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Heal SIBO Naturally Through Diet and Lifestyle
SMALL INTESTINE BACTERIAL OVERGROWTH
- Bacteria is vital to the health of your digestive system, as well as your overall wellbeing. It keeps your bowel movements regular, supports your immune system, and protects you from a number of diseases.
- It is possible, however, to have too much of a good thing when it comes to bacteria. When it proliferates in your small intestine, a condition called SIBO takes hold, causing a number of uncomfortable symptoms, including acne, eczema, diarrhea, depression, and others.
- SIBO can be officially diagnosed through a hydrogen breath test, where you’ll avoid foods like fruit, beans, and bread for 24-48 hours, then fast for 8-12 hours. Next, you’ll breathe into a breath collection tube a multiple times over a few hours, both before and after drinking a lactulose/glucose mixture.
- If you are diagnosed with SIBO, the bacteria can compete for nutrients and vitamins, potentially causing malnourishment and weight loss, and sometimes even stomach lining damage.
- Conventional medicine will treat SIBO with antibiotics, which does additional harm to the delicate microflora balance in the body. Additionally, the most popular antibiotic treatment (Rifaximin) has been found to only be effective in eradicating SIBO in half of all patients, according to studies.
- There are ways to resolve SIBO without antibiotics, by using herbs, natural antibiotics and antimicrobials, and other supportive supplements. Wild garlic, berberine, and oregano oil are popular choices for holistic treatment.
- Diet and lifestyle factors are incredibly important when healing from bacterial overgrowth, whether you decide to take a more conventional low-FODMAP diet approach or if you choose to boost your body’s beneficial bacteria by drinking bone broth and eating fermented foods.
- Apple cider vinegar and ileocecal valve massage are two additionaly ways to keep your digestive system in optimal shape during the healing process.
- It’s important to keep bowel movements frequent when treating SIBO, and natural supplements like Intestinal Mover by Microbe Formulas can help.
Today, most people are aware of the crucial role that “good” bacteria can play in promoting and maintaining the health and vitality of the body, especially in the digestive tract. After all, healthy intestinal flora is what prevents constipation, shields your large intestine from colon cancer, and even maintains your primary immunity.
Your small bowel is responsible for a number of important jobs when it comes to digesting foods and absorbing the nutrients you need for optimum health. It also has a part to play in the functioning of the immune system, as it contains a vast network of lymphoid cells—the cells responsible for regulating the immune system and fighting infection. The normal, beneficial bacteria in your stomach is the fuel that helps to keep every vital part of your system working as smoothly as possible. Not only do the microorganisms in your small intestine help to protect you against the buildup of pathogenic bacteria and yeast, but they superpower your body’s ability to absorb nutrients and produce helpful substances—vitamins like vitamin K, folate, and even short-chain fatty acids—designed to keep you feeling your best.
By helping to maintain normal activity in the muscles of the small bowel, your internal floral can improve the functionality of the peristaltic waves that move food through the gut. Unfortunately, when bacteria grow excessively in the wrong areas of the small intestine, problems can arise—as in this instance, it is possible to have too much of a good thing. While the large intestine should have up to 100 billion bacterial organisms present per teaspoon of fluid, the small intestine only has around 100 thousand. When that number multiplies, it creates the potential for a detrimental overgrowth.
Defining SIBO: What the Condition Can Mean for You
Small intestinal bacterial overgrowth is the term used to refer to excessive bacteria growth within the small intestine. Though your small intestine is the longest section of the digestive tract, a healthy intestine should only have a limited amount of bacteria within it. Instead, the most significant concentrations of bacteria should be found within the colon. If SIBO is present within the small intestine, then the overgrowth of bacteria could prevent nutrients from being absorbed properly into the blood-stream, particularly nutrients such as iron and fat-soluble vitamins.
Instead of helping the digestion process, excessive bacteria in the bowel takes over the small intestine and leads to the development of various uncomfortable symptoms, including those commonly associated with IBS. What’s more, in severe conditions, the problem can also lead to additional damage to the lining of the stomach.
As food passes along the small intestine, the bacterial overgrowth will interfere with the absorption and healthy digestive process. This means that the bacterium ends up consuming some of the nutrients and foods that you should be getting into your system. The result can be a number of unpleasant symptoms such as pain, bloating, and gas. Additionally, people suffering with SIBO may also experience other complications including immune reactions, generalized inflammation, and autoimmune disease. 1
What Factors Cause SIBO?
