If you struggle with chronic constipation, chronic diarrhea, abdominal bloating, and foul smelling gas it could be more than just IBS. 

You could have SIBO. 

In fact up to 85% of IBS cases are actually caused by SIBO.

If you have been struggling to manage your IBS symptoms, you could be one of those cases. This begs the question, “How do I know if my symptoms are caused by SIBO or something else?”

The truth is, you won’t know for sure until you’re able to consult a doctor. But, hopefully this article can bring more awareness about what SIBO is, what causes it, symptoms you’ll want to look out for, and what to do next if you think you may have SIBO. 

WHAT IS SIBO?

SIBO stands for Small Intestine Bacterial Overgrowth. If someone suffers from SIBO, that means an abnormal/excessive amount of bacteria or archaea (a single celled organism that is even older than bacteria) has set up camp in their small intestine. 

Here’s why this is bad…

The small intestine is intended to digest your food and then absorb its nutrients into the bloodstream, but if you have an overgrowth of bacteria living there, it will continually interfere with this process. 

The bacteria, or archaea, will absorb the nutrients from your food before your body gets the chance to, causing the food to ferment instead of being properly digested. During the fermentation process, the bacteria releases hydrogen and the archaea releases methane, which are gasses that cause your tummy to bloat. From there, depending on what type of SIBO you have, you’ll either experience diarrhea, constipation, or alternating periods of both. 

Less than ideal, right? 

Now that you have an idea of what SIBO is, let’s delve into the different types that can manifest in the body. 

SIBO sufferers will fall into one of three categories: diarrhea dominant (SIBO-D), constipation-dominant (SIBO-C), or a combination of both. 

SIBO-D: Hydrogen-Producing Bacteria is present

This is the more common form of SIBO, and is a result of an overgrowth of carbohydrate-fermenting bacteria that produces hydrogen gas in the small intestine. This production of hydrogen is what causes abdominal bloating and chronic diarrhea. 

SIBO-C: Methane-Producing Archaea is present

This type of SIBO is a result of an overgrowth of single-celled organisms called archaea as well as hydrogen-producing bacteria. When the bacteria ferments carbohydrates and produces hydrogen, the archaea will feed off that hydrogen and produce methane, which also causes abdominal bloating. The production of methane also slows down the transit time of your food leading to constipation. Not only is this uncomfortable, but it also allows even more bacteria to grow in the small intestine, leading to more methane production and more constipation. 

It’s a vicious cycle that can be hard to break. Killing archaea’s food source (aka, the hydrogen-producing bacteria) with antibiotics and antimicrobials often isn’t enough because they can survive for quite some time without hydrogen. So, this type of SIBO is much harder to eliminate than SIBO-D. 

The third type…

This type is a result of Sulphate-reducing bacteria (SRB) residing in the small intestine alongside archaea and hydrogen-producing bacteria. This overgrowth of SRB creates hydrogen Sulphide, which is a highly toxic gas (known for its rotten-egg smell) that can damage the cells of the intestinal wall that are responsible for absorbing nutrients into the bloodstream. Like archaea, it also feeds on hydrogen, so if you kill one, it can result in the overgrowth of the other. 

WHAT CAUSES SIBO?

The body has a number of mechanisms in place to prevent your small intestine from having an overgrowth of bacteria, but if one or more of these mechanisms are no longer functioning properly, SIBO can occur. 

Let’s talk about each mechanism in depth…

Stomach acid secretion - The stomach will create acid that kills off bad bacteria so it won’t enter the small intestine. So, if the stomach stops secreting acid for whatever reason, this can lead to that bacteria migrating to the small intestine and setting up camp. 

Bile secretion - The liver produces bile (an agent that fights off bad bacteria) which is stored in the gallbladder and then released into the small intestine. If this process is interfered with, bile doesn’t get to the small intestine and bad bacteria can grow and thrive. 

Migrating motor complex (MMC) - The wall of the small intestine will create waves of movement every 90-120 minutes (usually between meals) to move waste and unwanted bacteria into the large intestine and then the colon. If MMC is inhibited or unable to function, any bacteria in the small intestine will get stuck there. 

