vitamins drop, which impacts many functions in the body, including brain function. Inflammation may also increase as the body’s ability to regulate immune function deteriorates. Also, it seems no matter how much older adults suffering from SIBO supplement, they cannot improve their low vitamin D status or persistent anemia.

The most devastating consequence of untreated SIBO and malabsorption is that it profoundly affects brain health and function, increasing the risk of dementia. It also saps energy and vitality. When an older person complains of bloating and distention after meals, it should not be dismissed as a minor complaint but rather regarded as a red flag indicating for more serious problems down the road.

The cause and treatment of SIBO

A variety of things can cause SIBO, including antibiotic use, poor diet, and digestive damage, such as from a long-standing undiagnosed celiac condition.

In older adults (and in those who have sustained a concussion or brain injury), another cause to watch out for is declining brain function. The digestive tract depends on healthy brain function to work properly. When signals from the brain to the gut are inadequate, the ileocecal valve  which separates the large intestine from the small intestine, may weaken and allow contents from the large intestine to travel backward into the small intestine, where they colonize. It is not the bacteria themselves that cause SIBO symptoms, but the byproducts they produce. These bacteria also compete with the host for protein from food.

Treatment for SIBO includes a strict diet to starve the bacteria, as well as targeted botanicals to kill them. Doing specific exercises to improve communication between the brain and the gut can also help prevent SIBO from perpetuating.

Ask my office for more information.

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Do you meet the criteria for irritable bowel syndrome (IBS) and can’t find relief? Do you look pregnant thanks to a bloated belly? Are chronic diarrhea or constipation your constant companions? If so, you may be a victim of stubborn gut bacteria, also known as small intestinal bacterial overgrowth (SIBO).

While a long list of symptoms accompany SIBO, its trademark symptoms are a chronically bloated, distended belly; gas, which can cause flatulence, belching, or both; and a tendency toward chronic diarrhea, constipation, or both.

SIBO symptoms

  • Excess gas, flatulence, belching
  • Abdominal bloating from gas
  • Abdominal pain and cramping
  • Constipation, diarrhea, or both
  • Nausea or heartburn
  • Irritable bowel syndrome
  • Multiple food sensitivities
  • Leaky gut
  • Fatigue
  • Malabsorption symptoms (anemia or fatty stools)
  • Rosacea
  • Neurologic and muscular diseases

How SIBO causes bloating, gas, constipation, and diarrhea

The entire gastrointestinal (GI) tract contains bacteria, both good and bad. The small intestine contains bacteria different from that of the large intestine. In the case of SIBO, the small intestine contains too much bacteria, and these bacteria more closely resemble the bacteria of the colon. These bacteria consume sugars and carbohydrates, producing large amounts of gas. Not only does this gas cause bloating, belching, and flatulence, it is also behind chronic cases of constipation and diarrhea (depending on the type of gas produced).

SIBO causes leaky gut

In addition to producing gas, the bacteria create byproducts that irritate and damage the lining of the GI tract. This damage causes intestinal permeability, or “leaky gut,” a condition in which the lining of the intestine becomes damaged and overly porous, allowing undigested foods, infectious bacteria, and other pathogens into the bloodstream. This creates inflammation in the GI tract and throughout the body. And because the bacteria digest foods normally meant for the intestine to absorb, nutrient deficiencies and malabsorption are common side effects with SIBO.

SIBO linked with restless leg syndrome and other neurological conditions

In addition to causing gastric complaints, SIBO is linked with neurological and cognitive symptoms. One of the best known is a condition called restless leg syndrome.

How to manage SIBO

Diagnosing SIBO involves a hydrogen breath test, which has the patient ingesting sugar solutions and giving breath samples over a period of several hours. Although experts debate its validity, clinicians report hydrogen breath test results often correspond with symptoms. Standard medical treatment of SIBO, which includes expensive antibiotics, has a good success rate, but patients can relapse if they do not take preventive measures after treatment. Anecdotal reports show success using herbal antibiotics, although there are no published studies. A medical fast using a nutrition drink for two to three weeks shows a good success rate, as it starves the bacteria. But because no eating is allowed during the fast, many find it too challenging a remedy.

The Specific Carbohydrate Diet and Gut and Psychology Diet, which are widely touted online, also aim to starve the bacteria by eliminating foods the bacteria need to survive: all grains, most legumes, all sugars and sweeteners excluding honey, and starchy vegetables. Both diets require strict adherence for a full year after the resolution of symptoms. In real terms, this could mean being on the diet for up to four years.

The good thing about these two diets is that they are virtually identical to diets used to manage autoimmune disease and chronic inflammation, and can thus address far more than SIBO.

For more information, visit www.siboinfo.com.

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