The body is naturally equipped with a number of defenses against the development of SIBO, such as the following:
- Regular muscular activity within bowel walls
- Gastric acid secretion
- Immunoglobulins within intestinal fluid
- Valves to allow the flow of contents in the large bowel and prevent reflux into the small bowel
The reasoning behind a case of SIBO is usually more complex than simply noting one or two risk factors. Most of the time, it has something to do with one of the mechanisms above being damaged in some way. With that in mind, some risk factors linked with SIBO have been identified, which might include the following:
- A diagnosis of Irritable Bowel Syndrome
- Low levels of stomach acid
- Long-standing celiac disease or lactose intolerance
- Prior instances of bowel surgery
- Crohn’s disease
- Diabetes Mellitus
- Regular exposure to antibiotics
- Dysfunction in organ systems such as chronic pancreatitis, cirrhosis, or renal failure
In some cases, studies have found links between certain conditions or lifestyle factors and the presence of SIBO. For instance, heavy alcohol use is frequently associated with overgrowth of bacteria in the small intestines,2 and there has been some evidence of SIBO’s association with oral contraceptive pills, inflammatory bowel disease, and Crohn’s disease – though nothing yet confirms a definitive connection. One particularly interesting piece of research was done on 42 people suffering with fibromyalgia – and this study found that 100% of those people had SIBO.3
The Symptoms of SIBO
One of the biggest issues medical professionals have to face when managing SIBO is the fact that many symptoms mirror completely different gastrointestinal disorders, such as IBS. According to studies published by the World Journal of Gastroenterology, the similar symptoms occur because of the close connection between SIBO and IBS.4 Indeed, many experts recommend that doctors should first exclude SIBO before offering a diagnosis of IBS.
The symptoms often associated with SIBO:
- Joint Pain
- Weight Loss
The Complications of SIBO
It is crucial that people who experience the symptoms mentioned above speak to their doctors as soon as possible. While SIBO can result in many unpleasant experiences and side-effects by itself, there is also the risk that if this condition is left untreated, it might cause very serious complications in the long-standing health of those affected.
One of the most common problems associated with SIBO is that bacterial overgrowth can lead to malnutrition, as essential fats, carbohydrates, nutrients, proteins, and more are not properly absorbed, causing deficiencies in a number of areas:
- Vitamin K
- Vitamin E
- Vitamin D
- Vitamin A
- Vitamin B12
Each of these deficiencies can lead to further problems and symptoms, including confusion, fatigue, weakness, and even damage to the central nervous system over time.5
SIBO is diagnosed through a hydrogen breath test: either a Glucose (GBT) or a Lactulose Breath Tests (LBT). Before the test, patients typically restrict diet of sugar, grains, and dairy for a few days prior, then drink a solution of either glucose or lactulose during testing. Because diet has been restricted of most foods that would feed bacteria, the response to the prepared sugary drink (and presence of bacteria) is clearer.6
SIBO testing measures Hydrogen and Methane gas, which are produced by bacteria. With the GBT, a glucose drink is consumed. The GBT can measure bacterial issues in the upper end of the small intestine, considered a less-frequent area for bacterial overgrowth. With the LBT, lactulose is swallowed, which is an unabsorbable sugar. The LBT is useful for diagnosing issues in the most distant end of the small intestine, a much more common location. After the drink is consumed, the bacteria ferment the sugar, causing gas levels to increase. The most bacteria present, the higher the readings on the breath test.
The Concerns with Treating SIBO
Most of the time, small intestinal bacterial overgrowth will be treated conventionally with a course of antibiotics designed to reduce the amount of problem bacteria present. However, the problem with using antibiotics is that this can also kill off some of the healthy bacteria that is necessary for proper functioning of the digestive system.7
What’s more, even with the use of antibiotics over time, SIBO can be a very difficult condition to treat, as it has a tendency to recur in most people. In fact, studies have found that SIBO patients are more likely to experience significant gastrointestinal symptoms at a higher rate after treatment, when the condition recurs.8 The research suggests that simply treating the overgrowth is not enough for most people, instead successful treatment requires an address of the underlying cause of predisposing factor that lead to SIBO in the first place.
Although associations have been made between SIBO and a range of other diseases, it’s worth noting that abnormalities within gut motility are found as one of the most common associations. One of the studies previously published has found that individuals suffering with SIBO generally have delays in transition times for the small bowel, and might benefit from using an agent to increase the number of muscular contractions within the bowel, like Intestinal Mover.
The best treatment option is to focus on solutions that improve the overall health of the bowel system and the small intestine.
