Last Updated on 25 May 2022 by Brisbane Livewell Clinic
What is SIBO
Small Intestinal Bacterial Overgrowth.
SIBO can occur when the ileocecal valve (which connects the large and the small intestine) is dysfunctional, allowing large intestinal bacteria to migrate upwards into the small intestine, where they wreak havoc. We offer SILO testing or more accurately SIBO breath testing at all our Brisbane clinics
What is SIBO Testing?
The normal cleansing wave of the small intestine is disrupted, or stopped. This cleansing wave is called the Migrating Motor Complex (MMS), and occurs approximately every 90 minutes, typically between meals. The function of the MMC is to wash out accumulated bacteria and propel them toward the colon. The MMC is not related to the peristaltic waves of the large intestines.
The result is bacteria are allowed to grow and proliferate throughout the small intestine (a little over 6 meters in length).
SIBO and IBS
SIBO is a bacterial overgrowth in the small intestine that causes hydrogen, methane and/or hydrogen sulphide gas production. These gases cause the symptoms of IBS but also damage the intestinal wall.SIBO is the leading cause of IBS.
Practitioners across the nation are familiar with the frequent presentation of IBS in their clients.
IBS can have several causes— food sensitivities, dysbiosis of the large intestine, lack of digestive enzymes or hydrochloric acid, stress. All can cause digestive complaints that are often indistinguishable from one another.
SIBO is actually a very common undiagnosed cause of IBS (up to 84%) and thus shares some of the same presenting symptoms with IBS—Gas/bloating, diarrhoea/constipation, and abdominal cramping.
SIBO causes damage to the absorptive surface of the small intestine – the ability of the body to absorb nutrients from food.
The absorptive surface of the small intestine is likened to a shaggy carpet, with finger-like protrusions called villi. The surface of the villi contain microvilli, which act as the interface of absorption—microvilli secrete enzymes called “brush border enzymes” which break starches into single molecules and proteins into single amino acids, so these can be absorbed.
SIBO can result in
- Malabsorption of monosaccharides and amino acids (carbohydrates and proteins)
- Fermentation of disaccharides by bacteria causing hydrogen, methane and hydrogen sulphate gasses
- These gasses themselves are damaging to the gut wall
- Malabsorption of vitamins (especially B12 and Folic acid)
- Malabsorption of minerals (especially, magnesium, iron, and calcium SIBO can cause leaky gut, with a damaged gut wall allowing larger particles to pass through, causing an immune response
Causes of SIBO
- Post infectious: a case of gastroenteritis can often be the “heralding event” for the development of SIBO
- Overconsumption of simple carbohydrates
- Medications: proton pump inhibitors, morphine and other opiates, narcotics, possibly beta agonists and calcium channel blockers
- Stress: chronic stress can decrease stomach acid output (hypochlorhydria).
- Normal stomach acid levels are required to kill bacteria
- Stress also causes changes in the motility of the small intestines, causing a pooling and stagnation which allows for bacterial overgrowth
- Altered anatomy: malformation of the ileocecal valve, surgical intervention causing scarring and adhesions altering the normal anatomy of the small intestines
- Initial colonization of bad bacteria: caesarean birth, no breast feeding
Associated Conditions
- Fibromyalgia and Chronic Fatigue Syndrome – especially associated with diarrhoea dominant SIBO
- Chronic constipation – associated with methane-dominant SIBO
- Irritable bowel syndrome (IBS)
- Inflammatory Bowel disease (Crohn’s disease and ulcerative colitis)
- Acid reflux
- Coeliac disease
- Interstitial Cystitis
- Restless leg syndrome
- Acne Rosacea
- Diabetes
- Hypothyroidism
- Scleroderma
- Chronic Prostatitis
- Non-Alcoholic Steatohepatitis (NASH)
- Liver cirrhosis
- Diverticulitis
SIBO cannot be treated with diet alone. See a qualified SIBO Testing Practitioner at Brisbane Livewell Clinic for a review of your current health needs.
