Small Intestine Bacterial Overgrowth (SIBO)

Typically, the small intestine contains a relatively low number of bacteria compared to the large intestine. SIBO is a condition where an excessive population of bacteria accumulates in the small intestine.

SIBO and Irritable Bowel Syndrome (IBS)

People with IBS are more likely to have SIBO than the rest of the population. However, not everyone with an IBS diagnosis tests positive for SIBO.

SIBO and IBS share many symptoms, and it’s possible to experience both at the same time.

Bacteria

Bacteria are essential to the digestive system in the form of the gut microbiome. They mostly live in the large intestine. When a person’s microbiome becomes imbalanced, containing too many harmful species of microbes or not enough beneficial species, this is called dysbiosis. Dysbiosis can lead to malabsorption of nutrients, digestive issues, and other health problems.

The small intestine

The small intestine is the longest section of your digestive tract, measuring about 20 feet (6.1 meters). It is where food mixes with digestive juices and nutrients are absorbed into your bloodstream.

The small intestine has a relatively sparse population of bacteria, as its primary function is to absorb nutrients from the food we consume.

The level of bacteria is kept low because of the rapid flow of contents through the small intestine and the presence of bile. The bacteria that live in your small intestine play a vital role in digesting carbohydrates and producing certain vitamins.

With SIBO, the excessive bacteria in the small intestine are not necessarily harmful bacteria, they are just in the wrong place. They have either travelled upwards from your large intestine (colon), or downwards from your stomach because of insufficient stomach acid (stomach acid kills bacteria before they reach the small intestine). The far more common scenario is that they travel up from your large intestine.

SIBO

When there’s an abnormal increase in the overall bacterial population in the small intestine (i.e. an overgrowth), and/or the wrong bacteria, then we can experience problems (see below).

The wrong bacteria can overwhelm the beneficial bacteria that you need to be there, and they can upset your digestive system by feeding on products that aren’t meant for them.

The 3 types of SIBO?

Hydrogen-dominant, Methane-dominant and Sulphide-dominant SIBO are the three types.

1. Excessive hydrogen gas-producing bacteria promote diarrhea, as it pulls water into the bowel.

2. Those with an overgrowth of methane-producing bacteria tend towards constipation.

3. Organisms that create hydrogen sulphide (H2S) gas as a byproduct damage the cells of the body and typically experience diarrhea, though constipation can occur as well.

Only a tiny portion of SIBO cases are hydrogen sulphide dominant.

Why is there an overgrowth of bacteria?

Gastric secretions and the forward movement of food through the digestive system prevent too many bacteria from growing in the small intestine. However, if these functions do not work effectively, bacteria can multiply beyond their normal quantity.

Chronic stress, surgery, diseases, or structural issues can affect gastric secretions and slow the forward movement of food through the small intestine, creating a perfect breeding ground for bacteria.

Maintaining factors

While foods aren’t the original cause of the bacterial overgrowth, certain foods encourage the growth of the bacteria in your small intestine. If you’re feeding them their favourite foods, they’re going to multiply in number.

Problems Caused by SIBO:

The symptoms of SIBO can vary enormously from person to person depending on how mild or severe the overgrowth of bacteria is and whether someone has any coexisting conditions. In severe cases, the symptoms can be debilitating.

Here are the most common symptoms:

· Digestive Issues: Symptoms like bloating, gas, diarrhea, and constipation. As the bacteria in the small intestine feed on the food, the food ferments, creating gas.

· Nutrient Malabsorption: The overgrowth of bacteria can interfere with the absorption of nutrients, leading to deficiencies in vitamins and minerals.

· Inflammation: The excess bacteria can cause inflammation in the small intestine, leading to a condition known as leaky gut, where toxins and waste products enter the bloodstream.

· Weight Loss: In severe cases, SIBO can lead to unintentional weight loss and malnutrition.

What happens if SIBO is left untreated?

Common symptoms of SIBO — including gas, bloating, abdominal pain and distension — are uncomfortable enough. But left unmanaged, SIBO can cause more serious complications with long-term consequences. Malabsorption of fats, proteins and carbohydrates can lead to malnutrition and vitamin deficiencies. In particular, vitamin B12 deficiency can cause nervous system problems and anaemia. Poor calcium absorption can lead to long-term osteoporosis or kidney stones.

Treatments

The treatment approach for SIBO typically involves a combination of strategies aimed at reducing the bacterial overgrowth, addressing underlying causes, and managing symptoms.

Medical

The conventional medical treatment for SIBO involves the use of antibiotics and dietary changes. Sometimes, faecal microbiota transplants are used.

Gut Directed Hypnotherapy

Alongside medical treatments, gut directed hypnotherapy can help. Studies have shown that gut-directed hypnotherapy (GDH) can help restore normal gut motility and create significant improvements in symptoms like bloating, gas, and abdominal pain. It can decrease the brain’s awareness of that visceral hypersensitivity in the gut. One reason this is possible is because GDH helps restore normal communication between your gut and your brain. Besides enabling physical relief, GDH can help reduce the psychological aspects of SIBO, such as chronic stress, anxiety, embarrassment. Many people turn to GDH because it’s a safe, drug-free, non-invasive treatment option. There have been a lot of scientific studies that back the efficacy of GDH. The American College of Gastroenterology and the UK’s National Institute of Clinical Excellence (NICE) recommend GDH as a treatment for IBS.

What next?

If you suspect you may be experiencing symptoms of SIBO, consult with your doctor or health practitioner. Early diagnosis and treatment can help prevent potential complications and promote better overall health outcomes.

If you have a SIBO diagnosis and your symptoms have not responded well to traditional medication, then you might like to explore gut-directed hypnotherapy as an adjunct to your existing treatment.