Natural Solutions for SIBO
Perhaps one of the best ways to improve bowel health in a natural way is bone broth. This substance has been found within recipes and natural cooking for thousands of years, though it seems to be less common in the modern culture of food as we know it. For those who use it, bone broth can be a fantastic tool in helping the body to heal and manage problems more effectively. Specifically, it helps to starve away unwanted bacteria, while protecting muscle with the supplementation of minerals, amino acids (glycine and proline), and type-2 collagen. While proline supports the tightening of collagen and connective tissue, therefore fighting back against issues like leaky gut, glycine supports detoxification within the digestive system.
Collagen in bone broth can heal cells and promote cell regeneration, since it’s the underlying substance that forms the foundation of most human cells. As a result, consuming bone broth can be a fantastic solution for those searching for immediate relief from digestive tract issues and inflammation. Of course, it’s worth remembering that it’s best to move away from fish bones wherever possible, as they can include toxins and heavy metals that are dangerous to human health. Organic, cage-free chicken, organic grass-fed beef, and organic free-range turkey bones are all excellent choices for bone broth.
Make Your Own Bone Broth
With a little time and effort, bone broth is easy to make at home. The most important part is finding good-quality, grass-fed, organic bones to use. Typically, local farmer’s markets are the best place to find beef knuckle or pre-packaged bones (usually for a fair price). If you don’t have a farmer’s market nearby, then you can buy organic chickens at health food stores or even membership retail “clubs” like Costco. Avoid using non-organic bones, which would cause your broth to be full of toxins, antibiotics, and other unwanted substances.
There are two types of bones you can purchase for bone broth.
“Jointy bones,” which includes larger connective tissues and joints, are one option for making the most cartilage-rich broth. These include beef knuckle, oxtail, chicken feet and necks, for example. Some people swear by chicken feet for making the most gelatinous broth. For those without SIBO, these are often the best choice.
“Meaty bones” are bones still containing bits of meat, like a chicken carcass that has been picked mostly clean, ribs, or marrow bones. This type of bone has been found to be best for those suffering from SIBO.
Another important part of bone broth is the apple cider vinegar, which you pour over the bones prior to cooking the stock. Vinegar helps the bones to release minerals from the bones, extracted them, so you can create the healthiest broth possible.
While it is possible to make bone broth without all the veggies, they do help make the broth tastier and also add additional nutrients.
Want to learn how to make your own, SIBO-friendlier broth at home? Try this recipe:
-organic “meaty” bones
-2 organic carrots, roughly chopped
-leaves of 1 organic leek, roughly chopped
-1/2 fennel bulb
-1 inch ginger, roughly chopped
-salt and pepper to taste
-2 bay leaves (optional)
-2T apple cider vinegar
- Add the bones to the pot and pour the apple cider vinegar on them. Let sit for ten minutes.
- Add the rest of the ingredients.
- Fill the pot with filtered water.
- Stovetop: Bring the pot to boiling, then immediately turn down to low heat and cover. The pot should be very gently bubbling, not stagnant or boiling. Leave on stove covered for at least 24 hours.
- Instant Pot: For people with histamine-intolerance, it is possible to pressure cook your broth to release the same great nutrients in less time. Close the lid and set to “soup” for 120 minutes, then quick-release when finished.
- Strain the bones and vegetables out of the broth.
- Pour the broth into glass containers. Let cool sufficiently before putting lids on and storing in the fridge. If freezing, be sure to leave some air in the containers to account for expansion.
Buy Your Broth
If you don’t have time to make bone broth yourself, or if you’d prefer to just purchase it, there are a few options.
- Ancient Nutrition: This bone broth has been dried so it’s shelf-stable and will last quite a while in your pantry as a superfood staple. This brand, created by well-known health and wellness figures Josh Axe and Jordan Rubin, is produced using pressure and heat, then spray dried. Flavors include both savory and sweet: Dark Chocolate, Turmeric, Banana Creme, Cinnamon Apple, and more. Buy Ancient Nutrition broth here.
- Kettle and Fire: This is another shelf-stable brand, created by brothers Justin and Nick Mares. They use “jointy” bones, like knuckle and neck bones, to be sure the broth contains a good amount of collagen and gelatin. They also add organic vegetables and spices to flavor the broths, which, at this time, only come in chicken and beef flavor.
- Bare Bones: This brand raises organic chickens humanely, and also uses organic veggies with no added preservatives. It’s also shelf-stable, and comes in a few flavors, like Beef Tomato Spice and Chicken Rosemary Lemon.
