Do you have bloating? And nothing helps? Were you sent home with the stamp of IBS? Then it could also be SIBO-a chronic and often misunderstood condition arising from the gut that burdens untold numbers of patients in the Netherlands alone.

There is increasing evidence that bacterial overgrowth of small intestine plays a role in causing irritable bowel syndrome (PDS or IBS) .About 85% of all IBS is SIBO. This requires more explanation and especially a specialized practitioner who has experience with SIBO and can properly advise and treat you.

In SIBO, there are too many bacteria in the small intestine that actually belong in the large intestine, causing digestive problems. This causes a wide range of uncomfortable and often embarrassing symptoms for SIBO patients. The problem with a small intestine with too many bacteria is the fact that the bacteria eat along with our essential nutrients. This leads to a myriad of symptoms, such as extreme gas, bloating and altered stool patterns.

Delayed bowel movements (intestinal contractions of the small intestine) result from a bacterial accumulation in the small intestine. Underlying causes of delayed contractions can include anti-inflammatories, surgery, but stress can also be a cause. Other causes of bacterial overgrowth can include a lack of stomach acid (stomach acid kills bacteria, a lack of stomach acid can cause food in the stomach to ferment which in turn is food for bacteria).

Many people are misdiagnosed. They are sent home with “learn to live with it. Or they are temporarily given a diet that does not give any benefit, or only helps temporarily.

How do you know if you have SIBO?

The only way to diagnose this condition at this time is to take a SIBO breath test – an easy-to-use test in which you blow air into a tube after first taking a solution.

What are the causes of SIBO (and therefore IBS)?

• a lot of stress over an extended period of time,
• antibiotics,
• medication such as antacids,
• Severe diarrhea due to food poisoning,
• insufficient stomach acid, possibly due to stress or,
• insufficient stomach acid (due to antacids),
• Slow kneading of the small intestine,
• celiac disease or gluten intolerance,
• insufficient pancreatic function,
• lactose intolerance,
• A valve defect between small and large intestines,
• use of NSAIDs and opiates,
• immune deficiency, impaired sigA,
• operations in the gastrointestinal area.

In addition to a SIBO, we often test for:

1. Intolerances to food.
2. Parasites or fungi/yeasts like candida
3. Leaky gut ( zonulin alpha 1 antitriptase)
4. Digestion and absorption ( bile salts, bile, pancreatic elastase)
5. Stomach Acid

What you must realize beforehand is that I cannot treat you with dietary advice alone. Stewardship is definitely needed with (natural) remedies/supplementation to get the underlying issues right again. The goal here, of course, is for you to be able to eat everything normally again, without symptoms. But too often I find that people are very reluctant to supplement. They are so sometimes traumatized by the symptoms that taking a simple supplement like magnesium, probiotics or fiber, or some extra stomach acid takes too much convincing for me. Please realize that these are the tools, the tools, to make you better. Only with nutrition and endless killing ( regular antibiotics) drugs will you get to the cause (often a malfunctioning digestive system, or a microbiome which is not right, sometimes since childhood, really not remedied!

Of course, it is good to test exactly what is going on and then treat.

I am frequently asked what a Sibo test costs. However, I can only advise whether a Sibo test would be useful for you by first seeing you, examining you and identifying your symptoms. So you first come for an intake interview. Only then will we work with you to determine which possible tests provide insight and benefit. Testing goes through specialized laboratories that bill you directly. I am only the applicant for the test.

Cause and effect

Research shows that the main cause of SIBO is a reduction or delay in the mobility of food through intestinal passage, this affects the levels of bacteria present in the small intestine. Consider a stagnant pool of water where bacteria thrive and grow in large undesirable amounts as opposed to a clean, free-flowing stream. There are two main causes of delayed motility (movement) in the intestine. The sweeping motion should move undigested food and excess bacteria to the colon. When movement is defective, undigested food, becomes food for the bacteria that cause or exacerbate SIBO.

Some medical conditions and procedures can cause these changes. For example; scars after surgery, Inflammatory bowel disease, diverticulosis, blind loops, radiation damage, strictures, fistulas, intestinal pseudo-obstruction and adhesions due to surgery, are all known to affect or cause SIBO.

Right now, there are many reasons for SIBO. Anything that reduces the movements of the bowel causes SIBO. These can include blockages in the intestine, narcotic use of medication, opiates and other causes of mechanical delay.

Recently, however, a link between irritable bowel syndrome (IBS) and SIBO has been demonstrated and is now the most common reason for SIBO. In the case of IBS, it is believed that food poisoning (getting sick from specially pathogenic bacteria after eating bad food such as Salmonella, E. coli, Campylobacter, Shigella and even C. Difficile) leads to this problem in the past. With research, it has been shown that food poisoning and the associated toxin load, causes nerve damage to the small intestine. This partially causes a reduction in the number of cleaning waves of the small intestine and this leads to bacterial overgrowth. There is also a variant in which fungi participate, we call it SIFO. And some unlucky ones get MCAS ( mast cell activation and POTS (Postural orthostatic tachycardia syndrome)POTS is a condition where a change from lying down to standing causes an abnormally large increase in heart rate. This occurs with symptoms that may include lightheadedness, difficulty thinking, blurred vision, or weakness. Both images are still barely known.

What are SIBO symptoms?

