Small Intestinal Bacterial
Small intestinal bacterial overgrowth (SIBO) refers to an increase in the number of bacteria present in the small bowel. Rather than being caused by a single type of bacteria, SIBO involves an overgrowth of the various types of bacteria that should normally be found in the colon and their migration to the small bowel can cause a number of typical digestive issues.
This overgrowth can significantly disrupt the digestion of food and absorption of nutrients by damaging the mucosal lining of the small bowel leading to a leaky gut, decreased nutrient absorption and inflammation.
Furthermore, the byproducts resulting from bacterial breakdown of food can trigger episodes of loose stools as well as other symptoms.
SIBO Risk Factors
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Common SIBO Symptoms
SIBO Breath Testing
The diagnostic criterion considered for detecting Small Intestinal Bacterial Overgrowth (SIBO) is the Breath Test. This test involves administering a substrate after 24 hours of a non-fermentable diet. Breath samples are taken every 20 minutes for a total of 3 hours after the sustrate has been administered and the concentration of hydrogen and methane gases are measured in each sample. If there is a significant increase or an overall elevation in the levels of either of these gases, it indicates bacterial fermentation of the sugar and a positive diagnosis of SIBO.
There are other markers for SIBO with other tests such as the stool test but they are not a true diagnostic test.
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SIBO (Small Intestinal Bacterial Overgrowth) Treatment
The process of resolving the overgrowth typically requires a series of steps to be taken. Initially, the digestive tract terrain must be reset using either natural or pharmaceutical antimicrobials, in conjunction with dietary and nutraceutical therapies to restore gut health and minimise the risk of future recurrence.
Although various diets such as the low FODMAP diet have been found to be incredibly effective, it is important to remember that the root cause of the problem lies in the ecosystem’s interaction with food, and any diet should be only be used short term. If a diet is relied on as a long-term solution, the underlying issue has not been addressed and that is why many patients come in with the same symptoms as the underlying cause has not being met.
What sets The Edinburgh Centre for Functional Medicine in treating SIBO is our focus on the gut microbiome rather than focusing solely on the small intestine. While eradicating the overgrowth is paramount, we focus on beneficial flora that produce benefical molecules such as short chain fatty acids which bring the host multiple benefits.