Do you feel bloated—no matter if you have a salad, smoothie, or burger for lunch? It may be more than just what you ate.
An estimated three in four Americans experience gut discomfort—such as bloating, constipation, abdominal cramping, GERD, and nausea—on a regular basis. In fact, these symptoms are often considered so normal that over half of these people never discuss them with their doctor. However, these symptoms are not normal and can be addressed.
Just as fast food cheeseburgers and commercial ice cream are not what humans were designed to eat, many prevalent gut issues are not meant to experienced regularly. You weren’t born with chronic bloating and constipation, and there is often an underlying reason at play, like SIBO.
What is SIBO?
Small Intestinal Bacterial Overgrowth, or SIBO, is a silent epidemic affecting a vast majority of bloating and constipation sufferers and is defined as the overgrowth of gut bacteria in the small intestine.
The most common signs and symptoms of SIBO include:
- Feeling full, bloated, or gassy within one to two hours of eating
- IBS-like symptoms (intermittent constipation, loose stools, and diarrhea)
- Feeling bloated, brain fog, or a sugar rush (followed by a crash) after eating carbohydrates, starches, and FODMAP foods
- Unexplained weight loss or weight gain (that seems independent of diet)
- Cravings for foods that don’t make you feel well
- Feeling sick when you take a probiotic supplement or eat fermented foods
However, SIBO is hard to diagnose because signs and symptoms are so vast.
Other lesser known signs of
- Brittle nails and hair
- Skin breakouts like acne or eczema
- Allergies (food and seasonal)
- Anxiety and mood imbalances
- Autoimmune disease
- Low energy
- Lack of appetite or insatiable appetite
- Blood sugar imbalances (i.e. hungry every two to three hours, hypo/hyperglycemic episodes, cravings for sugar or caffeine)
- Inflammation (like high cholesterol)
- Food intolerances
- Migraines and chronic headaches
- ADD/ADHD and brain fog
With the wide array of symptoms, it’s no wonder SIBO often slides under the radar.
How does SIBO happen in the first place?
With SIBO, bacteria migrates from the colon (where most of it belongs and should be abundant) to the small intestines, where it becomes overrepresented.
Gut bacteria itself is not a bad thing. In fact, beneficial gut bacteria plays a positive role in health promotion, including balancing your mood, helping you think clearly, balancing blood sugar and hormones, regulating your metabolism, and aiding in healthy digestion. However, too much of a good thing is not a good thing.
In an ideal world, your small intestine is sterile and contains only 10,000 bacteria organisms, whereas your colon or large intestine contains 100 billion bacteria (10 to 11 times that amount). If this bacterial balance shifts, problems arise.
The overgrowth of bacteria in the wrong places doesn’t happen overnight, and there is not one thing that sets it off. As your small intestine’s ability to digest is compromised with the bacterial overgrowth, your body is unable to receive all the nutrients it needs for peak performance. Fun fact: the small intestine is the organ in your GI system responsible for the majority of digestion, which takes up to six to eight hours per meal.
Common triggers or predisposing factors of SIBO include:
Low stomach acid–you need stomach acid to break down food and keep unwanted food particles and toxins from attracting pathogenic bacteria.
Dysfunction of your gut motility–impaired ability of your digestive tract to push food through your system speedily and readily
Disrupted gut bacteria from outside stressors–including poor quality foods, undigested foods, prior food poisoning, chronic stress, long-term use of certain medications
Translation: Imbalance or stress to the natural state of digestion is the root cause of SIBO. Over time, if unaddressed, these triggers create the perfect storm for SIBO to occur.
The good news? SIBO is not a diagnosis like cancer. Knowledge is power, and if you discover you have it, it is highly correctable and remissible.
How do I know if I have SIBO?
The two primary methods that are used currently used to diagnose SIBO are SIBO breath testing and the aspiration of the small bowel using an endoscope. Since endoscopy is expensive and uncomfortable, the at-home SIBO breath test is the most popular and preferred test of choice.
