Small Intestinal Bacterial Overgrowth (SIBO)

The Gastro Clinic has diagnosed and helped many patients with SIBO. Most of them had been suffering the very unpleasant symptoms for years, without being correctly diagnosed. They had been treated for the symptoms, rather than the underlying cause. Many had received extensive antibiotic therapy in the past for various health issues, been on the oral contraceptive pill, or used hormone implants for contraception.

Small intestinal bacterial overgrowth (SIBO) refers to a condition, in which abnormally large numbers of bacteria are present in the small intestine and the types of bacteria in the small intestine resemble more the bacteria of the colon than the small intestine. This overgrowth also causes damage and inflammation to the gut wall.

The waves (muscular activity) that sweep through the small intestine are important for the digestion of food and to sweep bacteria out of the small intestine. Anything that interferes with these waves can result in SIBO by allowing the bacteria to stay longer and multiply in the small intestine. The lack of muscular activity also allows bacteria to spread backwards from the colon into the small intestine, which is why types of bacteria normally found only in the colon, are found in the small intestine. (see references 7)

Nerve damage or muscular diseases can also alter the normal activity of the intestinal muscles, causing the waves to reduce in intensity. Diabetes mellitus damages the nerve supply to the intestinal muscles. Scleroderma damages the intestinal muscles directly. The effect of these diseases on the waves causes SIBO.

Symptoms may include:

Abdominal pain - When bacteria digest food in the intestine, they produce gas. The gas can accumulate in the abdomen giving rise to painful abdominal bloating or distension.

Gas - Reduced digestion or absorption by the small intestine allows increased amounts of sugar and carbohydrate to reach the colon, where greater amounts of gas are produced. When bacteria digest food in the intestine, they produce gas

Bloating - The gas can accumulate in the abdomen giving rise to abdominal bloating or distension.

Diarrhoea - The bacteria also convert food into substances that are irritating or toxic to the cells of the inner lining of the small intestine and colon. These irritating substances produce diarrhoea by causing secretion of water into the intestine

Constipation - Some patients with SIBO have constipation rather than diarrhoea. There is some evidence that the bacterial production of methane causes constipation

Weight loss - When the bacterial overgrowth is severe, the bacteria may cause malabsorption of food and deficiencies of vitamins and minerals may develop, leading to weight loss

Aches – mostly in joints

Fatigue – sleep can be impaired; and a lack of good nutrition caused by malabsorption can result in constant tiredness

Before any herbal prescription is formulated, the extent of the SIBO must be ascertained by non-invasive laboratory testing. Once this is done, a plan is formulated, which incorporates herbal medication and nutritional modifications. Every patient’s experience of SIBO is different and that is why it is important to tailor the herbal formula by way of a personalised prescription to meet the unique needs of each patient. The bacterial overgrowth is dealt with and the gut lining, which is damaged and inflamed, is repaired through herbal medication and nutrition.