SIBO is a digestive condition that can be difficult to manage. It can be challenging to find the right treatment for SIBO, especially when there are many holistic options. Some practitioners may use supplements, elimination diets, and stress management tools. If you have tried all of these and still suffer from chronic symptoms like bloating, diarrhea, and constipation (or if your symptoms come and go), it might be time to see a Functional Medicine specialist.
Functional Medicine, which aims to find the root cause of symptoms, rather than just covering them up with drugs, has been proven to help those with SIBO. In this blog post, we will take a closer look at our East-meets-West Functional Medicine approach at Meeting Point Health for SIBO management and treatment.
What is SIBO?
SIBO stands for Small Intestinal Bacterial Overgrowth and is a condition that occurs when there’s an excess of bacteria in the small intestine. Functional Medicine considers SIBO to be one type of gut dysbiosis, which refers to changes in microbial balance within our digestive system. In Functional Medicine thinking , symptoms such as bloating, diarrhea or constipation are not just considered “normal symptoms” but rather clues about what might going on inside us biologically.
Symptoms
It can take anywhere from weeks, months up to years before you start experiencing symptoms because it depends on how long your body has been struggling with having too many bacteria present in your gastrointestinal tract. Symptoms include:
– discomfort, distention or bloating after eating, or just a regular feeling of fullness
– diarrhea, constipation or both
– gas / flatulence
Some people with SIBO may only experience one symptom while others might be affected by all three. If you’re experiencing at least two of these symptoms, it could indicate a problem but Functional Medicine also recognizes that there are many other possible causes for this as well.
Causes of SIBO
There are various causes of SIBO and Functional Medicine doctors look at everything from genetics to environmental factors. Likely causes include:
– gastrointestinal infections or fungal overgrowth from food or environment
– overuse of antibiotics that lead to dysbiosis of friendly bacteria
– overuse of PPIs that lead to low stomach acid; poorly digested food passes into the small intestine and begins to ferment
– chronic stress or illness that changes the ph of the stomach and intestines; this allows some bacteria and fungi to grow and others to die off
– slow movement of the gut (reduced peristalsis) in which stagnant food in the small intestine ferments and causes bacteria to grow where it shouldn’t
How is SIBO tested?
There are various tests that Functional Medicine doctors order to determine whether or not you might have SIBO. The most common is the lactulose breath test which measures how much hydrogen and methane gases come up through your mouth after ingesting a specific type of sugar (lactulose).
If there is an overgrowth in bacteria, then certain hydrogen-producing and methane-producing species will overwhelm carbohydrate-digesting bacterium, producing large amounts of both hydrogen and methane.
A functional stool test will also map out the health of your whole GI tract including which friendly bacteria in your gut are in overgrowth, the presence of pathogens such as klebsiella and citrobacter, a deficiency of digestive juices such as bile and pancreatic enzymes, inflammation, markers of intestinal permeability (leaky gut), markers of gluten sensitivity, and more.
Once you’ve determined that you have SIBO through a Stool Test and a Breath Test, there are different approaches to managing it depending on what is revealed in your labs.
Approaches to SIBO Treatment
Conventional medicine typically relies on antibiotics such as Rifaximin to treat SIBO. At Meeting Point Health, we take a holistic approach and have proven success in treating SIBO cases with remedies such as diet, herbs, supplements, acupuncture and ozone therapy.
Nutrition for SIBO
In Functional Medicine, we often recommend a customized diet plan based on the patients’ nutritional history, ancestry, and test results. We will likely recommend some sort of specific carbohydrate restriction plan to help starve out the bad bacteria in your gut since certain types of carbs make it easier for some species to proliferate and cause further damage to your gut lining (leaky gut.)
Where hydrogen and methane gases are particularly high, we will look at reducing the intake of foods that easily ferment in the gut such as artificial sweeteners, alcohol, and high-FODMAP (fermentable oligosaccharides, dissacharides, monosaccharide and polyol) carbohydrates.
Starting a medicinal diet can be hard to adjust to at first, but our Functional Medicine providers and health coaches are trained in the art of creating a sustainable customized meal plan for each individual.
Ozone Therapy for SIBO
Ozone therapy is a holistic treatment option which involves the introduction of ozone (which contains three oxygen molecules) into the body via an intravenous drip or rectal insufflation. When ozone interacts with the blood, it breaks down into O2, O-, H2O and H2O2. The bloodstream acts as a carrier for these oxygen metabolites, distributing them throughout all our cells where it has been shown to help kill off harmful pathogens. It also helps activate your own immune system and reduce inflammation by triggering antioxidant production to get rid of free radicals that have been shown to damage healthy cells within your GI tract.
Acupuncture for SIBO
Acupuncture is another holistic treatment option that has been used successfully in improving gut motility when it comes to managing cases of SIBO. Acupuncture treatment involves inserting hair thin needles at certain points of your body (usually your abdomen in cases such as SIBO) helping your nervous system communicate better with the rest of your cells and organs within your GI tract. Acupuncture helps improve blood flow and “peristalsis” which is the contraction and relaxation of your gut organs to move food and stool through your GI tract. We often use gentle electroacupuncture with specific frequencies to get your gut moving properly.
Herbal Remedies for SIBO
Specific herbal medicines are known to support detoxification pathways allowing us to more effectively remove toxins from the body including bacterial waste products associated with gut dysbiosis.
Herbal remedies such as activated charcoal, peppermint, and digestive enzymes can help calm and support digestion, while reducing gas and inflammation. However, if you are experiencing intense symptoms, it may feel like you are sensitive to many foods, herbs, and supplements. A Functional Medicine doctor will be able to create an individualized treatment plan based on your bloodwork, breath test, and stool test to determine whether or not you have SIBO, what type of SIBO you have (e.g., methane-producing vs. hydrogen-, etc.), as well as which specific herbal remedies will be most effective for your situation, as there are extensive herbal remedies to choose from.
LDN for SIBO
In Functional Medicine, we may use low-dose naltrexone (LDN) which is an FDA approved drug which we use to treat autoimmune diseases. LDN has been shown to improve intestinal permeability by repairing tight junctions between cells of the small intestine improving motility, pH balance, and thereby reducing bacterial overgrowth and allowing healthy absorption of nutrients within our GI tract. It also naturally increases endorphins or “feel good hormones” while decreasing inflammation throughout all systems of the body including the digestive system making it effective not just for SIBO but concurrent autoimmune diseases like Celiac or Hashimotos as well.
Probiotics & Prebiotics?
Specific strains of friendly bacteria have been shown time and again to help reduce symptoms associated with irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) and chronic fatigue syndrome (CFS). However, if SIBO is present, probiotics may not be helpful in the initial phases of treatment. Overpopulation of your gut with specific strains before establishing proper gut motility and pH can be harmful. In addition, some prebiotics will also exacerbate symptoms. In fact, remember those high-FODMAPs we were just talking about? High-FODMAP foods happen to be prebiotic. In the very beginning of treatment, when symptoms such as bloating are intense, it is better to hold off on probiotics and prebiotics. In later stages of treatment, we will introduce these when appropriate.
So in conclusion ….
If you are struggling with SIBO, it’s important to find a holistic treatment plan that is individualized for you. Our team at Meeting Point Health is experienced in fighting SIBO and other digestive disorders. Contact us if you think we can help!
~ Mary Anne Matta, MS MA LAC is a Functional Medicine and Integrative Medicine specialist. Her specialty focuses on gut health, autoimmune diseases, and environmentally-acquired illnesses such as Lyme and mold.
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