What is SIBO?

SIBO “Small Intestine Bacterial Overgrowth” is a medical condition during which excess bacteria start growing within the small intestine. 

The healthy Alimentary canal is home to trillion healthy bacteria, fungi, and viruses. These microbes are meant to be in your intestines and mostly work to keep your body function properly. Most microbes are present within the large intestine. Our small intestine contains much less as compared to the large intestine. The small intestine is where our food is mostly absorbed and bacteria interfering in this process is not much needed.

However when unwanted Bactria start creeping up and growing into the small intestine. It can be for the following various causes such as; 

• The gastric deficit Stomach acid which is the first line of defense against pathogens in our food kills off all the unwanted bacteria before the food goes for digestion but when our stomach acid is reduced which is mainly caused by the diet of high in processed food. It allows harmful bacteria to bypass the process.
• Structural problems in and around our small intestine including scar tissue that wraps around the outside of the small bowel, and swelling pouches of tissue that protrude through the enclosure of the small intestine.
• Slow motility in which food doesn’t move through the alimentary canal as quickly as it should which stems from a bout of food poisoning. 
• Food poisoning causes SIBO different bacteria which contaminate food and water we intake, all produce a neurotoxin called toxin B 3. It is a Cytol-ethal distending toxin, which means it causes the intestinal cells to become enlarged as the result the immune system starts reacting and produce antibodies against it, as the number of antibodies increases in the human body, the chances of developing SIBO also increase.
• Age. Older adults are at higher risk as they are incapable of producing enough gastric acid to digest food also have a higher chance of having diverticulosis.
• Medicines at times are the root of SIBO. These may include;

• Narcotics
• Drugs that treat irritable bowel syndrome
• Antibiotics that affect the number of bacteria in your small intestine 
• Medical conditions which can keep your intestine from working the way it should are;

• Diabetes
• Scleroderma
• HIV (cause weakened of the immune system)
• Ulcerative colitis

SIBO has two types. One is correlated with identifiable diseases or conditions but the other is not either of them have the same symptoms.

SIBO alimentary canal condition so most of the symptoms are typical to digestion. These include;

• Bloating
• Abdominal pain
• Diarrhea
• Gastric issue 
• Nausea 
• Constipation 
• Loose stools

The type which is related to intestinal diseases and conditions may result in, inability to absorption of fat-soluble vitamins A, D, E, and K and end up with nutrient deficiencies and malnutrition.

SIBO can be diagnosed by the healthcare practitioner through;

• Breath test 

The person tends to have sugar solution such as glucose or lactulose after a calculated interval of time measurement of hydrogen and methane in their breath is taken by a healthcare practitioner.

• Blood test

They measure and check for anemia or vitamins if the person has SIBO they have vitamins deficiency.

• Stool test

They check the amount of fat your intestine is absorbing.

• Imaging test

X-rays, CT scans, or MRI scans to look for the problem in your intestine.

• Small intestine aspirate and fluid culture

They pass an endoscope through your digestive tract to your small intestine and take the sample of the fluid inside and do a lab test called a culture.

Reason small intestinal bacterial overgrowth (SIBO) develops:

The longest section of the out alimentary canal is the small intestine approximately 20 feet or 6.1 meters. The purpose of the small intestine is to mix food with digestive juices and nutrients are absorbed into the bloodstream.

Colon (large intestine) and small intestine are very unlikely. Because of raid flow of content and presence of small intestine have few bacteria compare to the colon. In SIBO food bypass the small intestine becomes an ideal breeding environment for bacteria. The growth of bacteria affects the absorption of nutrients.

Complications caused by SIBO (Small Intestinal Bacterial Overgrowth):

• Poor absorption of Fats, Carbohydrates, and Proteins:

Bile salts help to digest fats that are broken down by your small intestine which led to incomplete digestion affecting the mucous lining (mucosa) of the small intestine resulting in poor absorption of fats, carbohydrates, and protein. It also leads to the production of many bacteria and their breakage also creates many bacterial compounds which can trigger diarrhea which can lead to other conditions like malnutrition and weight loss. 

• Vitamin Deficiency: 

The incomplete digestion of fats doesn’t enable the body to fully absorb the fat-soluble vitamins like vitamin A, D, E and K. vitamin B-12 plays a vital role in the functioning of our nervous system and the production of blood cells and DNA. The bacteria synthesize and use B-12 and its deficiency can lead to weakness, fatigue, and numbness of hands and feet. The severe deficiency of B-12 can cause damage to the central nervous system which is irreversible in certain conditions  

• Weakened bones (osteoporosis):

Osteoporosis is a disease that is caused by a deficiency of calcium. The damage of the intestine and overgrowing of bacteria can also result in a lack the absorption of calcium leading to many bone diseases including osteoporosis.

• Kidney Stones:

The improper functioning of absorbing calcium can also lead to the formation of kidney stones.

How to cure SIBO?

SIBO (Small Intestinal Bacterial Overgrowth) can be treated with antibiotics and a change in diet plan.

Antibiotics

The main cause of SIBO is the uncontrolled growth of bacteria so usually, antibiotics such as ciprofloxacin (Cipro), metronidazole (Flagyl), or rifaximin (Xifaxan) are used to get bacteria under control. Antibiotics help to decrease the number of bacteria but won’t be able to solve the root cause of the SIBO. To solve the root cause you need a diet.