Other Natural Tips for Healing SIBO
Most doctors will just prescribe Rifaximin, an antibiotic used to treat SIBO, which has been found to be only 50% effective according to studies.9 There are other, more natural methods to try at home first. Along with consuming collagen-rich bone broth, there are other at-home solutions for healing your gut and improving the microflora in your small intestine.
- Chew your food: With any type of intestinal ailment, chewing food thoroughly can relieve some pressure on your digestive system and prevent large pieces of food from passing through the gastrointestinal tract and inflaming your body. Chewing your food enough—until it’s mostly all liquid—can especially help if you suffer with intestinal permeability along with SIBO.
- Use herbal antibiotics and antimicrobial: Oregano oil, wild garlic, or berberine, may be useful for keeping the bacteria in check, as recommended by Dr. Mullin, author of The Inside Tract: Your Good Gut Guide to Great Digestive Health.
- Avoid carbs, sugar, and artificial sugar: It has been proven through numerous studies that carbohydrates and sugar can fuel SIBO growth, while fiber protects it. Instead of crackers, load up on salads, roasted veggies, greens, and healthy smoothies.10
- Remove gluten and dairy: Sometimes, SIBO is caused by undiagnosed celiac disease and severe lactose intolerance. These foods are also common culprits in causing inflammation in the body.
- Try a low FODMAP diet: This diet avoids foods that might feed the bacteria (like fructans in wheat or sorbitol in fruit). The only problem with this diet is that it requires restriction of many fruits, vegetables, and foods that are otherwise healthy and full of nutrients, like beets, cauliflower, mushrooms, shallots, berries, and avocado.11
- Add in gut-healthy, fermented foods: There is much debate about whether fermented foods will make SIBO worse, or help heal it. Many current studies are finding that, even though fermented food contain bacteria (and there’s already an overgrowth), they also have so many gut-healing properties that they’re beneficial for SIBO patients in small amounts. Start slow! 12
- Take probiotics and eat prebiotics: Conventional wisdom would tell someone to avoid probiotics and prebiotics, since there is already an overgrowth of bacteria. New research has found certain types of probiotics are very healing to individuals with SIBO.13 Benefits included enhancing mucosal barriers, lowering inflammation, boosting the immune system, and keeping other pathogens in check.14
- Experiment with fasting: Intermittent fasting might be beneficial for some with SIBO, since consuming food can fill the body with fermentation byproducts.15 Short-term bone broth fasting can also starve the bacteria, lessening the overgrowth. Shorter, slower (no carb, no sugar) meals have been helpful for others when treating SIBO. Try both, and see how your body responds.
- Drink apple cider vinegar: Apple cider vinegar (ACV) is helpful in boosting digestion and upping hydrochloric acid in the body, which breaks down food. Add a tablespoon to an 8-ounce glass of water before a meal, or use it as a dressing on your salad.
- Cook up a pot of bone broth: Like fermented foods, there is the possibility that consuming bone broth could feed the bacteria in your gut, but it’s incredibly healing to your digestive system. Bone broth is full of the protein gelatin, which stimulates stomach acid, and glutamine, which protects the walls of the intestines. One tip is to make your broth from “meaty bones,” rather than “jointy” cartilage-rich bones. This will make the resulting broth contain less glycosaminoglycans, which are carbs. And we all know carbs turn to sugar in the body and potentially feed the very bacteria we’re trying to get rid of.
- Massage your ileocecal valve: Researchers studying SIBO have found that patients with the condition often have a dysfunctional ileocecal valve, which connects the small to the large intestine. If it’s closed, you may struggle with constipation. If it’s stuck open, you can experience diarrhea and malabsorption. But in terms of SIBO, an open valve can also allow various bacteria to enter the small intestine. An ileocecal massage, done at home, can help keep the valve in place and functionain properly.16
- Keep your bowels moving: Improving frequency of bowel movements is helpful for overall detoxification. Intestinal Mover by Microbe Formulas is a natural gut motility aid that doesn’t cause dependence or cramping. Be sure to drink enough water and eat fiber, as well.
Managing, and Overcoming SIBO
Treatment for SIBO is not a simple concept, particularly because it is so prone to recurrence. However, it’s fair to suggest that most experts agree the focus lies within promoting the growth of good bacteria in the gut, and reducing the growth of bad bacteria. Bone broth, which helps to promote strength within your internal muscles can be particularly effective, as it gets rid of some of the excess bacteria that should not be clogging up the small intestine, while promoting quicker healing.
