My gut has been acting up again. I went for a very long symptom free period. But SIBO (Small Intestinal Bowel Overgrowth) is back and it is time for me to reassess my diet, supplements, do some testing, and get a handle on it again. SIBO is very common and unfortunately has a high rate of recurrence. SIBO occurs when there is an excess of bacteria in the upper small intestine. These bacteria ferment the carbs you eat into gas and the gas causes pressure and pain usually manifesting in abdominal pain and bloating. Other common symptoms are gas, constipation, diarrhea, and malabsorption. The symptom that haunts me the most is uncomfortable bloating, and I know I am not alone, as this seems to be one of the predominant complaints I hear from my own clients.

The two processes that most commonly predispose you to bacterial overgrowth in the upper small intestine are diminished gastric acid secretion (acid that your stomach produces when you eat) and small intestine dysmotility ((muscle contractions in your GI tract are not working properly). Gastric acid produced in your stomach suppresses the growth of ingested bacteria, thereby limiting bacterial counts in the upper small intestine. Diminished acid production (hypochlorhydria) becomes more prevalent as you age and also occurs when you take PPI’s (protein pump inhibitors). Normal GI motility involves a complex, tightly coordinated series of events designed to move material through the GI tract. SIBO can also be caused by gastric bypass surgery, structural abnormalities of the GI tract, IBS, and narcotic use.

Other risk factors and signs/symptoms for SIBO:

You have recently taken antibiotics or have a history of antibiotic use.
You feel worse when you take probiotics with prebiotics.
Eating more fiber causes constipation, even when you drink plenty of water.
Your lab work reveals low ferritin levels without any apparent other cause.
You have experienced gut infections (especially h Pylori).

Why has my SIBO come back? Well, I don’t know for sure. But these are my best guesses:

I got lazy with taking my enzyme supplement that contains Betaine HCl (hydrochloric acid). Betaine HCl supports stomach acid secretion, which in turn suppresses growth of unwanted bacteria in the upper small intestine.
I was taking thyroid support for awhile, which I discontinued due to side effects. The thyroid gland, being the master gland of metabolism, helps to support normal GI motility (muscular contractions in the GI tract).
Summer came and I started eating more fruits like cherries, peaches, nectarines, and apricots. Great food for the bacteria!

SIBO is complicated and normally many steps have to be taken to address it and prevent its recurrence. In fact, I highly recommend that you work with a qualified nutritionist or practitioner to test for SIBO and other factors that may be contributing to it and create a plan to address it. However, here are five simple steps that you can take now to start tackling SIBO if you know you have it or suspect that you do:

1. Let at least 4 hours go by in between your meals. When you are fasting, you typically get a gurgling sound in stomach. This is good. This means that cleaning up is taking place. It should happen every 90 minutes when the stomach is empty. This is referred to as a small bowel cleaning wave.

2. Make or purchase bone broth and drink liberally to help decrease inflammation and heal up the gut.

3. Take a digestive enzyme supplement that contains Betaine HCl with your meals.

4. Restrict the amount of fermentable carbs in your diet until your SIBO is resolved. Then you can add them back in. Foods high in FODMAPS (Fermentable Oligo-Di-Monosaccharides and Polyols) should be avoided. These include garlic, onions, brussels sprouts, broccoli, asparagus, artichokes, apples, cherries, grapes, nectarines, peaches, pears, and apricots.

5. Take a soil based probiotic supplement, which also acts as an antimicrobial to help kill off the unwanted bacteria.

NOTE: Work with a practitioner to test for other contributing factors to SIBO like a gut infection or hypothyroidism. There are also different types of SIBO, and your health care practitioner can help you put together a dietary and supplement plan that effectively addresses your type of SIBO.

If you think you have SIBO, please schedule a complementary strategy session with me to discuss! Complimentary Strategy Session