Definition:

Small intestine bacterial overgrowth (SIBO) is a syndrome in which excessive bacteria exist in the small intestine. The symptoms of SIBO may include diarrhea, constipation, flatulence, abdominal pain, bloating, and bloating. This conference focused on the mechanisms underlying the condition and its diagnosis, treatment, prognosis, and associations with other conditions.

Facts:

• SIBO can lead to malabsorption of nutrients such as fat-soluble vitamins (A, D, E, and K), B12, calcium, and iron.
• The above nutritional deficiencies can lead to symptoms, including weakness, fatigue, confusion, and damage to the central nervous system.
• SIBO can also lead to symptoms associated with IBS  and can cause damage to the stomach lining.
• Common causes/risk factors of SIBO: food poisoning, proton pump inhibitors (PPIs), and adhesions.
• The most common underlying cause of developing SIBO is perhaps due to absent or impaired migrating motor complex (MMC), which is a cyclic, recurring motility pattern that occurs in the stomach and small bowel during fasting.
• Hydrogen (SIBO) or Methane (Intestinal Methanogenic Overgrowth AKA IMO) are the types of gases that can be detected by testing.  Methane and/or constipation cases are harder to treat.
• When treating SIBO with antibiotics, the relapse rate can be high.
• In the gut, methane is produced almost exclusively by archaea, a single-called organism, namely Methanobrevibacter smithii. These microorganisms are similar in size to bacteria, although their cell wall structure is different.
• Methanogenic bacteria can form biofilms. Biofilms are a collective of one or more types of microorganisms that can grow on many different surfaces. Microorganisms that form biofilms include bacteria, fungi, and protists. One common example of a biofilm is dental plaque, a slimy buildup of bacteria that forms on the surfaces of teeth.
• Other medical conditions, such as rheumatoid arthritis (RA) and histamine intolerance, have also been associated with SIBO.
• Some patients may have SIFO alone or in combination with SIBO. Small intestinal fungal overgrowth (SIFO) is characterized by the presence of an excessive number of fungal organisms in the small intestine associated with gastrointestinal (GI) symptoms. Candidiasis is known to cause GI symptoms, particularly in immunocompromised patients or those receiving steroids or antibiotics.

Symptoms:

• Nausea and vomiting
• Bloating and gas
• Diarrhea 
• Malnutrition
• Weight Loss
• Inflammatory/autoimmunity and Joint pain
• Constipation is more common in IMO
• Other symptoms: fatigue, rashes (including acne, eczema, psoriasis, and rosacea), depression, asthma, Etc.

 Causes and risk factors

• Underlying medical conditions such as diabetes, pancreatitis, aging, diverticulitis, immune system disorders, celiac disease, abdominal surgeries, Etc.
• Certain medications such as immunosuppressants, narcotics, antibiotics, proton-pump inhibitors, Etc.

Diagnostic Tests:

• Breath test, using glucose or lactulose, to measure the amount of hydrogen or methane gas produced by the bacteria in the small intestine.
• SIBO home test kit.
• Small intestine aspirate and fluid culture, which is currently the gold standard test for SIBO diagnosis.

Treatment:

The treatment of SIBO can be complicated, and the relapse rate is high; therefore, a comprehensive treatment approach is needed in most cases.  An integrative treatment plan emphasizing a combination of traditional and functional medicine modalities, including prescription medications, supplements, and changes in diet and lifestyle, seems to offer the most effective treatment approach to SIBO.

For more information and to make an appointment, please contact Carolina Integrative Clinic at 919-869-6661 or email us at office@ciclinic.com.

Telehealth and long-distance consultations are offered.