Inside: Advanced SIBO Treatment including – what is SIBO, SIBO Symptoms, Tests for SIBO and a Comprehensive 3 Step program for treatment for SIBO. Get rid of SIBO permanently.
What is SIBO?
SIBO or Small Intestinal Bacterial Overgrowth is a condition where there is an overgrowth of bacteria in your gut.
We have trillions of bacteria in our gut but most of them are located in the large intestine, but in SIBO we have either overgrowth or overabundance of bad bacteria especially in the small intestine (hence the name!).
Several people have been mislabeled to be suffering from IBS ( Irritable bowel syndrome) while in reality, they were suffering from SIBO.
These people after being diagnosed with IBS were given antidepressant medications telling that they were making up these symptoms in their head.
But now we know that these symptoms were because of an underlying condition called SIBO which is causing them to feel miserable.
The good news is that SIBO is treatable but the bad news is that if proper protocol is not followed, SIBO returns in a very high percentage of people.
SIBO is notorious for coming back even after successful treatment, but with a comprehensive approach, you can cure SIBO and prevent it from returning.
For that, we need to first understand the symptoms of SIBO and also the underlying causes of SIBO.
Because of this imbalance in our gut bacteria we see the typical symptoms of SIBO.
Small intestinal bacterial overgrowth comes with a host of symptoms, so it is very important to first know if your symptoms can be because of SIBO or not.
19 Symptoms associated with SIBO
Below are the most common symptoms associated with SIBO
- Abdominal pain
- Fullness even with small meals
- SIBO Fatigue
- Stomach gurgling
- Frequent burping
- Brain fog
- Joint pain
- Food allergies
Why did I get SIBO?
As I mentioned that our gut harbors trillions of bacteria, but in SIBO there is basically an imbalance in those bacteria. A person suffering from SIBO will have more bad bacteria as compared to the good ones, in small intestine specifically!
The easy way to understand why some one gets SIBO is:
When you are born, your gut is empty and ready for bacteria to come and live there. Now there can be good or bad bacteria. When you got breastfed, it created an environment that was appropriate for good bacteria to live in your gut, and also you got good bacteria from breast milk.
But if you got bottle fed there was an environment that promoted bad bacteria to come and live there.
Now over the course of your life, there were things which would have happened which have promoted the growth of bad bacteria and caused the death of good bacteria.
Various stressors that can contribute to this imbalance of bacterial that we see in SIBO are — poor food choices, stress, physical trauma, medicines like antibiotics, ibuprofen, steroids, toxins, infections like ebv, parasites, and nutritional deficiencies.
So over the course of time, more and more bad bacteria replaces the good bacteria and that leads to the starting of SIBO. It’s a slow and gradual process, so most of us will not know exactly when this started.
But if you look back at our life you will be able to figure out some of these stressors which might be contributing to SIBO.
Test for SIBO
It was very difficult to test for SIBO; the more definitive test was an invasive procedure where they will need to collect samples from your intestine to figure out whether you had SIBO or not.
But now we have easy tests that can be used to check for SIBO.
These are SIBO breath tests that check for the gas produced by the bacteria in your gut and measure them.
There are different SIBO breath tests available like glucose and lactulose breath tests.
I find the lactulose breath test to be the most sensitive.
Lactose Test for SIBO — In this particular test you are given a lactulose drink and measure the gas levels for 2 or 3 hours. This test checks the level of hydrogen and methane and based on the numbers during this test it is determined whether the patient has SIBO or not.
Are there different forms of SIBO
So as I mentioned there are two different gases that are measured in the lactulose breath test.
Based on which gas is high, patients can be diagnosed with either hydrogen or methane predominant SIBO. Sometimes people might have both hydrogen and methane SIBO.
Why is it important to know which kind of SIBO do you have because it determines what kind of treatment you will need as the treatment differs. Methane predominant SIBO is difficult to treat and the most common symptom associated with it is constipation.
3 Step Comprehensive SIBO treatment
The conventional SIBO treatment is to use antibiotics because — the conventional SIBO Treatment belief is to kill the bad bacteria and that will do the trick of fixing SIBO issues.
But I often see people that even after the SIBO treatment with antibiotics their symptoms still persist or have returned as soon as they stopped the antibiotics for SIBO Treatment.
The symptoms return sometimes even after sibo herbal treatment protocol or herbal antibiotics for sibo.
