Functional Medicine’s Strategy for SIBO: An Overview

SIBO: An Overview

SIBO, or Small Intestinal Bacterial Overgrowth, is a term that refers to the abnormal growth of bacteria in the small intestine. This gastrointestinal disorder is prevalent and a commonly overlooked cause of irritable bowel syndrome (IBS)-like digestive symptoms such as abdominal discomfort, abnormal bowel movements, and bloating. The condition occurs when the concentration of bacteria in the small intestine rises dramatically, causing excessive gas and symptoms due to the bacterial fermentation of dietary carbohydrates.

Recognizing the Different Subtypes of SIBO

SIBO can be classified into three distinct subtypes. These subtypes are distinguished by the gaseous metabolic byproducts that the bacteria residing in the intestines produce.

Identifying Symptoms of SIBO

SIBO symptoms arise from bacterial fermentation within the small intestine, intestinal immune activation, inflammation, increased intestinal permeability, and poor digestion and absorption of nutrients. Common symptoms include abdominal pain, gas, flatulence, bloating, and diarrhea. Other symptoms can include heartburn, reflux, nausea, burping, constipation, and increasing food sensitivities.

Leaky gut caused by SIBO may also be responsible for symptoms outside the digestive tract, including fatigue, brain fog, headaches, changes in mood, skin issues, and joint pain. Moreover, because SIBO can disrupt healthy digestion and absorption, it's not uncommon for nutrient deficiencies to manifest.

Understanding the Causes of SIBO

SIBO can result from various medications, medical conditions, and lifestyle habits. SIBO most often results from reduced intestinal immunity, motility, and compartmentalization.

Stomach acid and other digestive enzymes act as part of the body's first defense against infection by killing bacteria passing through the digestive tract. When there are deficiencies in stomach acid, pancreatic enzymes, and/or bile, bacteria can overgrow within the upper digestive tract.

During fasting, the migrating motor complex (MMC) is a reflexive wave of small intestinal smooth muscle contractions (peristalsis). A diminished MMC and slowed intestinal motility impair the downward movement of bacteria through the small intestine into the colon.

Intestinal and abdominal structural abnormalities can impair intestinal motility and weaken the sphincters that compartmentalize the small and large intestines. These may contribute to the development of SIBO.

Functional Medicine Diagnostics of SIBO

Comprehensive stool tests measure fecal biomarkers that can provide insight into the underlying causes and consequences of SIBO. The GI 360 stool test by Doctor's Data offers a comprehensive look at the gut function along with a detailed view of the microbiome.

Vinculin & CdtB Antibodies

Positive vinculin and CdtB antibodies confirm a diagnosis of post-infectious IBS, which is indicative of intestinal motility dysfunction and increased incidence of SIBO.

Cortisol Testing

Salivary cortisol testing can identify maladaptive stress responses by qualifying and quantifying cortisol secretion patterns.

Micronutrient Testing

Nutrient deficiencies caused by SIBO can exacerbate extraintestinal symptoms and impair gut healing.

Thyroid Panel

Hypothyroidism impairs digestive enzyme secretions and intestinal motility, perpetuates intestinal and systemic inflammation, and exacerbates symptoms like fatigue and constipation.

Hemoglobin A1c (HbA1c)

Diabetes-related nerve damage to the intestines causes gastroparesis (slowed stomach emptying) and impaired intestinal motility.

Imaging

Some patients may need imaging to confirm the diagnosis of inflammatory bowel disorders, structural abnormalities, and MMC deficiencies.

Dietary and Nutritional Considerations for SIBO

Modifying the diet to limit fermentable carbohydrates can help relieve symptoms as SIBO is treated.

Understanding and Addressing SIBO

Small Intestinal Bacterial Overgrowth (SIBO) is a common digestive issue involving bacteria overgrowth in incorrect areas. It triggers significant symptoms and complications related to leaky gut and malabsorption. Successful SIBO treatment requires both rectifying predisposing imbalances and antibiotic therapy. With its complex nature and tendency to recur, pinpointing root causes via functional testing aids in the prevention and supports gastrointestinal health.

Begin your journey to better digestive health with Internal Healing & Wellness MD. Contact us today for personalized care and a comprehensive approach to managing conditions like SIBO.