Diet:

SIBO caused excessive gas production which is caused by the lurking of bacteria in the small intestine and the mobility of food.

The key approach to treat SIBO is to reduce the fermentable foods so that a low FODMAP diet comes. Before starting on the detail of the FODMAP diet there is another sort of diet also such as the elemental diet, the precise carbohydrate diet, and the GAPS (gut and psychology syndrome) diet.

Besides from FODMAP diet, others are only supported by anecdotal evidence or single studies but on the other hand, the FODMAP diet has been heavily researched and has even be reported to have  75% success rate in irritable bowel syndrome.

Even though diet is very helpful but also not enough to treat SIBO. You have the change your lifestyle you have to include exercise and relaxation which is equally important.

The finest diet to treat SIBO:

As the research and reported show low FODMAP diet which stands for ‘Fermentable Oligosaccharides, Disaccharides, Monosaccharides And POLYOLS’ is the finest diet to treat SIBO.

It just involves cutting a few foods out in which some are healthy foods also which is why the maximum time recommended for the diet is one to two months. If the improvement starts showing the duration can be reduced appropriately. It’s all depends on the individual and how fast improvement is start showing.

Best time to start the SIBO diet:

It’s all depends on the seriousness of symptoms, as there is no right time to start the diet.

The individual’s normal dietary routine and they have already tried before for example, there’s lots of research suggest that probiotics can decontaminate the small intestine so there are various option to consider before.

Once the SIBO is confirmed by test the diet should be implemented for the quickest symptoms.

How to do the SIBO diet:

FODMAP diet involves three-stage

1. Restriction
2. Re-introduction
3. Personalisation

If the symptoms are improved by the first stage restriction then it’s important for you don’t skip the second stage reintroduction stage. Start with the moderate diet food according to the FODMAP guideline, then move to a high diet according to FODMAP foods. It will help the individual to identify FODMAPs you are most sensitive to also how much high diet FODMAP food triggers your symptoms.

Keep in mind low FODMAP diet is only for the short term it is not recommended to stay on it for long. The individual has to diversify the diet as quickly as possible and reintroduce fiber in their diet. Fiber is needed in the diet to support the bacteria in the large intestine.

When the long-term FODMAP diet is aimed the approach always personalizes the individual diet according to foods that trigger their symptoms and the rest they have to return to the normal diet as possible.

 What to eat on a SIBO diet:

The idea of diet sound easier to keep on track what you need to avoid during a restrictive diet, we motivate our community to see it as an opportunity and enjoy it. How is its opportunity? Hear us out: this is the time when you reason, to try new foods, to explore new food experiences, to get engage with the cooking and preparing food, and to visit the part of the supermarket you rarely visit. Reason of diet allows you to discover your new favorites the think you thought you will never try. This process might be transformative for you.

There is still so many wealth of food you can eat while doing a low FODMAP diet:

• The protein you can have is all fresh animal products like meat, poultry, fish, seafood, and eggs.
• Starch you can have grains such as oats, quinoa, sourdough spelled bread and rice, plus white potato and turnip.
• vegetables you can have carrot, cherry tomatoes, aubergine, bok choy, spring onion, cucumber spinach, and green beans.
• The fruit you can have is banana, blueberry, orange, raspberry, strawberry, rhubarb, lemon and lime, grapes, kiwi fruit, pineapple.
• Fats you can have coconut oil, ghee, olive oil, lard, hard cheese.

This diet is not as restrictive as generally, people think of this as you can see in the list of food above. All this food can be ingredients of some of your favorite food recipes. 

The food you have to avoid while doing the FODMAP diet is:

• Vegetables you should avoid onions, broccoli, leeks, asparagus, garlic, cabbage, artichoke, okra, sugar snap peas.
• Grains you have to avoid wheat, rye, and barley.
• The fruit you have to avoid apples, apricots, blackberries, cherries, dries fruits, mango, peach, pears, and plums.
• For dairy, you have to avoid fresh cheese, milk, and yogurt.

For successfully navigating SIBO dietary changes

1. Keep it simple when you start few basic recipes and use them to prepare simple food for yourself. You might have to repeat few meals for lost at first. Try to avoid fancy recipes right away. At first, the important thing is getting comfortable with dietary change and try to figure out which food is triggering your symptoms, then you explore recipes and add more options to your menu.
2. Be prepared to go to the supermarket and stock your pantry with the ingredients you will use for your basic menu plan. Also, try to remove all high FODMAPs foods so it won’t be tempting for you. Load your freezer up with all the low FODMAPs foods.
3. Be as strict as possible about your diet for 2 to 4 weeks because the immediate goal is to resolve symptoms and set a baseline for the food reintroductions.
4. Don’t stay on any diet too long if it’s not working consider a different approach and find out which is working for you.
5. Reintroduce foods slowly and one at a time. Pay attention to your symptoms for two days after reintroduction of any food if its goes well you are ready to reintroduce the new food to the diet. If it’s not going well wait still your symptoms are under control before introducing other foods in your diet.

To wrap it all up:

Try to find out why you got SIBO and for now on start a food diary to see if everyday foods may have anything to which you may be sensitive it’s a healthy habit. Few things are healthy and we should focus on it like start intermittent fasting, stop snacking and chew your food well. Stop eating raw vegetables and add high fiber foods to your diet and decrease stress by eliminating things all these practices will help you live a healthy life.