The reason is for returning SIBO symptoms are — Correct SIBO treatment is not only about killing the bad bacteria but also rebalancing the gut bacteria and reducing inflammation, improving gut immunity, and improving the growth of good bacteria.
3 Step SIBO Treatment Protocol —
Here is a the comprehensive SIBO
- Reducing inflammation in your gut and improving gut immunity
- The killing of bad bacteria
- Rebuilding your gut with good bacteria
Step 1: Reducing inflammation and Improving gut immunity
This is the first step that is needed to start the process of getting rid of SIBO. Here diet plays an important role as it can help with reducing inflammation and at the same time can help improve immunity in your gut so that you can fight off all that bad bacteria.
For this, you need to follow a Low FODMAP diet with a few modifications and this is the most common SIBO diet. The basis of the Low Fodmap diet is that it avoids food which are Oligosaccharides, Disaccharides, Monosaccharides, Polyols.
All these are forms of carbohydrates that are not absorbed by the gut properly and thus are fermentable. Because of excessive fermentation from an overgrowth of bacteria, it leads to gas formation and leads to the typical symptoms of bloating, gas, and pain.
The SIBO diet that I like to follow is – modification of this Low Fodmap diet which not only focuses on removing foods which are fermentable but also foods which cause inflammation.
Please follow this link for SIBO/IBS diet.
This SIBO diet is important because it also focuses on food which reduces inflammation like removing gluten, dairy, corn, processed meat.
During this time eat lots of food which improves gut immunity like ginger, mint, turmeric, bone broth, collagen powder.
During this step add these supplements :
- SBI protect powder to help boost gut immunity.
- GI review powder to help with healing the gut and also leaky gut.
Step 2. Killing off the bad bacteria
In this step we are going to kill off the bad bacteria so that we can start the process of rebalancing your gut microbiome. There are various ways of doing it. Below are the few SIBO treatment protocols that can be followed.
Traditional antibiotic route. So if you have hydrogen SIBO then rifaximin is the drug of choice and works really well in eradicating SIBO. If methane is also present then Neomycin medicine is typically added along with rifaximin.
SIBO herbal treatment protocol: Alternative route is using herbal preparation to help with SIBO. There was a research study to compare the herbal route with antibiotic route and it showed that the herbal route was equally efficacious. So obviously this is my choice and it works great.
Step 3. Rebuilding your gut:
Now we have reduced inflammation, and we have improved gut immunity and killed off the bad bacteria. Now is the time to rebuild your gut so that your gut remains healthy and that’s the way you can avoid SIBO from returning.
- Digestion: Most of the people with SIBO will have impaired digestion so you should use Digestive enzymes to help with SIBO and also consider using Betaine HCL which is to help with protein digestion in the stomach. Stomach acid is your natural defense against bacteria and when you have low stomach acid the bacteria can escape and can contribute to SIBO. So you can consider using stomach acid supplements to aid in digestion. But beware too much stomach acid can cause ulcers.
- Gut Motility: Several people with SIBO might have issues with gut motility and their predominant symptom is constipation. So if you do have constipation it is important for the future to work on it so that the SIBO does not return. For that you can use ginger and mint teas, Magnesium citrate, psyllium husk, Motility pro supplements.
- Probiotics: Now the use of probiotics is a hot topic in SIBO, as there are two camps of thought one saying no probiotics and the other one saying yes to probiotics. I am not going to go into this discussion for now as this is a huge topic. But I feel that soil based probiotics are a good choice to use in SIBO, as we need to feed some good bacteria to our gut. So megaspore probiotic is a good soil based probiotic to be used in this situation.
- Stress: Stress is an important contributor to SIBO. Stress not only reduces our bodies immunity but it also contributes towards killing off good bacteria and thus it is so common for a patient’s SIBO to return back after going through a stressful situation in their life. So I always recommend developing a self care practice to reduce this daily stress like meditation, deep breathing, yoga.
Summary of The Most Advanced SIBO Treatment Plan to Permanently Get Rid of SIBO —
So this is my 3 step process for the treatment of SIBO and also to make sure SIBO does not return back. Most of the people will have good success if they follow this protocol. There will still be some whose SIBO doesn’t get resolved and they will be best suited to work with Functional medicine physicians to understand the root causes of their SIBO as there are several other things that can be contributing to SIBO and might need more in depth work for it.
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