- Fasano, Alessio. “Leaky Gut and Autoimmune Diseases.” Clinical Reviews in Allergy & Immunology 42.1 (2011): 71-78. PubMed. Web. 9 Jan. 2018.
- Gabbard, Scott L., Brian E. Lacy, Gary M. Levine, and Michael D. Crowell. “The Impact of Alcohol Consumption and Cholecystectomy on Small Intestinal Bacterial Overgrowth.” Digestive Diseases and Sciences 59.3 (2013): 638-44. PubMed. Web. 9 Jan. 2018.
- Bures, Jan et al. “Small Intestinal Bacterial Overgrowth Syndrome.” World Journal of Gastroenterology 16.24 (2010): 2978–2990. PMC. Web. 9 Jan. 2018.
- Ghoshal, Uday C, and Deepakshi Srivastava. “Irritable Bowel Syndrome and Small Intestinal Bacterial Overgrowth: Meaningful Association or Unnecessary Hype.” World Journal of Gastroenterology : WJG 20.10 (2014): 2482–2491. PMC. Web. 12 Jan. 2018.
- “Blind Loop Syndrome.” Mayo Clinic. Mayo Foundation for Medical Education and Research, 26 Feb. 2015. Web. 09 Jan. 2018.
- Miazga, A., et al. “Current views on the etiopathogenesis, clinical manifestation, diagnostics, treatment and correlation with other nosological entities of SIBO.” Advances in Medical Sciences 60.1 (2015): 118-124. Web. 09 Jan. 2018.
- Lauritano, Ernesto C., et al. “Small Intestinal Bacterial Overgrowth Recurrence After Antibiotic Therapy.” The American Journal of Gastroenterology 103.8 (2008): 2031-035. PubMed. Web. 9 Jan. 2018.
- Peralta, Sergio, Claudia Cottone, Tiziana Doveri, Piero Luigi Almasio, and Antonio Craxi. “Small Intestine Bacterial Overgrowth and Irritable Bowel Syndrome-related Symptoms: Experience with Rifaximin.” World Journal of Gastroenterology 15.21 (2009): 2628. PubMed. Web. 2 Jan. 2018.
- Ierardi, Enzo, Giuseppe Losurdo, Claudia Sorrentino, Floriana Giorgio, Giuseppe Rossi, Annalisa Marinaro, Katia Romy Romagno, Alfredo Di Leo, and Mariabeatrice Principi. “Macronutrient Intakes in Obese Subjects with or without Small Intestinal Bacterial Overgrowth: An Alimentary Survey.” Scandinavian Journal of Gastroenterology 51.3 (2015): 277-80. Taylor Francis Online. Web. 7 Jan. 2018.
- Halmos, Emma P., Claus T. Christophersen, Anthony R. Bird, Susan J. Shepherd, Peter R. Gibson, and Jane G. Muir. “Diets That Differ in Their FODMAP Content Alter the Colonic Luminal Microenvironment.” Gut 64.1 (2014): 93-100. PubMed. Web. 2 Jan. 2018.
- Salem, A., & Ronald, B. C. “Small Intestinal Bacterial Overgrowth (SIBO).” Journal of Gastrointestinal and Digestive System 4.225 (2014). Omics Online. Web. 09 Jan. 2018.
- Chen, Wei Chung, and Eamonn M.M. Quigley. “Probiotics, Prebiotics & Synbiotics in Small Intestinal Bacterial Overgrowth: Opening up a New Therapeutic Horizon!” The Indian Journal of Medical Research 140.5 (2014): 582–584. PubMed. Web. 06 Jan. 2018.
- Quigley EMM, Quera R. “Small intestinal bacterial overgrowth: roles of antibiotics, prebiotics, and probiotics.” Gastroenterology 2.1 (2006): 78–90. PubMed. Web. 09 Jan. 2018.
- Freuman, Tamara Duker. “SIBO: A Four-Letter Word for Bloating.” U.S. News. 25 March 2014. Web. 09 Jan. 2018.
- Roland, Bani Chander, Gerard E. Mullin, Monica Passi, Xi Zheng, Ahmed Salem, Robert Yolken, and Pankaj Jay Pasricha. “A Prospective Evaluation of Ileocecal Valve Dysfunction and Intestinal Motility Derangements in Small Intestinal Bacterial Overgrowth.” Digestive Diseases and Sciences 62.12 (2017): 3525-535. PubMed. Web. 9 Jan. 2018.