Gut Health

Best Nutrients for Fighting SIBO

Best Nutrients for Fighting SIBO

Your gut plays an important role in your health. Trillions of microorganisms in the gut, known collectively as the gut microbiome, support your digestive function, immunity, hormonal health, mental health and much more. When the gut microbiome has a friendly balance of gut bacteria, it allows the bacteria in the gut to carry out their many functions. When there is an imbalance, however, it can allow other pathogens to grow out of control and can lead to conditions like small intestinal bacterial overgrowth (SIBO).

 

What Is SIBO?

 

bacterial overgrowth under microscope

 

SIBO stands for “small intestinal bacterial overgrowth.” It means that the bacteria that live in your small intestine have overgrown and are interfering with your normal digestive functions. SIBO is the result of an imbalance of the microorganisms in your gut that maintain healthy digestion. When too many bacteria, or the wrong kind, populate the small intestine, it can lead to uncomfortable symptoms such as gas and diarrhea. It can also inhibit your ability to digest and absorb nutrients from your food. This condition is also known as blind loop syndrome.

 

Essentially, SIBO occurs due to an imbalance in your gut microbiome that allows the small bacteria to grow beyond healthy levels. Your body maintains the balance of microorganisms in your gut through a complex network of chemical and mechanical functions. In order for SIBO to occur, one or more of these functions must be failing.

 

Gastric acid, bile, enzymes and immunoglobulins are some of the chemicals that control bacteria in the small intestine. Different conditions can inhibit these chemical functions and interfere with your microbial balance. Additionally, when the emptying of food contents from the small intestine into the large intestine is slowed or impaired, the bacteria in the small intestine have more time to breed, and the bacteria in the large intestine may begin to creep upward leading to SIBO.

 

What Causes SIBO?

 

SIBO commonly results when a circumstance, such as surgery or disease, slows the passage of food and waste products in the digestive tract, creating a breeding ground for bacteria. The excess bacteria often cause diarrhea and may also cause weight loss and malnutrition.

 

While SIBO is most commonly caused by a complication of abdominal surgery, this condition can also result from structural problems and from certain diseases. Sometimes surgery is needed to correct the problem, but antibiotics are the most common treatment for SIBO.

 

Some of the primary causes of SIBO include:

 

  • Low stomach acid (hypochlorhydria). This condition reduces the body’s ability to moderate bacterial growth. Some of the primary factors that may reduce your stomach acid levels include Pylori infection, prolonged use of medications such as antacids and proton pump inhibitors, and gastric bypass surgery.

 

  • Small intestine dysmotility. Small intestine dysmotility means that the waste in the small intestine is retained for too long before emptying into the large intestine. This allows the small intestine bacteria to continue to multiply, while the large intestine bacteria may also make their way into the small intestine. Some dysmotility disorders include gastroparesis, intestinal pseudo-obstruction, and hypothyroidism.

 

  • Structural problems in the small intestine. Structural issues in the small intestine can inhibit motility and the regular clearing of residual bacteria and create extra nooks and small areas for bacteria to accumulate. These can be caused by gastrointestinal diseases or by complications of surgery. Structural problems include small bowel diverticulosis, small bowel obstruction, bowel fistulas, abdominal adhesions, intestinal strictures, and prior bowel resection surgery.

 

  • Overuse of certain medications. The overuse of certain medications can also upset the normal balance of intestinal flora. Such as antibiotics, narcotics, and gastric acid suppressants.

 

How Common Is SIBO?

 

It is unknown exactly how common SIBO is. Many doctors assume that SIBO is generally underdiagnosed, and the prevalence among healthy people is not known. However, some studies indicate that up to 80% of people with irritable bowel syndrome (IBS) have SIBO. Mild cases of SIBO may be asymptomatic, while moderate cases feature many non-specific symptoms that overlap with other conditions, such as IBS. SIBO isn’t often directly tested for, and even when it is, the tests that are currently available are imperfect.

 

What Are the Symptoms of SIBO?

 

Common signs and symptoms of SIBO often include:

 

  • Abdominal pain
  • Bloating
  • Gas
  • Digestive issues
  • Loss of appetite
  • Nausea
  • An uncomfortable feeling of fullness after eating
  • Diarrhea
  • Unintentional weight loss
  • Malnutrition

 

How Do You Treat SIBO?

 

Whenever possible, doctors treat SIBO by dealing with the underlying problem — for example, by surgically repairing a postoperative loop, stricture or fistula. But a loop can't always be reversed. In that case, treatment focuses on correcting nutritional deficiencies and eliminating bacterial overgrowth.

 

For most people, the initial way to treat bacterial overgrowth is with antibiotics. Antibiotics are powerful compounds that kill bacteria. Doctors may start a treatment of antibiotics if your symptoms and medical history strongly suggest this is the cause, even when test results are inconclusive or without any testing at all.

 

A short course of antibiotics often significantly reduces the number of abnormal bacteria. But bacteria can return when the antibiotic is discontinued, so treatment may need to be long term. Doctors may also switch among different antibiotics to help prevent bacterial resistance.

 

The issue with antibiotics, however, is that they kill off the beneficial bacteria in your gut, which can lead to many other digestive issues. Therefore, it is critical that after a round of antibiotic treatment you replenish your gut bacteria with beneficial probiotics.

 

Correcting nutritional deficiencies is also a crucial part of treating SIBO, particularly in people that are suffering from severe weight loss. Treatments for correcting nutritional deficiencies often includes nutritional supplements like vitamin B-12, calcium, iron, and other vitamin supplements.

 

Often, a lactose-free diet is also recommended. Damage to the small intestine may cause you to lose the ability to digest milk sugar (lactose). In that case, it's important to avoid most lactose-containing products, or use lactase preparations that help digest milk sugar.