• Heavy bloating (gas) feeling pregnant
• Flatulence
• Farmers
• Abdominal pain, cramps
• Obstipation usually associated with methane dominance
• Diarrhea usually associated with SIBO with hydrogen
• Alternating diarrhea or constipation
• Intestinal permeability ( leaky gut) 50% have SIBO

Symptoms related to the stomach:

• Stomach acid (reflux or GERD)
• Nausea

Leaky bowel symptoms:

• Food hypersensitivities (intolerances)
• Lactose intolerance
• Fructose intolerance
• Sucrose intolerance
• immune reactions ( auto immunity)
• Headache
• Joint Pain
• fibromyalgia (70% have SIBO!)
• Fatigue
• Skin symptoms (such as rosacea, eczema or rash)
• Respiratory symptoms (such as asthma)
• Mood symptoms (such as depression)
• Brain symptoms (such as autism)

Systemic complaints:

• headache,
• fatigue, chronic fatigue (CFS)
• rosacea,
• restless legs
• Malabsorption symptoms that can lead to Steatorrhea (fatty stools)
• oily stool
• Anemia (iron, or B12)
• Weight loss or weight gain
• cystitis
• prostate complaints
• deficiencies in fat-soluble vitamins ADE andK(2)

Other conditions associated with SIBO include: hypothyroidism, lactose intolerance, Crohn’s disease, systemic sclerosis, celiac disease, chronic pancreatitis, diabetes with autonomic neuropathy, fibromyalgia and chronic regional pain syndrome, hepatic encephalopathy, non-alcoholic hepatitis, interstitial cystitis, restless legs syndrome and acne rosacea.

How does the gut work?

The intestines are divided into the esophagus (food pipe), stomach, small intestine (where all food is digested) and large intestine (where only waste is processed and water is taken out). The slower the gut moves, the easier it is for bacteria to stay in one place and start growing. When you eat, food passes quickly through the esophagus to the stomach. The stomach acid helps digest proteins and also kills bacteria from the food you eat. The food is then delivered very slowly from the stomach into the small intestine for further digestion, before being absorbed into the blood. However, not all foods can be processed by humans. People sometimes cannot process certain carbohydrates such as cellulose (most plant substances contain this). The time from eating to completing digestion takes about 2 hours. The small intestine is about 3.5 meters long.

Although the colon absorbs most of the water, almost 90% of the water has already been absorbed by the small intestine.

Eating and fasting

To understand why a particular diet and the use of natural antibacterials can be helpful, you need to understand what bacterial overgrowth in the small intestine (SIBO) is and why it happens. SIBO affects people in many different ways – Digestive symptoms are usually described as bloating, constipation and/or diarrhea, but it is a complicated condition that can cause a very wide range of symptoms. Often missed as a causative factor, SIBO can play a role in: chronic fatigue (CFS), roseacea, restless legs, cystitis, absorption problems of vitamins and minerals and many more health problems.

The human gut is made of nerves and muscles that help make food available to the body. However, there are two positions for the gut. These are “eating mode” and “cleaning mode.” When you are eating, all the food you eat is in the gut and it is busy mixing, spreading and absorbing the food. If you don’t eat, the gut needs to be cleared. This is most important in the small intestine where food is absorbed. In the small intestine, there is a strong, repetitive and moving kneading every 90 minutes called the cleansing wave”. This wave of motion is responsible for cleaning the small intestine which drives all the remaining, non-digestible material into the large intestine so that the next time you eat your small intestine is clean and ready for use.

Nutrition must be adjusted at SIBO

Eating healthy does not help against SIBO. Sometimes it only makes it worse because then a lot of digestible fiber is eaten. These actually create more gases in the small intestine because the bacteria that are there now break them down. That should have happened in the colon. So between meals, it is better not to consume calorie foods between meals. So no sweets during work …..

What is bacterial overgrowth of small intestine (SIBO)?

The human gut has more bacterial cells than even the number of human cells in our body. This is normal. Almost all of these bacteria are found in the large intestine. This is because the colon is the slowest passage area. The slower the gut, the easier bacteria grow and settle. On the other hand, the small intestine normally has a low bacterial count. This is due to stomach acid, pancreas and bile, the kneading motion of the small intestine, but especially the cleansing waves mentioned above.

Bacterial overgrowth (SIBO) is not an infection. They are not “bad” bacteria. It is simply the situation of having too many bacteria of the normal kind in the small intestine. They do not belong there in high numbers.

What can negatively affect SIBO:

Remember what we just wrote; the colon is about 1 meter long and receives only waste products to process. The small intestine is about 3.5 meters long and contains mostly fresh, easy-to-use, novel food. Normally, when wastes enter the colon, it is the leftover material that we could not digest. We could not digest it because it is difficult to digest. The bacteria can digest it slowly. This produces a little gas as is normal for everyone. The colon is only 1 meter long, so when there is gas in it, it does not fill much space.

Now think about the small intestine and bacterial overgrowth. You have a total of 3.5 meters of intestines, with as it is with SIBO, with too many bacteria in them, combined with easily digestible fresh food. Gas is then easy for bacteria to produce, and since the small intestine takes up a lot of space in our stomach, it means you can develop quite a bloated feeling. Like being pregnant, we then hear from our patients.

What can Complimed do for you?

We first determine if you have SIBO and then do a targeted examination. We advise you what foods you should not eat and what foods you should eat. There are a number of diets that can be used to manage the symptoms of SIBO. Diet alone will not eradicate SIBO. However, changes in diet can support an anti-bacterial program and can help make you more comfortable by alleviating some of the symptoms. The suitability of one diet for one person and another for someone else is very confusing. The individual suitability of one diet over another is probably caused by the type of bacteria causing the overgrowth.

You will follow a focused bowel protocol in which we will focus on bowel movement, flora and counteracting gas-forming bacteria in the small intestine. In this, you must be willing to use my advice and the resources to be deployed for this purpose. You will feel a lot better!