Immune system - the fluid that resides in the small intestine contains antibodies called immunoglobulins that fight bacteria and other pathogens. If something is off with the body’s immune system, the small intestine may not have the antibodies it needs to fight off bacteria that passes through.

Ileocecal valve - this is a one way valve that allows the contents of the small intestine to enter the large intestine without the contents of the large intestine flowing back up. If this valve fails, the millions of bacteria that live in the large intestine (this is where they’re supposed to live) can make their way into the small intestine. 

These functions of the body can be interrupted due to a myriad of reasons, including:

• Gastroenteritis, caused by a parasite, bacteria, yeast, etc (aka, food poisoning). 
• Lyme disease 
• Clostridium difficile 
• Inflammatory bowel disease 
• Scleroderma 
• Diabetes 
• Ehlers-Danlos syndrome 
• Hypothyroidism 
• Medications such as opiates or the recurrent use of antibiotics 
• Surgery or injury resulting in muscle or nerve damage 
• Autonomic nervous system dysfunction resulting in sympathetic dominance
• Adhesions or obstructions from abdominal surgery or nonsurgical causes such as trauma 
• Inflammatory bowel disease stricture 
• Ileocecal valve removal or impairment 
• Volvulus 
• Cancer 
• Superior mesenteric artery syndrome 
• Non-draining pockets
• Hypochlorhydria 
• Altered bile flow and enzyme production
• Medications such as proton pump inhibitors 
• Immunodeficiency 
• Leaky gut 

This is why it’s important to talk to your doctor about your medical history so you can get to the root of what’s causing your SIBO. 

I say this because if you eliminate the bacteria overgrowth in the small intestine without also addressing what caused it to happen in the first place, it will come back.

SYMPTOMS TO LOOK OUT FOR…

The most common symptoms of SIBO are:

• Bloating within 1 hour after eating
• Chronic diarrhea, chronic constipation, or alternating constipation and diarrhea
• Burping after meals
• Experience acid reflux after meals
• Gas that smells extremely foul (more so than normal)
• Stomach discomfort or cramping

Secondary symptoms that can occur:

• Restless legs during sleep
• Joint pain
• Changes in mood
• Multiple food sensitivities
• Respiratory symptoms, like asthma
• Acne or skin rashes
• Memory issues or brain fog
• Chronic iron and/or B12 deficiency
• Weight gain or weight loss
• Poor quality sleep

Other clues that it could be SIBO:

• Your digestive symptoms temporarily improve during the use of antibiotics. 
• Upping your fiber intake, or using fibre supplements like Metamucil, makes things worse
• Taking pre-biotics and probiotics actually makes you feel worse, not better. 

THE LONG TERM EFFECTS SIBO CAN HAVE ON YOUR HEALTH 

Aside from the frustrating and sometimes embarrassing symptoms of bloating, diarrhea, constipation, and foul gas…SIBO leads to chronic malnutrition which is bad for your overall health in the long run. 

This happens in two different ways: 

1. Damage to the wall of the small intestine - the overgrowth of bacteria (whichever ones are present) and the various gasses they emit can damage the lining of the intestinal wall, preventing the absorption of nutrients and leading to a leaky gut. 

2. The bacteria absorbs nutrients before your own cells - As I mentioned before, any overgrowth of bacteria in the small intestine will consume essential nutrients that your body needs before your own cells can. Ones like, vitamin B12, magnesium, iron, calcium, and amino acids found in protein (which are the building blocks for growth and repair in the body). 

WHAT TO DO IF YOU THINK YOU MIGHT HAVE SIBO…

SIBO is poorly understood by western medicine and will often go undiagnosed. However, there are many naturopathic physicians that are able to provide insight on this condition and help patients find relief. 

The best way to know for sure is to be tested for it, which is something I am more than happy to help with. Schedule a free consultation call with me, if you’d like to discuss your symptoms and from there I can recommend the best strategy for treatment. 

Gut health is a bit of a buzzword right now, and that’s because the overall health of our gut affects the rest of our body. Today I’m going to share some tips for keeping your gut in tip-top shape, but before I do that… 

Let’s define what the gut actually is, shall we? 

Contrary to popular belief, the gut is not the stomach. The gut consists of the small and large intestines. The small intestine is where the majority of nutrients from food we’ve consumed get absorbed into the bloodstream, and the large intestine is where all of your microbes live, also known as your gut microbiome (the ecosystem of microbes living in your gut). 