It involves breathing into a sample collection tube and bag at home every 20 minutes over the course of three hours. One to two days before the test, you are advised to cut out all high-fiber and lactose-containing foods including vegetables, fruits, nuts and seeds, beans, grains, condiments, and spices and herbs (except salt and pepper). These foods contain sugars that bacteria love. Limiting starches and sugars in foods prior to the test allows results to fully showcase whether or not you naturally have more bacteria in the gut.
During the test, hydrogen and methane gases from your breath are collected for assessment. Since SIBO is associated with an overproduction of either or both of these gases, test results will indicate if your body has increased levels when you breathe into the test tube. That said, false positives are not abnormal.
Lab testing is not perfect and if results come back negative, SIBO is not always ruled out. Hydrogen-Sulfide SIBO is often supposed if SIBO test results come back nearly at zero, with seemingly no measure of hydrogen or methane based gas at all, and SIBO-related symptoms still persist.
Consult with a functional medicine practitioner, nutritionist, or GI specialist familiar with SIBO testing for custom direction and interpretation of results. If lab testing is not in the cards for you and your clinical signs indicate that you may have SIBO, a short-term herbal treatment using a SIBO gut-healing protocol may be better than not treating for SIBO at all.
STRESS AND LIFESTYLE HACKS
Last but not least, hacking stress is essential. Understanding the top stressors in your health, lifestyle, and mindset connected to SIBO can help you keep from merely bandaging the condition with food and supplements.
Some stressors to consider may include:
- Eating fast or on-the-go (not chewing your food thoroughly)
- Low water intake
- Undersleeping (less than seven hours for most people)
- Overtraining (highly correlated with digestive disturbances)
- Processed foods, bars, and shakes
- Stevia and artificial sweetener consumption
- High coffee consumption (more than one cup of quality coffee each day)
- Hydrogenated oils from
- restaurant food
- Long-term birth control use, NSAIDs, or other medications
- Stuffing your emotions
- Trying to do it all
- Eating foods you’re intolerant to
- Disrupted circadian rhythm
Stress is inevitable, but the more you can gradually focus on changing one thing at a time, the more chance your body gets to heal.
What to do about it?
SIBO treatment typically consists of a combination of:
- An anti-inflammatory diet
- A targeted, antimicrobial herb complex and gut-healing supplement protocol
- Stress management/reduction
Stress is a buzzword, often overlooked in our world today that is full of stress (like rush hour traffic, high-intensity workouts, and hours spent staring at our screens and phones). Nevertheless, stress is also the main driver of all disease—gut symptoms included. Understanding the specific stressors that may have triggered SIBO or still continue driving your condition is imperative.
Here are a few essential steps from my initial Gut Love Reset eating you can implement right away if you suspect SIBO:
- Eat real foods, including sustainable proteins, healthy fats, veggies, and some starchy tubers.
- Avoid wheat, dairy, beans/legumes, pastas and breads, sugar, poor quality coffee, artificial sweeteners, and most packaged and refined foods.
- Consider FODMAPS. Many people find they are sensitive to FODMAP foods like broccoli, brussels sprouts, apples, onions, asparagus, pears, peaches, cherries, mangos, and avocados, so it is encouraged you maintain awareness about FODMAPS and how they impact how you feel. For some, a low-FODMAP diet can be beneficial.
- Eat prebiotic carbs. Contrary to popular belief, eating real-food starches and carbohydrates—like sweet potatoes, potatoes, white Jasmine rice, winter squashes, beets, carrots, plantains, etc.—is not a bad thing, particularly when combined with anti-microbial herbal supplements. These foods can provide beneficial prebiotics, essential for healthy gut bacteria.
- Eat probiotic foods. In addition to taking a probiotic supplement, probiotic foods in small condiment-sized doses, including sauerkraut, kimchi, and low-sugar kombucha can assist in promoting healthy bacterial balance.
I customize supplemental protocols for clients, taking into consideration their unique presentation of SIBO and their symptoms, but a few universal supports SIBO sufferers can benefit from include:
- Soil-Based Probiotics
- Partially Hydrolyzed Guar Gum (prebiotic fiber to help your probiotics stick)
- Apple Cider Vinegar
- (1 tablespoon in water) or HCL capsules (with meals)
- Anti-Microbial Herbs
Full SIBO treatment is not recommended without the advice of a provider.