SIBO (or “small intestinal bacterial overgrowth”) is a condition that remains largely unknown to the public. Yet, it significantly impacts the daily lives of many people. It is characterized by digestive issues that can negatively affect quality of life: bloating, flatulence, abdominal pain, and a distended stomach . Painful digestion, intense fatigue… What are the causes of SIBO? What should you eat if you have SIBO? Are there any treatments? Let's take a closer look.
What is SIBO disease?
SIBO ( Small Intestinal Bacterial Overgrowth ) is characterized by an increase in the number of bacteria in the small intestine .
Dora Moutot , a journalist who also suffers from SIBO, sums it up very well: "They have no business being there, but they squat and create a whole host of problems, including horrifying gas!"
As a reminder, our digestive tract runs from the mouth to the anus and is naturally colonized by a variety of microorganisms (bacteria, fungi, viruses, etc.). This is what makes up the gut microbiota. Sometimes, these bacteria multiply uncontrollably and cause a host of problems.
This proliferation occurs when bacteria from the colon migrate into the small intestine. The problem is that the small intestine absorbs food, while the colon ferments what remains. These two parts of the intestine are therefore lined with distinct bacteria. But when they migrate back up to the small intestine, they will:
- damage the intestinal flora ,
- cause a malabsorption disorder
- cause digestive problems of varying severity.
How do you catch SIBO?
The causes of SIBO are numerous. There are several risk factors:
- short bowel syndrome
- Crohn's disease
- blind loop syndrome (overgrowth of bacterial flora in the small intestine)
- bowel motility disorder
- too low a level of hydrochloric acid in the gastric fluid
- complications related to diabetes
- diverticular disease of the small intestine
- alcoholism
- kidney failure
- advanced age
- immunodeficiency
- Parkinson's disease
SIBO disease testing: how to do it?
Due to very similar symptoms, SIBO is often confused with irritable bowel syndrome, celiac disease (gluten intolerance), or lactose intolerance. However, it is a distinct condition. To avoid misdiagnosis and ensure appropriate treatment, a precise diagnosis of SIBO is available.
To detect SIBO, two tests are possible:
1. Analysis of bacteria by taking fluid from the small intestine (a rather invasive method as it requires an endoscopy, but very rarely prescribed).
2. Glucose breath test , which measures the concentration of hydrogen and methane in the breath. All you have to do is ingest a sugar cube!
The bacteria that cause SIBO produce hydrogen and methane when they break down carbohydrates in the small intestine, so they are easy to identify. But be careful, gastroenterologist Professor François Mion warns us: “The sensitivity of these tests is nevertheless imperfect; there can be false positives or false negatives.”
What are the symptoms of SIBO?
It is possible to experience no symptoms other than weight loss or deficiencies in nutrients, fat-soluble vitamins (A and D), and carbohydrates. Most often, SIBO symptoms involve digestive problems:
- bloating
- abdominal discomfort
- excessive flatulence
- diarrhea
- constipation
- gastroesophageal reflux
- steatorrhea (abnormally high amount of lipids in the stool)
Other symptoms such as nausea, unintentional weight loss or gain, or food allergies may be related to SIBO.
How to treat SIBO?
There is no cure for SIBO as such, but it is possible to manage SIBO by combining several methods. Antibiotics, natural remedies, diet, lifestyle changes… Here are all the recommendations to follow if you suffer from SIBO
Taking antibiotics
A doctor may prescribe antibiotic and/or antiparasitic treatment. The goal is not to eradicate the bacterial flora, but to modify it in order to improve symptoms. Because the intestinal flora is full of diverse bacteria, broad-spectrum antibiotics are necessary. The most commonly prescribed are rifaximin , amoxicillin , ciprofloxacin , or metronidazole .
This course of antibiotics lasts for 8 to 10 days. It is recommended to follow 1 to 3 courses depending on the recurrence, alternating antibiotics and spacing them 1 month apart.
Natural treatment for SIBO disease
The drawback of antibiotics is that they only treat the symptoms. And when the underlying problem isn't addressed, SIBO can easily recur. Indeed, the initial causes of SIBO are varied (stress, unbalanced diet, poor gastric emptying, insufficient chewing, etc.).
To naturally relieve SIBO, it is therefore advisable to:
- Strengthening the immune system : in order to avoid any recurrence, it is important to stimulate the immune system with Zinc, vitamin D or natural immunostimulating and immunomodulating active ingredients (Echinacea, Reishi, Shiitake…).
- Restoring gut flora : taking probiotics alone isn't enough as a first step; you must first eliminate bacterial overgrowth. Once that's done, it's beneficial to boost your gut microbiota with probiotics. Our new Microbiota & Skin supplement contains four probiotic strains selected for their effectiveness on digestion, microbiota health, and maintaining the balance of the intestinal lining. The abundance of beneficial bacteria will help them thrive and overcome harmful bacteria.
- Improving your lifestyle : regular physical activity helps regulate the motility of the gastrointestinal system and facilitates stomach emptying. Effective stress management (meditation, hypnosis, yoga, etc.) is also recommended. Remember, our gut is like our second brain!
- Cleansing the gut microbiota : certain antimicrobial and antifungal plants can relieve SIBO symptoms. This is the case with essential oils of peppermint, thyme, clove, caraway, true lavender, and oregano.
To soothe gas and flatulence, carminative plants such as lemon balm, basil and peppermint are recommended.
What should I eat if I have SIBO?
Diet alone does not cure SIBO, but it can help relieve some symptoms such as abdominal pain and diarrhea. To avoid feeding the bacteria responsible for SIBO, it is beneficial to adopt a low-fermentation diet.
Indeed, fermentation should take place in the colon, not the small intestine. Fermentable sugars are carbohydrates that are very difficult to digest and that the small intestine struggles to absorb. A low-FODMAP diet is therefore recommended to reduce the proliferation of bacteria and fungi in the small intestine.
The FODMAP (Fermentable Oligo, Di, Monosaccharides And Polyols) diet, created by nutritionist Sue Shepherd, aims to promote meals without "fermentable" carbohydrates. Specifically, it involves reducing high-fiber vegetables, starchy foods, and lactose. Instead, it favors:
- Fruits and vegetables low in oligosaccharides: carrot, celery, endive, green beans, lettuce, tomato, squash, parsnip, courgette, turnip, banana, red fruits, kiwi, orange, grapefruit, rhubarb, melon.
- Dairy products: lactose-free milk, rice milk, almond milk, soft or cooked cheese.
- Starchy foods: buckwheat, rice, oats, polenta, millet, tapioca, potato, corn.
- Non-industrial meats and eggs.
- And dark chocolate for a little treat!
When SIBO symptoms begin to subside, you can very gradually reintroduce FODMAPs into your diet.
At the same time, it is important to eat meals in a calm environment, avoid stress at the table, eat smaller portions and chew thoroughly.
To go further: here are even more tips for taking care of your gut microbiota .
