Antibiotics and Low-FODMAP diets are not treating your SIBO!
SIBO stands for small intestinal bacterial overgrowth which are categorized by symptoms such as:
Chronic bloating, progressively worse throughout the day
Loose stools
Constipation
Or alternating between loose stools and constipation
Gas
Rosacea
SIBO occurs when normal bacteria in the large intestine migrates up into the small intestines where it is not meant to be in large amounts. When this bacteria collinates in the small intestines it leads to the disruptive symptoms that characterize SIBO like chronic bloating, loose stools or constipation.
SIBO is very common, 70% of anyone who has IBS or IBS-like symptoms is suspected to have SIBO as part of their root cause. However many people even after conventional treatment struggle with frequent recurrence of SIBO, where SIBO symptoms come back multiple times. This happens because the real root cause of SIBO is not being treated.
You may have heard about this condition and how the only treatment is antibiotics and a low-fodmap diet - but we are here to tell you about the real root cause of SIBO.
How might you feel if you have SIBO?
SIBO is due to an overgrowth of bacteria in the small intestines, these bacteria produce gases that disrupt the gut and lead to the symptoms of SIBO. Because the small intestines don't have the ability to expand and contract to the extent of the large intestines these gases lead to bloating, pain and distention that gets progressively worse throughout the day as these bacteria produce more gas from the breakdown of carbohydrates and fibers in foods. SIBO can present as either diarrhea or constipation or even have someone oscillating between both diarrhea and constipation. SIBO can cause cramping and pain in the GI system particularly in the upper GI that presents around the belly button or higher. SIBO can also contribute to inflammation in the GI system which can result in non-GI symptoms such as fatigue and rosacea on the skin.
SIBO is not a root cause-
SIBO symptoms are due to the overgrowth of bacteria, but the root cause is not SIBO alone.
The real question to be asking is why is the bacteria able to overgrow in the first place?
The real root cause of SIBO is due to issues with the gut environment including lack of bile production or flow from the liver and gallbladder, parasitic infections, stress, low stomach acid, poor eating hygiene and some other contributing factors. When SIBO is only treated with antibiotic or antimicrobial herbs and the gut environment is not addressed, this is often when we see cases of chronic recurrence of SIBO. Therefore, to fully address SIBO and prevent recurrent both the unique needs of the gut environment must be addressed AND the opportunistic bacterial overgrowth must be treated. We have found that when we treat the root cause, and address the symptoms from a functional perspective, this is when we see clients overcoming SIBO for the long term!
To assess the unique root causes in the gut environment a comprehensive stool test is the best tool. We actually don’t use SIBO breath testing in our practice because we don’t find it to be a helpful testing tool and has a high rate of false test results.
DO I need to avoid FODMAPs to heal SIBO?
Sometimes SIBO can be mistaken for food sensitivities, this is because SIBO symptoms can be flared by specific foods that feed bacteria in the GI system. What we need to remember is that SIBO is an overgrowth of normal bacteria, so any foods that feed normal bacteria can trigger worsening symptoms of SIBO. This does not make these foods "bad" foods, but it does suggest the presence of SIBO.
Foods that feed bacteria and thus can contribute to the symptoms of SIBO, are known as FODMAP foods. FODMAP foods are fermentable carbohydrate foods that feed bacteria such as:
apples
mangoes
pears
garlic
onions
cauliflower
kidney beans, among others.
FODMAP foods are needed as a part of a healthy diet to feed and nourish overall beneficial bacteria, so these are not foods that we want to avoid for the long term. However, short term if someone notices that specific high FODMAP foods such as garlic or onions drive significant symptoms it may be helpful to reduce or avoid those foods while addressing the root cause of SIBO. However, long term avoidance of these foods is not needed or recommended and just avoiding FODMAPs is not a treatment for SIBO. FODMAPs are also not causing SIBO, so you can eat these food without panic that you are making SIBO happen through your food choices. The best part is once the root causes of SIBO are addressed, these FODMAP foods are able to be eaten symptom free!
Have you been struggling with the symptoms of SIBO? Don’t get stuck on the SIBO merry-go-round and get to the root of your chronic SIBO for good! Interested in learning more about how we can help, book a strategy call to learn more about what the best fit is for you!
