Gas, bloating, brain fog, diarrhea: none of it is fun, especially when it just won’t quit. When these symptoms don’t go away, the cause could be SIBO (small intestinal bacterial overgrowth). This overgrowth of bacteria has many causes ranging from post-surgical complications to stress and poor diet—but the good news is, you don’t have to live with it indefinitely. Here, the crash course to understanding SIBO.
What is SIBO?
SIBO is an acronym for small intestinal bacterial overgrowth. The condition is exactly what it sounds like: too much bacteria in the small intestine. SIBO also decreases your body’s intestinal motility, or its ability to move food through the digestive tract. “SIBO can deplete you completely and cause massive malnutrition of nutrients because vitamins and minerals are mainly absorbed in the small intestine,” says Dr. Nigma Talib, ND, a naturopathic doctor and the author of Younger Skin Starts in the Gut.
What are the symptoms of SIBO?
Most often, SIBO symptoms include abdominal pain, gas, loss of appetite, nausea, bloating, and/or diarrhea—but some people with SIBO may show additional signs such as pustular acne, Dr. Talib says. Other people complain of brain fog or fatigue. “SIBO doesn’t discriminate on age,” Dr. Talib says. “Anybody has the ability to get SIBO, whether in their 20s or 30s or 70s and 80s.”
The best way to know if you have SIBO is to have your doctor run a diagnostic test. “You’re the guide to the doctor that you’re seeing, whether it be a naturopathic doctor, a gastroenterologist, or your primary GP,” Dr. Talib says. “You can say, ‘I think I might have SIBO. Can we run some tests?'” Your health care provider has an array of diagnostic options, from breath tests to stool tests, to help evaluate your bacteria levels.
How can you treat SIBO?
If you do wind up having SIBO, many doctors prescribe a course of antibiotics, typically Xifaxan, to address the overgrowth. But, Dr. Talib says, that doesn’t always work as a long-term solution. “In my clinical experience, from 30 to 50 perent of people end up getting rebound SIBO,” she says.
For these people, she typically uses a combination of botanicals and digestive enzymes to adjust the pH of the stomach, which prevents bacteria overgrowth. She also uses specific probiotics, the FODMAP diet, and cupping along with stress-reducing lifestyle and diet changes. “There are a number of ways we can treat SIBO,” she says, “but it depends on the person and how long you’ve had it.” Typically, the longer you’ve had SIBO, the more time it will take to address it, she says—but most people see improvement within a couple of weeks.
To prevent a recurrence, Dr. Talib recommends staying on the FODMAP diet for a bit longer after symptoms have disappeared. (The idea is to ensure that all of the bacterial overgrowth has gone.) Next, support your intestinal mobility by exercising and staying hydrated. “You always want movement in your intestines,” Dr. Talib says. “Anything that’s going to enable your bowels to move, especially a lot of fresh water, will clean out the guts and improve pancreatic function.”
The good news? Taking care of SIBO may make you feel better in more ways than one. “Once people get resolved with SIBO, not only do they notice that their digestive symptoms improve, but their cognitive function improves and their skin is more clear,” Dr. Talib says. So if you’ve been experiencing symptoms, getting a diagnostic test might be the painless first step to feeling better all over.
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