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SIBO; an overgrowth of bacteria causing GI problems

If you or your known have been experiencing symptoms like bloating, gas, abdominal pain then you should know about Small Intestinal Bacterial Overgrowth ( SIBO )

We all have bacteria in the gut (majorly large intestine) and they play a major role in digestion. If the “good” bacteria that help you digest food can’t keep up with the harmful bacteria, the “bad” germs can multiply too fast, leading to an imbalance.Hence when too many bacteria, or the wrong kind, populate the small intestine, it can lead to uncomfortable symptoms such as gas and diarrhea. It can also inhibit your ability to digest and absorb nutrients from food. This is SIBO (small intestinal bacterial overgrowth) 

As a result, the small intestine is not able to handle a large number of bacteria growing inside it. When a person eats, these bacteria begin to ferment the food. Hence to put it in simple words SIBO is a common digestive imbalance often found in patients that experience bloating, flatulence and burping, and a change in their bowel habits, becoming either more constipated or tending towards diarrhea.

Types of SIBO :

There are three different types of SIBO, differentiated by the main types of gas produced by the bacterial overgrowth in the small intestine.

1. Hydrogen Dominant (SIBO-D):

D-Stands for Diarrhea i.e. when there is an overgrowth of bacteria in the small intestine that product hydrogen then the patient is suffering from SIBO-D 

As a normal process bacteria produce hydrogen gas as a by-product of carbohydrate fermentation in the digestive system & hydrogen does exist in our large intestine as a by-product of this fermentation. But when large amounts of hydrogen gas is produced then the problem starts. This causes fast transit time and/or loose stools.

2. Methane Dominant (SIBO-C):

C-Stands for constipation. Now along with bacteria, our intestinal flora also consists of organisms known as Archaea which are a bit different than bacteria as they are single-celled organisms that don’t have a nucleus. They feed off of hydrogen that bacteria produce during the fermentation of carbohydrates (fiber specifically) and then produce methane as a byproduct of their digestion.

Due to Lactose malabsorption and decreased motility of the digestive tract, there is an overgrowth of archaea in the gut leading to more methane production which leads to constipation and excessive bloating.

3. Hydrogen Sulfide Dominant:

Our body uses sulfur for our cells and microbiome. It then detoxes and excretes most of the by-products of sulfur metabolism.

In a healthy person, a small amount of sulfur is converted into hydrogen sulfide. But if too much hydrogen sulfide is produced by our microbiome then the natural way to detoxify it in the gut is overwhelmed & it can cause many health issues, including SIBO.

What causes SIBO:

When Bacteria grow and stick around too long and the food is not moving in the right way then SIBO usually starts

Things that can cause SIBO or make it more likely are :

Low production of acid due to factors like H.Pylori infection, prolonged use of medicine like antacid & proton pump inhibitors or gastric bypass surgery or in old age 
Too long retention of waster in the small intestine before emptying into large intestine allowing small intestine bacteria to continue to multiply while large intestine bacteria make way         nto the small intestine in conditions like gastroparesis
Due to anatomical change in small intestine inhibiting motility and regular clearing of residual bacteria 
Due to medical conditions like diabetes, Irritable Bowel Syndrome or weak immune system affecting intestinal immunity to certain bacteria
Medications like  antibiotics that affect the bacteria in the intestine or narcotics

What are the symptoms of SIBO?
SIBO symptoms often mimic other disease states, the most common symptoms are :
Abdominal pain
Abdominal distension
Unintentional weight loss

What happens if SIBO is left untreated?
SIBO can cause more serious complications with long-term consequences. 

  • Excess bacteria in the small intestine
  • Breaks down bile salts which have a role in fat digestion hence resulting in diarrhea
  • Also, the incomplete absorption of fats result in poor absorption of Vitamin A, D, E, K causing a vitamin deficiency