If you’ve been treating leaky gut by following the 4 Rs but not seeing much progress, it could be that you’re dealing with SIBO – small intestine bacterial overgrowth. SIBO (pronounced SEE-bo) is a cause of leaky gut, but treatment for the two is a bit different.

The most common symptoms of SIBO are abdominal pain or discomfort, bloating/distention, diarrhea and/or constipation, and extreme burping and gas. It tends to be under-diagnosed since it shares so many symptoms with other gastrointestinal disorders and is not often considered.

The small intestine is a huge part of the digestive tract. At more than 20 feet long, it takes up most of the space in the abdomen. Above it, the stomach’s job is to secrete acid and mix it with the chewed up food to start breaking it down. After churning for awhile, this mixture is sent to the small intestine where it’s broken down even further with diffent enzymes. Here nutrients are absorbed into the bloodstream. Some nutrients are also manufactured here.

After all that acid and enzyme treatment, there is very little bacteria in the small intestine and of only specific strains. This is normal. The main bacteria colonies that are so important to good health are a little further down in the colon (large intestine).

There is a valve between the small and large intestine called the ileocecal valve designed to keep things moving forward in a one way direction (small intestine to large intestine). If the ileocecal valve is damaged, stuck or not working properly due to a neurological problem, digested material can go backward into the small intestine. Along with digested material, the normal bacteria of the colon will be added to the mix.

But remember, bacteria, even the good kind, doesn’t belong in the small intestine. Its presence can set off an inflammatory cascade with far reaching effects. Other digestive issues of course, like GERD, leaky gut and IBS, but also hormone production, mood, and brain function can be affected.

Clearly this is not a good thing.

There are many circumstances that can lead to SIBO, but the primary factor seems to be gastroenteritis (stomach flu) in your medical history. And who hasn’t had stomach flu at some point?

There are greater and lesser degrees of physical damage caused by these infections, so a bout with stomach problems doesn’t necessarily mean you’ll get SIBO. But if your gut is sufficiently damaged, intestinal function will be impaired. Some of these dysfunctions include:

  • The ileocecal valve could malfunction and cause a backup
  • Some of the carpet-like villi on the intestinal wall could become scarred and unable to absorb nutrients, leading to a fermentation problem which can then cause more opening of the ileocecal valve.
  • The gut flushing action, movement that’s supposed to happen between meals, might shut down.

But whatever the cause, bacteria that is normally considered beneficial relocates to where it doesn’t belong. Instead of helping, it becomes a troublemaker.

If you suspect you have SIBO, the most common lab test used is a breath test for incomplete digestion. Organic acids testing from urine is becoming popular as well.

Once you’re diagnosed, some doctors choose to treat SIBO with low level antibiotics. Others believe the antibiotic cure is short lived, and that the SIBO will nearly always return. It seems to depend on many variables, both physical and emotional.

Most practitioners seem to agree that inflammatory foods must be removed from the diet. No starches, sugar, alcohol or grains. Probiotics, along with other supplements can be a problem because they can feed the condition. Most dairy products and legumes are a no-no. And sometimes, even certain fruits and vegetables must be avoided.

Often overlooked when treating SIBO are the neurological and stress components. Neurological function is important to stimulate proper digestive motility and function. Dealing with stress is essential as it directly affects digestive and neurological function.

Getting proper nutrition while starving out the SIBO is like a tightrope act and everyone is different. Finding the right balance for you as an individual is the key.


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