 

Foods to Fight SIBO

 

People treating SIBO often choose to follow the SIBO diet. The SIBO diet is a gradual elimination diet that is meant to reduce inflammation in the digestive tract and bacterial overgrowth in your small intestine.

 

In some cases, eliminating only sugars can ease symptoms. Doctors also often suggest incorporating a diet low in FODMAPs, which are difficult-to-digest carbs that are fermented by gut bacteria in the colon. When carbs can’t break down, they sit in your gut and can cause symptoms such as diarrhea and bloating. In addition, if there is bacterial overgrowth, the small intestine bacteria begin to ferment the carbs too early, causing many symptoms.

 

The SIBO diet is more focused on what not to eat than on exactly what to eat. It suggests eliminating high FODMAP foods in order to prevent fermentation in the gut and the proliferation of intestinal bacteria. High FODMAP foods to avoid include:

 

  • high-fructose corn syrup
  • agave nectar
  • honey
  • soda and soft drinks
  • garlic
  • onions
  • asparagus
  • butternut squash
  • cauliflower
  • artichokes
  • beans
  • peas
  • barley
  • rye
  • grains
  • apples
  • dried fruits
  • sausage
  • flavored yogurt
  • ice cream
  • sweetened cereals

 

While the list of foods you should avoid can be restrictive, there are still a number of foods you can enjoy while on this temporary diet. A SIBO diet should focus on foods high in fiber and low in sugar. Some of the acceptable foods for a low FODMAP diet include:

 

  • meat
  • fish
  • eggs
  • crackers, gluten-free
  • oatmeal
  • unsweetened cereal (made from low FODMAP grains)
  • spaghetti squash and summer squashes
  • broccoli (heads only, less than 3/4 cup)
  • leafy greens
  • carrots
  • rice or gluten-free noodles
  • olives
  • peanuts
  • potatoes
  • pumpkin
  • quinoa
  • seeds
  • some fruits (blueberries, grapes, oranges, and strawberries)

 

Herbs to Fight SIBO

 

In addition to following a low FODMAP diet, certain herbs may also be able to help kill the overgrowth of bacteria in the small intestine. For example, pomegranate peel extract has incredibly potent antimicrobial effects, with an extremely broad range of action against multiple pathogens. A tincture including pomegranate peel may help to kill bad bacteria and prevent them from overpopulating the small intestine.

 

Black Walnut is another antimicrobial herb that has been used for centuries to kill pathogenic bacteria and parasitic organisms and to detoxify the colon. Black Walnut is also useful for helping maintain an internal condition that is unfavorable to fungi and pathogenic bacteria.

 

Other useful herbs for treating a SIBO infection include:

 

Best Probiotic to Fight SIBO

 

One of the best things for helping fight off SIBO is to introduce the right kind of probiotic. Probiotics are beneficial bacteria that help to maintain a healthy balance in your gut microbiome. When supplementing with a probiotic, it will help to correct microbial imbalances over time, especially when taken after a cleanse that helped to eliminate the overgrowth of pathogenic organisms.

 

The best probiotic to choose is a multi-strain probiotic that has been 20 and 50 culture forming units (CFUs). A probiotic with multiple strains will better help to colonize the intestinal tract, helping to kill off the overgrowth of bad bacteria and restore a regular balance in the gut.

 

Summary

 

SIBO is a condition in which the bacteria that live in your small intestine have overgrown and are interfering with your normal digestive functions. Essentially, SIBO occurs due to an imbalance in your gut microbiome that allows the small bacteria to grow beyond healthy levels.

 

This condition can lead to many uncomfortable symptoms such as:

  • Abdominal pain
  • Bloating
  • Gas
  • Digestive issues
  • Loss of appetite
  • Nausea
  • An uncomfortable feeling of fullness after eating
  • Diarrhea
  • Unintentional weight loss
  • Malnutrition

 

In order to treat SIBO, doctors usually focus on correcting nutritional deficiencies and eliminating bacterial overgrowth. For most people, the initial way to treat bacterial overgrowth is with antibiotics. These can do a great job of killing the bad bacteria, but may kill beneficial bacteria as well, which is why it is often recommended to supplement with a good probiotic after a round of antibiotics in order to restore balance in the gut microbiome.

 

Some people try to treat SIBO naturally by focusing on diet and herbs. A diet low in FODMAPS, which are difficult-to-digest carbs that are fermented by gut bacteria in the colon, is usually recommended. When carbs can’t break down, they sit in your gut and can cause symptoms such as diarrhea and bloating. In addition, if there is bacterial overgrowth, the small intestine bacteria begin to ferment the carbs too early, causing many symptoms.

 

A low FODMAP diet can be followed while also using powerful antimicrobial herbs to kill SIBO as an alternative to prescription antibiotics. Some of the best herbs for fighting SIBO include:

 

  • Pomegranate peel
  • Black walnut
  • Grapefruit seed extract
  • Oregano oil
  • Garlic
  • Berberine, found in goldenseal and Oregon grape.
  • Olive leaf extract
  • Pau d'arco

 

As with any medical condition, it is recommended to speak with your doctor about the best way to diagnose and treat SIBO. In addition to treatment, it is also important to focus on prevention by maintaining proper gut health, as well as by following a healthy diet and lifestyle.

 

 

 

 

References:

https://www.ncbi.nlm.nih.gov/books/NBK546634/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386065/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6884350/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030608/

https://pubmed.ncbi.nlm.nih.gov/24891990/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748159/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966170/

https://pubmed.ncbi.nlm.nih.gov/31947991/

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