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Small Intestinal Bacterial Overgrowth (SIBO)

Definition-​ Small intestinal bacterial overgrowth (SIBO) occurs when there is an abnormal increase in bacterial population in the small intestine.  Common bacteria can be overgrown or bacteria not commonly found in that part of the colon can be present.

Causes

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  • Constipation can slow the passage of food and waste products through the digestive tract allowing bacteria to multiply excessively.

  • Medications that cause constipation like opioids and GLP-1s

  • Complications of abdominal surgery, including gastric bypass for obesity and gastrectomy to treat peptic ulcers and stomach cancer

  • Certain medical diseases, including Crohn's disease, radiation enteritis, scleroderma, celiac disease, diabetes or other conditions that can slow movement (motility) of food and waste products through the small intestine.

  • Structural problems in and around your small intestine, including scar tissue (intestinal adhesions) that can wrap around the outside of the small bowel, and bulging pouches of tissue that protrude through the wall of the small intestine (intestinal diverticulosis)

Symptoms

  • Loss of appetite

  • Abdominal pain

  • Nausea

  • Bloating

  • An uncomfortable feeling of fullness after eating

  • Diarrhea

  • Unintentional weight loss

  • Malnutrition from inflammation and bacteria-produced toxins

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Complications

  • Malnutrition due to poor absorption of fats, carbohydrates and proteins. Bile salts and mucous lining are harmed by bacteria thus decreasing nutrient absorption capabilities and increasing risk of diarrhea and weight loss.

  • Vitamin deficiency. As a result of incomplete absorption of fats, your body can't fully absorb the fat-soluble vitamins A, D, E and K. Bacteria in the small intestine synthesize as well as use vitamin B-12, which is essential for the normal functioning of your nervous system and the production of blood cells and DNA.

    • The overgrowth of bacteria can result in B-12 deficiency that can lead to weakness, fatigue, tingling, and numbness in your hands and feet and, in advanced cases, to mental confusion. Damage to your central nervous system resulting from B-12 deficiency may be irreversible.

  • Weakened bones (osteoporosis). Over time, damage to your intestine from abnormal bacterial growth causes poor calcium absorption, and eventually may lead to bone diseases, such as osteoporosis.

  • Kidney stones. Poor calcium absorption may also eventually result in kidney stones.

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Because all systems in your body rely on one another to function correctly, other systems in your body may not work efficiently.

Functional Medicine Approach

  • You will have a full assessment of your current lifestyle, nutrition, stress level and management, and sleep health and hygiene.

  • Individualized plans of care will be created by the practitioner and patient. 

  • Depending on your specific symptoms, there may be more targeted assessment and testing of blood sugar metabolism, thyroid function, pituitary. or hypothalamus function and cardiovascular assessment, gut imbalances, food intolerances, toxin screening, hormone imbalance, antibody intolerances, inflammatory markers, and/or deficiencies of nutrients.  

  • After finding the root cause of illness plans may be revised.  Solutions can be multi-layered and take time, especially auto-immune disease and hormone imbalance.  We may need to integrate care with a specialist after referral.

  • Detox plans are gentle and supervised if necessary.

Goals of Treatment

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Results vary and depend on the stage of your disease process and your commitment to treatment.

  • Decreased diarrhea and bathroom emergencies

  • Decreased rectal pain and hemorrhoids 

  • Decreased anxiety about outings and travel

  • Decreased abdominal pain

  • Decreased joint pain

  • Decreased visits to the doctor’s office

  • Decreased money spent on medication

  • Return to normal weight

  • Increased ability to eat a variety of foods

  • Increased energy for friends, family, and activities

  • Increased suppleness of hair, skin, and nails

 

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Commitment to treatment will improve outcomes.

We will support you every step of the way!

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