I know you’re probably thinking, “What the heck is a microbe?” 

Basically, they are tiny organisms (bacteria, viruses, parasites, etc.) that live in your gut, and they do a myriad of different things to help the body. 

Here’s a short list of their job description:

• They produce vitamins (including vitamin K and vitamin B)
• They produce short chain fatty acids, which fuel all of your gut cells
• They support immune function and defend against pathogens
• They ferment fiber that your body can’t digest
• They Influence your mood and mental health
• They regulate the health of the gut
• They influence sleep
• They support hormone regulation
• They regulate the metabolism
• They influence how often you go #2

In short, when we refer to gut health, we’re referring to the health of those two organs. Think of your stomach, liver, pancreas and gallbladder as accessory organs who play a supporting role in helping the gut with digestion. 

Okay, now that we’ve gotten that out of the way, here are some tips for keeping your gut happy and healthy. 

Tip No. 1 - Eat a variety of whole, nutrient-rich, plant-based foods.

Remember microbes? Well, there are over a thousand different species that live in your gut and they all thrive on different foods, so variety really is the spice of life here! You want to avoid processed foods (anything that comes in a package or a box) as much as possible, and eat more whole, plant-based foods (vegetables, fruit, whole grains, pulses, legumes, nuts and seeds). Current research shows that our bodies need closer to 30 different types of plant based foods a week. 

I know that sounds like a pretty tall order, but here are a few ways to implement more of them into your diet:

• Try a new plant based food every week. Have you always wanted to try dragonfruit? Go ahead, be adventurous! Pick one up the next time you’re at the supermarket. 
• Try out a subscription for a box of produce to be delivered straight to your door. They usually send a variety of different fruits and veggies based on what’s in season. 
• Befriend your freezer to keep fruits and veggies from going bad, and to ensure that you always have some on hand.
• Buy a nut/seed mix, or make your own, to sprinkle on top of soups, salads and roasted veggies. 
• Opt for a bag of mixed greens instead of just spinach to add variety.
• Experiment with different herbs and spices when cooking.
• Try out some of these recipes.

*Pro tip: if you have a vegetable that you aren’t sure what to do with, when in doubt, drizzle it with olive oil and sea salt, and pop it in the oven. 

 Tip No. 2 - Fiber, fiber and more FIBER! 

Fiber is so much more than something that keeps you, well…regular. It is the unsung hero of gut health, and in my opinion, is severely underrated! 

Here’s why…

• Like I mentioned earlier, certain types of fiber that your body can’t digest are fermented by your gut microbes, and this produces short chain fatty acids, which give your gut energy and play a crucial role in other areas of health. 
• It slows down the body's absorption of sugars found in carbohydrates, which can support your energy level. 
• It creates an environment that helps beneficial gut bacteria thrive
• It can reduce the risk of diseases like high cholesterol, heart disease, diabetes, diverticular disease and bowel cancer.
• And of course, it bulks up your stool and softens it by allowing it to retain water, which supports gut transit time and prevents uncomfortable situations like constipation.

Your microbiome loves fiber, and needs a variety of it to do its job well. Luckily, there is a lot of fiber found in plant-based foods, so tip number one goes hand in hand with tip number two. 

Tip No. 3 - Eat sugar in moderation. 
​
Just like all things, when it comes to sugar, it’s good to practice moderation. The body does need sugar to function because it’s the brain’s choice of fuel, however, if you eat more sugar than your small intestine can process (about 7 teaspoons to be exact) it then gets passed down to the large intestine, and starts messing with the beneficial bacteria down there. It can even switch up the environment of your gut microbiome so it ends up supporting the less helpful bacteria instead. 

So, what kind of sugar should you be eating?

Well, the sugar found in fruits and vegetables is going to be your best bet because they also contain fiber which, as I stated earlier, slows down the rate that sugar is absorbed into the bloodstream while providing fuel for all your little gut microbes, so it’s a win-win!

Tip No. 4 - Stay hydrated.

