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SIBO: The Most Commonly Missed Cause of IBS

SIBO: The Most Commonly Missed Cause of IBS
By: @drmelissa.co

Bloating, abdominal discomfort, unusual gas, constipation and/or diarrhoea are all symptoms that western medicine commonly chalks up to Irritable Bowel Syndrome (IBS). But IBS is essentially a blanket diagnosis for a group of symptoms, without providing any insight into the cause of the symptoms or curative treatments. 

Small Intestinal Bacterial Overgrowth (SIBO) is a condition of the small intestine. The human gut contains trillions of bacteria — also referred to as the gut microbiome — most of which should reside in the large intestine. Problems arise when these microbes start to migrate from their home in the large intestine back up into the small intestine, where they are not meant to be in abundance. The bacteria may be “good” or “bad” in nature.

Symptoms of SIBO are vast and vary from person to person. Bloating is a very common symptom. Frequent or very malodorous gas is another (especially gas that smells like sulphur or rotten eggs). Abdominal pain and discomfort, as well as fullness or “slow digestion" are other common symptoms. Bowel movements for those with SIBO can vary - some individuals suffer from constipation, others from loose and/or urgent stools, or sometimes both. Increased belching, nausea, heartburn, low energy, skin afflictions like acne, rosacea, or eczema, and changes to mood can be other downstream effects of this digestive disturbance.

SIBO has a variety of potential causes including an inability for the body to properly propel digested food and bacteria forward through the digestive tract (also known as the Migrating Motor Complex), low stomach acid, insufficient bile produced and released by the liver and gallbladder, history of traumatic brain injury, intestinal adhesions or strictures (sometimes caused by past surgery or abdominal trauma), and dysfunction of the valves between different sections of the digestive tract. Stress can make SIBO worse, but is not typically a root cause symptom.

In order to determine if you have SIBO, a confirmatory stool or breath test must be ordered through your doctor. If there is a positive result, it is important to treat. The bacterial overgrowth in SIBO can be treated with natural herbs and nutrients or with pharmaceuticals. Typically, only mild cases are best treated naturally, while moderate to severe cases respond best to pharmaceuticals; however each case is individual, and all options must be discussed. This initial treatment can often improve or cure symptoms.

After treatment, it is important to also address the cause of SIBO and ensure preventative measures are put in place to ensure the SIBO does not return; once you have had SIBO, it is more likely to come back if proper care is not taken. A maintenance protocol is recommended after the initial treatment with close follow-up for the proceeding 3 to 6 months. This will often include supplementation, nutritional and lifestyle recommendations. From here, regular follow-ups are suggested to keep the digestive tract functioning optimally.

If you suspect you may have SIBO and are awaiting a visit with your doctor, there are a few lifestyle changes you can implement to begin to ease your digestive tract. See below.

Short Term Fasting

The gut contracts approximately every 90-120 minutes, which pushes food and bacteria forward through the gut — which is desirable! Unfortunately, eating disrupts this process. It can be helpful to fast for at least three hours between meals and snacks, and have one large fast between dinner and breakfast the next day. But do not delay breakfast too long; eating breakfast within 90 minutes of rising can help maintain optimal health overall

Stimulate the Vagus Nerve

The vagus nerve is a large nerve that runs down the torso, and mediates how well the body is able to move food and bacteria forward through the digestive tract. Stimulating this nerve is a great way to improve digestion. To do this, engage in deep, slow belly breathing daily for 5 to 10 minutes, 2-3x per day. Singing, humming and/or chanting can also help to activate this nerve.

If you are suffering with digestive disturbance, remember, root cause medicine will always seek to understand why you are experiencing the symptoms you are experiencing instead of just providing you with a diagnosis. When we know the why, we can provide the body with what it needs to heal itself and maintain optimal health. As always, seek the help of a licensed medical provider for individualised care.
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