Understanding SIBO: A Functional Medicine Approach
Understanding SIBO: A Functional Medicine Approach
Small Intestinal Bacterial Overgrowth (SIBO) can be a daunting and isolating condition, impacting the quality of life for many individuals. As a functional medicine practitioner in Austin, I have helped many patients over the last 10 years understand and manage SIBO. In this comprehensive guide, we'll explore the causes, symptoms, diagnosis, and treatment options for SIBO, with a focus on how functional medicine can offer a personalized and effective approach to improving gut health.
What is SIBO?
SIBO occurs when there's an overgrowth of bacteria in the small intestine, an area that typically has fewer bacteria compared to the large intestine. This imbalance can lead to a range of uncomfortable symptoms but knowing that your experience is valid and shared by many can be the first step toward finding relief. The problem many people face in finding a correct diagnosis early on. This is because a colonoscopy and work up by a Gastroenterologist will often be completely normal. This can be frustrating because many are then told their symptoms are not being caused by their digestive system, when indeed they are.
Causes of SIBO
Understanding the root causes of SIBO is essential for effective treatment. Here are some common factors, but the list can be endless:
Motility Disorders: Conditions such as irritable bowel syndrome (IBS), scleroderma, and diabetes can disrupt the normal movement of the small intestine, creating an environment where bacteria can thrive.
Gallbladder issues: The gallbladder helps store bile that is secreted during digestion of fats. Poor bile secretion, gallstones, gallbladder sludge and removal of your gallbladder will affect your ability to digest fats and vitamins.
Food Poisoning and Parasitic Infections: Often times, people will experience SIBO after traveling abroad and getting sick. Parasitic and bacterial infections must be tested for, even if you have recovered years ago from the initial food poisoning illness.
Achlorhydria: Low stomach acid levels, often due to long-term use of proton pump inhibitors (PPIs) or H. pylori infection, can allow bacteria to survive the acidic environment of the stomach and grow in the small intestine.
Hypothyroidism: Thyroid hormones like T4 help produce hydrochloric acid in the stomach, a vitally important step in digestion. Thyroid hormones also activate motility and peristalsis of food through the stomach via the vagus nerve.
Concussion: the vagus nerve exits the brainstem and innervates function of all our internal organs. A concussion causes a neuro-inflammatory response in the brain that can downregulate function of the vagus nerve causing a downstream effect of poor digestion and motility.
Symptoms of SIBO
Living with SIBO can be challenging, especially since its symptoms often mimic those of other gastrointestinal issues. Common symptoms include:
Bloating and Abdominal Distension: Feeling uncomfortably full and noticing your abdomen swell can be distressing. Typically bloating will be the least in the morning or with fasting and worsen after eating a meal.
Diarrhea/Constipation/ or both: Loose, watery stools can be frequent and unpredictable, affecting your daily routine. Others experience severe constipation or alternate between the two.
Abdominal Pain and Discomfort: Persistent cramping and discomfort can make it hard to enjoy life’s simple pleasures.
Malabsorption: Struggling with nutrient deficiencies can lead to weight loss, anemia, and fatigue, affecting your overall health.
Gas and Belching: Excessive gas can be embarrassing and uncomfortable, disrupting social interactions.
Fatigue: Chronic tiredness can make everyday tasks feel like monumental challenges.
Diagnosing SIBO
Accurate diagnosis is key to finding the right treatment path. Here’s how we typically identify SIBO:
Breath Tests: Hydrogen and methane breath tests are common, non-invasive methods. By analyzing your breath after ingesting a sugar solution, we can detect elevated levels of gases that indicate bacterial overgrowth. The downfall with this test is that there is a 50% false negative rate.
Specific food triggers: Keeping a food journal can often be even more useful than an expensive diagnostic test. Healthy foods high in fiber like veggies, fruits, beans and legumes will often worsen SIBO symptoms. High carbohydrate and starchy foods also increase symptoms. If you can eat a steak or chicken and feel great after with no SIBO symptoms, that is often more diagnostic than a test.
Stool Tests: Analyzing stool can provide indirect evidence of SIBO, such as fat malabsorption or changes in gut microbiota and parasitic infections.
Blood Tests: While not diagnostic on their own, blood tests can highlight nutritional deficiencies linked to SIBO, thyroid hormone abnormalities, liver dysfunction and gallbladder issues.
Treatment Options for SIBO
Finding the right treatment can feel like a journey, but there are several paths we can explore together through functional medicine:
Antibiotics: Antibiotics, such as rifaximin, can be prescribed by your primary care doctor, however only treating SIBO with antibiotics often results in a 90% recurrence rate.
Dietary Modifications: Adjusting your diet can significantly impact symptom relief. Low-FODMAP diets, which reduce fermentable carbohydrates, are often recommended. Carnivore diets and ketogenic diets can also be very beneficial for some.
Nutritional Support: Addressing nutrient deficiencies is crucial. Supplementing with vitamins and minerals like B12, iron, leaky gut support and fat-soluble vitamins (A, D, E, K) can help counteract malabsorption effects.
Addressing Underlying Conditions: Treating the root causes of SIBO, whether it’s optimizing diabetes control, balancing hypothyroidism or receiving treatment for an old concussion, is essential for long-term relief.
Preventing Recurrence
SIBO can recur in up to 90% of cases, but there are ways to reduce the risk and maintain your progress:
Regular Monitoring: Follow-up appointments and monitoring for symptom recurrence can help us catch and address SIBO early.
Dietary Adjustments: Continuing with dietary modifications, such as a modified low-FODMAP diet, can help keep symptoms at bay.
Lifestyle Changes: Stress management, regular exercise, and adequate hydration support overall gastrointestinal health and reduce the risk of SIBO returning.
Work with a practitioner to identify the root cause of your SIBO in the first place.
The Role of a Functional Medicine Approach
Our clinic located in the West Lake area of Austin, offers a personalized and holistic approach to treating SIBO and enhancing gut health. By addressing the root causes and considering the whole person, functional medicine can provide more comprehensive and lasting solutions. Collaboration between gastroenterologists, dietitians, and primary care physicians ensures a tailored and effective treatment plan, giving you the best chance for lasting relief.
SIBO is a challenging condition, but with the right support and treatment, you can regain your quality of life. As a functional medicine practitioner in Austin, I’ve seen the difference that understanding, accurate diagnosis, and comprehensive treatment can make. Remember, you’re not alone in this journey. Together, we can find the path to relief and health, one step at a time.
Contact our office www.drmedinaclinic.com or call 512-399-4276 to schedule a free 20 min consultation with the doctor to learn how we can help you overcome years of chronic SIBO symptoms.
Stay healthy my friends,
Dr. Ernesto Medina
