Small Intestine Bacterial Overgrowth (SIBO)

SIBO is a condition where an excessive population of bacteria accumulates in the small intestine. Typically, the small intestine contains a relatively low number of bacteria compared to the large intestine.

People with IBS are more likely to have SIBO than the rest of the population. However, not everyone with an IBS diagnosis tests positive for SIBO.
SIBO and IBS share many symptoms, and it’s possible to experience both at the same time.

Bacteria are essential to the digestive system, in the form of the gut microbiome. They mostly live in the large intestine. When a person’s microbiome becomes imbalanced, containing too many harmful species of microbes or not enough beneficial species this is called dysbiosis. Dysbiosis can lead to malabsorption of nutrients, digestive issues, and other health problems.

The small intestine is the longest section of your digestive tract, measuring about 20 feet (6.1 meters). It is where food mixes with digestive juices and nutrients are absorbed into your bloodstream. 

The small intestine is designed to have a relatively low population of bacteria, as its primary function is to absorb nutrients from the food we consume. 

The level of bacteria is kept low due to rapid flow of contents and the presence of bile. The bacteria that live in your small intestine play a vital role in digesting carbohydrates and producing certain vitamins.

In the case of SIBO, the excessive bacteria in the small intestine are not necessarily harmful bacteria, they are just in the wrong place. They have either travelled upwards from your large intestine (colon), or downwards from your stomach due to insufficient stomach acid (stomach acid kills bacteria). The far more common scenario is that they travel up from your large intestine.

When there's an abnormal increase in the overall bacterial population in the small intestine (i.e. an overgrowth), and/or the presence of the wrong kind of bacteria then we can experience problems (see below).

The wrong bacteria can overwhelm the beneficial bacteria that you need to be there, and they can upset your digestive system by feeding on products that aren’t meant for them.

Hydrogen-dominant, Methane-dominant and Sulphide-dominant SIBO are the three types. 

1. Excessive hydrogen gas producing bacteria tend to promote diarrhea, as it pulls water into the bowel.

2. Those with an overgrowth of methane producing bacteria, tend towards constipation. 

3. Organisms that create hydrogen sulphide (H2S) gas as a byproduct damages the cells of the body and typically experience diarrhea, though constipation can occur also. 

Only a very small portion of SIBO cases is hydrogen sulphide dominant.

Gastric secretions and the forward movement of food through the digestive system prevent too many bacteria from growing in the small intestine. However, if these functions do not work effectively, bacteria can multiply beyond their normal quantity. 

Chronic stress, surgery, diseases, or structural issues can affect gastric secretions and slow the forward movement of food through the small intestine, creating a perfect breeding ground for bacteria.

While foods aren’t the original cause of the bacterial overgrowth, certain foods encourage the growth of the bacteria in your small intestine. If you’re feeding them their favourite foods, they’re going to multiply in number.

The symptoms of SIBO can vary enormously from person to person depending on how mild or severe the overgrowth of bacteria is and whether someone has any coexisting conditions. In severe cases the symptoms can be debilitating. 

Here are the most common symptoms: 

• Digestive Issues: Symptoms like bloating, gas, diarrhea, and constipation. As the bacteria, in the small intestine, feed on the food it ferments creating gas. 

• Nutrient Malabsorption: The overgrowth of bacteria can interfere with the absorption of nutrients, leading to deficiencies in vitamins and minerals. 

• Inflammation: The excess bacteria can cause inflammation in the small intestine, leading to a condition known as leaky gut, where toxins and waste products enter the bloodstream. 

• Weight Loss: In severe cases, SIBO can lead to unintentional weight loss and malnutrition.

Common symptoms of SIBO — including gas, bloating, abdominal pain and distension — are uncomfortable enough. But left unmanaged, SIBO can cause more serious complications with long-term consequences. Malabsorption of fats, proteins and carbohydrates can lead to malnutrition and vitamin deficiencies. In particular, vitamin B12 deficiency can cause nervous system problems and anaemia. Poor calcium absorption can lead to long-term osteoporosis or kidney stones.

The treatment approach for SIBO typically involves a combination of strategies aimed at reducing the bacterial overgrowth, addressing underlying causes, and managing symptoms.

Medical
The conventional medical treatment for SIBO involves the use of antibiotics and dietary changes. In some cases, faecal microbiota transplants are used.

Gut Directed Hypnotherapy
Alongside medical treatments gut directed hypnotherapy can help. Studies have shown that gut-directed hypnotherapy (GDH) can help restore normal gut motility and create significant improvements in symptoms like bloating, gas, and abdominal pain. It can decrease the brain’s awareness of that visceral hypersensitivity in the gut. 

One reason this is possible is because GDH helps restore normal communication between your gut and your brain. In addition to enabling physical relief, GDH can help reduce the psychological aspects of SIBO such as chronic stress, anxiety, embarrassment. 

Many people turn to GDH because it’s a safe, drug-free, non-invasive treatment option. There have been a lot of scientific studies that back the efficacy of GDH. The American College of Gastroenterology and the UK’s National Institute of Clinical Excellence (NICE) recommend GDH as a treatment for IBS.

If you suspect you may be experiencing symptoms of SIBO, don't hesitate to seek medical attention. Early diagnosis and treatment can help prevent potential complications and promote better overall health outcomes.

If you are curious about gut directed hypnotherapy and how it can help you gain relief from your SIBO or Irritable Bowel Syndrome head over to IBS Hypnotherapy NZ.