SIBO: what it is, symptoms and natural treatment to restore balance

Our body has evolved to develop unique systems of microorganisms in different parts of the body. The set of bacteria and fungi that live in the human body, whether commensal, symbiotic or pathogenic, is the microbiota, which has different compositions in each area of ​​the body.

The problem is that sometimes bacteria from the colon spread to the small intestine, where they are not usually.It is what is known as SIBO. Since most of the bacteria are in the colon and large intestine, having a SIBO in the small intestine (where digestion and nutrient absorption occur) can lead to many symptoms and disorders.

“The cause of SIBO may be the low acidity in the stomach or one low intestinal motility that prevents cleaning our intestine of food remains and bacteria so that they come out through the feces. And another cause may be the integrity of the ileocecal valve that separates the large and small intestine,” explains Dr. Blas López Rueda, urologist, who is an expert in SIBO.

sibo: what is it

The SIBO (Small Intestinal Bacterial Overgrowth) it’s a bacterial overgrowth in the small intestine that come from the large intestine. If what proliferates are fungi, we talk about SIFO (Small Intestinal Fungal Overgrowth).

When you have SIBO, because there is an excess of bacteria in the small intestine, food ferments and therefore gas can be produced (with or without pain) and substances can be produced that give rise to bloating, bloating, diarrhoea, nausea, vomiting, reflux….

To treat SIBO, it is usual to give antibiotics such as metronidazole, riflaximin or neomycin. However, with this treatment, after eliminating some species, other harmful overgrowths tend to occur.

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The best is determine the type of SIBO or SIFO we suffer through a diagnostic test and observing our symptoms, establishing the causes and provide the body with the resources to regulate overgrowth.

For the natural treatment of SIBO It is recommended to follow a low FODMAP diet, that is, low in short-chain carbohydrates and easily fermentable sugar alcohols. We also have Natural medicine which, in some cases, are helpful as an alternative to drugs.

SIBO: CAUSES

The intestinal microbiota of each person varies throughout life. In the early years it is conditioned by the type of delivery and lactation (artificial or maternal). In adulthood, diet, lifestyle, drug use, stress and even the place where one lives modulate the microbiota.

The changes induced by external factors can lead to the overgrowth of some species to the detriment of others. Until recently it was thought that this intestinal “dysbiosis” was always due to an increase in pathogenic bacteria or fungi. However, an excess of bacteria or yeast –even of the beneficial or commensal– It can favor a SIBO or SIFO and alter the intestinal ecosystem.

Between the most common causes and triggers of a SIBO or SIFO we find the following:

Hypochlorhydria. The lack of acid in the stomach prevents the digestion of food, causes reflux and malabsorption, and favors the proteolytic microbiota. Gastric protectors, infection by Helicobacter pylorihypothyroidism or autoimmune processes cause this deficit.bile insufficiency. Bile acids have antibacterial action. Its scarcity produces constipation and ball-shaped feces. Infusions of bitter herbs (boldo, dandelion, fumitory…), as well as a tablespoon of olive oil with lemon juice on an empty stomach improve hepatobiliary function.enzyme deficiency. Digestive overload, age and systemic pathologies deplete pancreatic function. The feces are foul-smelling, with a tendency to diarrhea.intolerances. Celiac disease, non-celiac gluten sensitivity, allergy to milk protein, parasites, medications or autoimmune inflammations deteriorate the intestinal villi and alter the synthesis of enzymes such as lactase.Lack of digestive rest. Snacking between meals paralyzes the peristaltic movements that drag bacteria to be eliminated.Stress. Maintained over time, it inhibits the production of enzymes, increases intestinal permeability and alters the microbiota.

SIBO: symptoms and how to detect it

The gases we produce are one of the keys to knowing if we have a bacterial overgrowth in the intestine.

A healthy person produces every day between 0.5 and 1.8 liters of gases in the intestine. The most common are:

Carbon dioxide (CO2)Hydrogen (H2)Methane (CH4)Hydrogen sulfide (H2S)

While the first three do not smell, although they can be audible when expelled, hydrogen sulfide (H2S) gases are usually quieter, but they stink like rotten eggs. The excess or imbalance of these gases, produced by the intestinal microbiota, is related to inflammatory processes and metabolic and cardiovascular diseases.

We can detect it through a diagnostic test or by observing our symptoms:

1. With diagnostic test

To evaluate if you have SIBO, a expiratory gas test (breath test) after administration of lactulose or glucose. If the exhalation of these gases is rapid, it indicates that there is bacterial overgrowth.

2. For the symptoms of sibo

SIBO can be due to several reasons. our symptoms can give us information about the type of bacterial overgrowth that we are suffering, because the proliferation of one type or another of bacteria is going to give rise to a certain symptomatology.

Observe what is happening in our intestine and it will help us determine what SIBO we suffer from.

