If you are treating your leaky gut by following the 4 Rs and you’re not seeing much progress, it could be that you’re dealing with SIBO – small intestine bacterial overgrowth. SIBO (pronounced SEE-bo) is one of the causes of leaky gut, but treatment for the two is a bit different.

The most common symptoms of SIBO are abdominal pain or discomfort, bloating/distention, diarrhea and/or constipation, and extreme burping and passing gas. It tends to be under-diagnosed since it shares so many symptoms with other gastrointestinal disorders.

A Bit of Background

The small intestine is a big part of the digestive tract. More than 20 feet long, it takes up most of the space in the abdomen. Above it, the stomach’s job is to mix chewed up food with acid, and really start to break down the pieces of food. After churning for awhile, this mixture is sent to the small intestine where it’s broken down even further, and nutrients are absorbed into the bloodstream. Several nutrients are also manufactured here.

After all that acid treatment, there is really very little bacteria in the small intestine, and only specific varieties. Which is how it’s supposed to be. The main bacteria colonies that are so important to good health are a little further down in the colon (large intestine).

There is a one-way valve between the small and large gut – the ileocecal valve (ICV) – designed to keep things moving forward. If the ICV gets damaged or even just stuck, digested material can go backward into the small intestine. By then, the normal colon bacteria, simply trying to do their job to keep us healthy, has been added to the mix.

But remember, bacteria, even the good kind, doesn’t belong in the small intestine. Its presence can set off an inflammatory cascade with far reaching effects. Other digestive issues of course, like GERD, leaky gut, IBS… but also hormone production, mood, and brain function can be affected.

Obviously, this is not something you’d want to happen.

There are many circumstances that can lead to SIBO, but the primary factor appears to be gastroenteritis (stomach flu) in your medical history. And who hasn’t had stomach flu at some point?

There are greater and lesser degrees of physical damage caused by these infections, so a bout with tummy problems doesn’t necessarily mean you’ll get SIBO. But if your gut is sufficiently damaged, intestinal function will be impaired.

  • The ICV could malfunction and cause a backup.
  • Some of the carpet-like villi on the intestinal wall could become scarred and unable to absorb nutrients, leading to a fermentation problem and blowing the ICV.
  • The gut flushing action that’s supposed to happen between meals might shut down (a housekeeping problem).

But whatever the cause, bacteria that is normally considered beneficial relocates to where it doesn’t belong. Instead of helping, it becomes a troublemaker.

If you suspect you have SIBO, the most common lab test used is a breath test for incomplete digestion.  While this test can let us know if there are gas producing bacteria it doesn’t really help us get to the underlying “why” or “what” beyond a broad, general sense.   Looking at other markers such as what we will find in an organic acids test or a comprehensive stool analysis will provide information upstream from the potential overgrowth.

Once you’re diagnosed, some doctors choose to treat SIBO with low level antibiotics. Others believe the antibiotic cure is short lived, and that the SIBO will nearly always return. It all depends on a multitude of circumstances, both physical and emotional.  As with any health challenge we need to look at the big picture and be aware of how the things we are utilizing affect not just what we intend, but how the substance affects other areas of our health.

Most practitioners seem to agree that inflammatory foods must be removed from the diet. No starches, sugar, or alcohol. No grains. No probiotics or prebiotics. Most dairy products and legumes are a no-no. And sometimes, even fruits must be avoided.  Which is why you have probably seen a plethora of conflicting information as you search the internet – do you see the common theme?  We have to approach the food choices from a holistic standpoint as well – what works for me may not work for you even though we may have the same “diagnosis”.

Getting enough nutrition while starving out the SIBO begins to look like a tightrope act, not to mention longterm can lead to additional health challenges.  If you are suspecting an overgrowth I would encourage you to take advantage of my free consultation before jumping into a lot of tests, protocols and food restrictions.  And, for those of you who have been on this journey for a while and are still having difficulty regaining your health – let’s jump on a call and get your health back on track!

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