Dehydration is one of the most common causes of constipation. If you aren’t drinking enough water your body is going to absorb it from your large intestine in an attempt to hydrate itself, making your stools hard and incredibly difficult to pass. Now, not only is this uncomfortable, but if your stools are stuck in your large intestine, this creates a hostile environment for your beneficial gut microbes, ultimately causing an imbalance in your gut microbiome (which as we know affects quite a bit of things in the body).

To prevent this, we need to be mindful of our fluid intake. The body needs around 1.5 liters of water a day (maybe more depending on your fiber intake, body weight, etc.) so, drink up!

*Pro tip: swap fizzy drinks containing preservatives for kombucha, home-made herbal iced tea, or carbonated water with herbs.

Tip No. 5 - Consume more prebiotics + probiotics.

I know their names are fairly similar, but prebiotics and probiotics are not the same thing. They both play very different roles, and your gut needs a good mix of both in order to stay healthy. 

Let’s get to know our new friends, yeah? 

A probiotic is a living microorganism that, when consumed enough through food or drink, transfers a health benefit to the host (aka, you!). 

Here are some foods containing probiotics…

• Live yogurt (the “live” detail is important here).
• Kimchi
• Sauerkraut
• Kefir
• Miso
• Kombucha

A prebiotic is a specific type of fiber that feeds all the good bacteria living in your gut. 

Here are some foods containing prebiotics…

• Onion
• Garlic
• Leeks
• Chicory
• Bananas (the ones that aren’t quite ripe)
• Asparagus
• Artichokes
• Olives
• Plums
• Apples
• Almonds
• Bran

Tip No. 6 - Cut back on alcohol consumption.

Drinking excessively on a regular basis can cause inflammation in the gut, which can result in the lining becoming more permeable or “leaky.” This is problematic because whole food particles, as well as other particles in the gut, like toxins, are able to pass through the gut lining and into the bloodstream, which can trigger numerous different immune responses in the body. In cases like this, one may find that their body can no longer tolerate certain foods that they used to eat all the time without experiencing symptoms.

The bottom line is, while alcohol can be nice to have occasionally, our bodies aren’t meant to process it consistently. Just like with sugar, enjoy it in moderation. 

Tip No. 7 - Exercise regularly!

Studies have shown that exercising can increase the population of good bacteria in your gastrointestinal tract by up to 40%! Not only that, it keeps you pretty regular too. 

However, it’s just as important to not push yourself too hard, and to make sure that you’re also getting plenty of rest to avoid causing your body too much stress, because prolonged periods of stress can have a negative effect on the gut. 

The moral of the story? Think like Goldilocks. Get your body moving at an intensity that is just right, while also getting plenty of rest in between.

Tip No. 8 - Find ways to help your body relax when experiencing stress.

Did you know that your brain and your gut communicate back and forth like old pals? This is made possible through the gut brain axis, which is a combination of the vagus nerve (a channel of communication that connects the gut and the brain physically) and hormones called neurotransmitters which allow them to communicate chemically. 

If this sounds crazy to you, think of it this way…

Have you ever felt butterflies in your stomach when you were nervous or anxious about something? That’s because of the gut brain axis! So, if your brain is experiencing stress, it’s definitely talking to your gut about it, and vice versa. Which begs the question…

How does stress affect the gut?

Well, in response to stress, your body produces the hormone cortisol which…

• Diverts blood away from the gut to your muscles (a response to help you fight or run from your stressor)⁠.⠀
• Slows the production of saliva, meaning the enzymes that break down food are reduced which impairs digestion.
• Decreases prostaglandins, which protect your stomach from acid (some experience a more sensitive tummy when stressed) ⁠⠀
• Either slows digestion or causes diarrhea, which might mean you aren’t absorbing nutrients as well⁠⠀
• Weakens your immune system (70% of which is found in your gut).⁠⠀
• Can cause the stomach and esophagus to spasm.

All that to say, helping your body move from fight, flight or freeze to rest and digest mode is crucial during stressful situations. Do whatever helps you relax, whether that be yoga, breath work or a nice bubble bath. 

…and there you have it!

If you’ve made it this far, I applaud you. I hope that this helped you generate a few practical ideas for how you can start improving your gut health today. If you’d like me to take a closer look at your gut, and what it needs specifically, I’m always an appointment away!