Excess hydrogen gases. They cause gastric fullness and abdominal distension after eating, but without pain. There is a tendency to diarrhea, although not always. They are due to an excess of fermentative microbiota and a deficit of the muconutrient, which causes intestinal permeability. The black grape and blueberry protocyanidins are your allies, because they favor the growth of bacteria such as Akkermansia muciniphilawhich reinforce the intestinal barrier and displace hydrogen-producing bacteria.Excess methane gases. They don’t smell but they are noisy and the floating stools, sometimes in the form of balls. Abdominal swelling appears hours after eating and there is usually constipation. It is due to an excess of archaea. This SIBO causes a wide variety of symptoms: cholesterol, overweight, anorexia, type 2 diabetes, diverticula, periodontitis, headache, low serotonin, depression, chronic pain and inflammation.Excess hydrogen sulfide gases. They smell like rotten eggs and stools are often pasty or diarrheal. They are formed by an excess of proteolytic bacteria such as Clostridium, Helicobacter either Klebsiella. There is greater intestinal permeability, abdominal pain, irritable colon… If they persist, they can give rise to ulcerative colitis, chronic fatigue, arthritis and other rheumatic diseases.

SIBO: Natural treatment to restore the microbiota

The body has its own systems to maintain the balance of the microbiota, but there are many situations that can reduce our digestive capacity. It is when these systems fail that bacterial overgrowth occurs.

Along with the low FODMAP diet, these are some of the more effective remedies and measures to control SIBO, although you should always consult a specialist doctor:

Essential oils: 2 or 3 drops of essential oil of oregano, thyme and/or savory dissolved in 1 tablespoon of olive oil, 3 times a day, eliminate pathogenic bacteria and fungi.Garlic: Allicin inhibits the growth of harmful microorganisms. In dry extract (300 mg daily) or liquid (20 drops in 10 ml of water, 1 time a day).Sagebrush: It contains essential oils and other compounds that give it antibacterial, antiseptic and anti-inflammatory properties. Reduces the production of methane gases. A dose of 500 mg three times a day is usually recommended.Berberine: Reduce excess archaea, giardia and proteolytic bacteria. It is anti-inflammatory and anti-diarrheal. A 500 mg three times a day is usually recommended.Quebracho: The quebracho extract (Schinopsis balansae) binds to archaebacteria, breaks their cell walls, and inhibits the enzyme that enables methane formation. It can be mixed with other plants that enhance its action, such as horse chestnut (Aesculus hippocastanum) and peppermint. From 550 to 1,500 mg daily.Fasting and exercise: Intermittent fasting 8/16 and exercise also help. Intermittent fasting stimulates the migratory motor complex, peristaltic movements that are activated after eating, every 90-120 minutes, and which drag waste and bacteria through the digestive tract to the colon to be eliminated.

Low FODMAP Diet for SIBO

In SIBO it is advisable to follow a diet low in FODMAPs or short-chain carbohydrates and easily fermentable sugar alcohols, but no more than 6-8 weeks. Some people do not digest these types of carbohydrates and alcohols well, so they reach the large intestine and feed harmful intestinal bacteria.

Between the foods to avoid we find: garlic, artichoke, onion, cauliflower, asparagus, leek, beetroot, wheat, rye, cashew nuts, dried fruit, avocado, custard apple, dates, figs, apple, pear, peach, banana, watermelon, legumes, mushrooms and sweeteners.

this is a small menu example for low FODMAP diet:

Breakfast. Tea, coffee or infusion (with lactose-free or vegetable milk, less soy) + oat flakes with lactose-free yogurt or 2 slices of spelled bread (from sourdough) with serrano ham + 1 piece of low-FODMAP fruit (strawberries , blueberries, tangerine, papaya, pineapple, grape…).Meal. Arugula with tomato, cucumber, red pepper and olives + Quinoa, rice or buckwheat stew with low FODMAP vegetables (carrots, green beans, zucchini, spinach…).Snack. Low FODMAP fruit or nuts (pine nuts, pecans, Brazil nuts…)Dinner. Pumpkin cream with ginger + plain or potato omelette + 1 low-FODMAP fruit or lactose-free yogurt.

why are there bacteria and fungi in the intestine

To understand how a SIBO or SIFO occurs, it is important to first understand how the microbiota works and What is the function of each group of microorganisms? in health, because that will also help us understand what happens when their colonies are reduced or increased.

Every day millions of reactions occur in the body that condition our health. A large number occur in the intestine and are the work of the 100 trillion microorganisms that make up the intestinal microbiota. These microorganisms fulfill essential metabolic functions:

They help digestion and nutrient absorption.synthesize certain vitamins or modify them, activating them and making them useful for the body.produce fatty acids short-chain protein (SCFA) from indigestible fiber –which play an important role as a source of energy for…