What exactly is SIBO?
SIBO stands for “small intestinal bacterial overgrowth.” It indicates that the bacteria in your small intestine are overgrown and that the mechanisms that normally keep your gut flora in balance are not functioning. Bacteria in your small intestine are normal and healthy, but too many can cause digestive issues, especially if they are the wrong kind. The wrong bacteria can crowd out the beneficial bacteria you need, and they can upset your digestive system by feeding on products that aren’t meant for them.
What happens during SIBO?
Carbohydrates are digested and converted into gas and short-chain fatty acids by bacteria in the small intestine. More bacteria can lead to more gas and other byproducts, which can cause diarrhea. The bacteria also consume proteins, vitamin B12, and bile salts, which are supposed to help you digest fats. All of this leads to poor fat digestion and absorption of nutrients, particularly calcium and fat-soluble vitamins. In the short term, this causes a variety of gastrointestinal symptoms, and in the long run, it causes malnutrition. Vitamin and mineral deficiencies can cause long-term damage to your bones and nervous system.
What are the signs of SIBO?
SIBO symptoms can be similar to those of a number of other gastrointestinal conditions, and SIBO is frequently caused by another condition. Depending on the severity of your condition, you may experience some or all of the following:
- Pain in the abdomen.
- Distension of the abdomen.
- Weight loss without intention.
Risk Factors Linked to SIBO-
The following factors increase your risk of SIBO:
- Obesity or ulcer-related gastric surgery
- A defect in the small intestine’s structure
- Small intestine injury
- An abnormal connection (fistula) between two bowel segments.
- Crohn’s disease, lymphoma of the small intestine, or scleroderma of the small intestine
- Abdominal radiation therapy history
- Small intestine diverticulosis
- Previous abdominal surgery-induced adhesions
What causes SIBO?
The following can cause small intestinal bacterial overgrowth (SIBO):
- Abdominal surgery complications include gastric bypass for obesity and gastrectomy for peptic ulcers and stomach cancer.
- Structural issues in and around your small intestine, such as scar tissue (intestinal adhesions) that can wrap around the outside of the small bowel and tissue pouches that protrude through the wall of the small intestine (intestinal diverticulosis).
- Certain medical conditions, such as Crohn’s disease, radiation enteritis, scleroderma, celiac disease, diabetes, or others, can slow the movement of food and waste products through the small intestine (motility).
How is SIBOs identified?
You may have tests to check for bacterial overgrowth in your small intestine, poor fat absorption, or other problems that may be causing or contributing to your symptoms in order to diagnose small intestinal bacterial overgrowth (SIBO). Typical tests include:
Breath testing. This noninvasive test measures the amount of hydrogen or methane you exhale after drinking a glucose and water mixture. A sudden increase in the amount of hydrogen or methane exhaled may indicate bacterial overgrowth in your small intestine. Breath testing is less specific than other types of tests for detecting bacterial overgrowth, despite being widely available.
Small intestine aspirate and fluid culture. Currently, this test is the gold standard for detecting bacterial overgrowth. A long, flexible tube (endoscope) is passed down your throat and through your upper digestive tract to your small intestine to obtain the fluid sample. A sample of intestinal fluid is taken and tested in a laboratory for bacterial growth.
How is SIBO treated?
Whenever possible, doctors treat SIBO by addressing the underlying issue, such as surgically repairing a postoperative loop, stricture, or fistula. However, a loop cannot always be reversed. Treatment in this case focuses on correcting nutritional deficiencies and eliminating bacterial overgrowth.
- Antibiotic therapy
Bacterial overgrowth is usually treated with antibiotics. Even without testing, doctors may start this treatment if your symptoms and medical history strongly suggest it. Testing may be done if antibiotics fail. Antibiotics reduce abnormal bacteria. Bacteria can return after antibiotics are stopped, so treatment may be long-term. Some people with a small intestine loop doesn’t need antibiotics for long, while others do. Doctors may switch antibiotics to reduce bacterial resistance. Antibiotics kill most intestinal bacteria, normal and abnormal. Antibiotics can cause diarrhea, among other issues. Switching drugs can help.
- Nutritional support
In severe weight loss cases, SIBO treatment requires nutritional correction. Malnutrition can be treated, but its damage cannot. These treatments may improve vitamin deficiencies, intestinal distress, and weight gain:
- Supplemental nutrition. SIBO patients may need intramuscular vitamin B-12 injections, oral vitamins, calcium, and iron.
- Diet without lactose. Small intestine damage may prevent milk sugar digestion (lactose). If so, avoid most lactose-containing products or use lactase to digest milk sugar.