Good gut health is crucial for maintaining an overall level of wellness. In recent years, it’s come to the fore as being of paramount importance for sick and healthy people alike. Among other things, the state of our gut can affect how our immune system functions, which in turn affects how likely we are to both catch and recover from infections and illnesses. Our gut microbiome is full of over one thousand species of friendly bacteria. Usually, these assist in breaking down what we eat and drink, and absorbing nutrients from it. They can further influence several diseases and have an impact on our metabolism and even our mood. However, bacterial imbalances can occur due to different reasons. One such imbalance is called Small Intestine Bacterial Overgrowth (SIBO) syndrome. Here, bacteria that are supposed to reside in the colon move towards the ileum – which, under normal conditions, only hosts a very small amount of bacteria.
Excess bacteria can survive and thrive by feeding off the undigested food in your small intestine. Sugar and carbohydrates are particularly useful to them, which is why excessive consumption of these two foodstuffs will often prolong or exacerbate the condition. Carbohydrates are also responsible for producing hydrogen as a by-product of the fermentation process. This extra hydrogen can then in turn feed archaea, which are single-celled organisms that live in your small intestine. The by-product of this process is methane, which means you have both high levels of hydrogen and methane in your gut when you suffer from SIBO. Both these gases can cause different symptoms, depending on which one is more predominant in the individual. Either way, it’s a vicious cycle that can continue building upon itself, causing increased symptoms and discomfort in patients.
Speaking of symptoms: what should you be looking out for when it comes to SIBO symptoms? Unfortunately, many disorders of the gut have very similar symptoms, so if you have a number of the following, you shouldn’t necessarily assume you have the condition. Always check with a doctor, as they will be better able to determine what’s making you sick, and how to treat it.
A very common symptom with many gastrointestinal issues, bloating can be ascribed to gases building up within your gut. Eating carb-heavy meals will often exacerbate this symptom. Some things that can help include splitting three big meals per day into five or six smaller ones, and adding fennel, anise or cumin seeds to your diet – these have carminative effects and relieve from bloating and cramping.
A pertinent sign of a digestive system under stress. In SIBO, the excessive colonisation of the small intestine prevents it from its actual function – the absorption of water and nutrients. What follows may not only be diarrhoea, but also a nutrient or mineral depletion and disturbances in fat absorption/metabolism to the point of steatorrhea.
Flatulence is an uncomfortable topic for most people. It is the natural transition after bloating and can also negatively impact quality of life. If you’re experiencing bloating and flatulence, foods that are known to foster gas production – such as cabbage, leguminous plants and onions – should be avoided. Carminative substances and a heating bottle may also help here.
Pain and cramping are hallmark symptoms of SIBO, which is caused by a general upset within the intestinal system. Certain herbal remedies, unsweetened tea and general relaxation can help to decrease abdominal pain. To further reduce pain, foods consumed should be easily absorbed and therefore gently prepared – by steaming, for example.
Although this is much less common than diarrhoea, it still affects many patients with SIBO. An increase of water intake, along with digestion-improving remedies such as dry bread, dried figs or flaxseeds, can help to increase digestion and remove the symptoms of constipation.
Irritable bowel syndrome or inflammatory bowel disease
The two types of inflammatory bowel disease, ulcerative colitis and Crohn's disease, involve the digestive system being severely impaired and altered by inflammatory processes. Irritable bowel syndrome, on the other hand, covers all symptoms concerning a ‘healthy’ digestive tract that is not functioning well in certain areas. SIBO, IBS and IBD do have a connecting link, and can cause or worsen each other. However, not all of these links have been identified or clearly explained. It’s important to properly identify the cause of any symptoms to ensure the right treatment.
Numerous vitamin and mineral deficiencies
Usually, the small intestine is not colonised by a high number of bacteria; this ensures its function in nutrient absorption to supply the body with all it needs. Due to the false colonisation in SIBO, this function is impaired. The gut struggles with absorption and the additional problem of fermentation in the upper intestine, causing increased gas production. To avoid nutrient deficiencies, it is advisable to consume easily and quickly digested foods, which can be absorbed at an early stage in the upper small intestine before reaching the lower small intestine and the increased numbers of bacteria. Supplementation of important nutrients can also help to increase the likeliness of absorption.
Malabsorption of fat
Malabsorption of fat can also turn into a big problem, as energy delivery to our body can be severely affected when fats cannot be absorbed properly. Fatty stools (steatorrhea) are a sign of a malabsorption of fat. This is primarily caused by the loss of bile acids required for fat absorption. Bile acids are usually recycled in the terminal ileum for further use. If this is not possible, due to the colonisation, they reach the colon and are eliminated with faeces. The higher the loss of bile acids, the sooner the body can’t compensate anymore and stops absorbing fats.
Furthermore, fat-soluble vitamin uptake (A, D, E and K) is impaired by the malabsorption of fat. In cases of steatorrhea, long-chain fatty acids can be temporarily replaced with medium-chain fatty acids (MCFAs). MCFAs do not require bile acids or enzymatic breakdown for absorption. Some main sources are coconut oil (e.g. caprylic acid and lauric acid), palm oil and, to some extent, dairy products. Specific dietary products are also available.
Chronic illnesses such as chronic fatigue syndrome, fibromyalgia, autoimmune disorders and diabetes
As our gut plays host to a majority of our immune system and influences many different body parts through the so-called ‘gut-brain axis’, SIBO can influence mood or cause fatigue. Nevertheless, these are non-specific symptoms, and can have both serious and relatively harmless causes.
Food intolerances are common in SIBO patients, as many foods can no longer be properly digested. For example, fructose and lactose absorption are often impaired. A high intake of dietary fibre should be avoided, as well as (un-ground) wholegrain products, cabbage, leguminous plants, foods high in fat, salted or fried foods, and excess sweets. Foods that are consumed should be freshly prepared and easy to digest. Proper chewing and water intake are also important.
As you can see, the list of symptoms and complications are quite varied and potentially dangerous, especially if left untreated. So how exactly do you treat SIBO once it’s been professionally diagnosed? Typically, the condition is combated with a run of antibiotic therapy and dietary changes. Starving the bacteria of foods they thrive on is an important first step in the process, which means cutting down on your intake of sugar, alcohol and carbohydrates. Taking their place will be vegetables, leafy greens, proteins, healthy fats and some fruit. After that, the antibiotics will be at their most effective, so the next stage is destroying the bacteria and eradicating them from the small intestine. It’s important to use antibiotics that are designed to target the bad bacteria and leave the good bacteria untouched.
Finally, the last step in the treatment chain is restoring whatever good bacteria you may have lost in the process. Dietary changes and implementations are key here, and supplements can also help. Make Well produces a large range of varied, all-natural supplements designed to support the treatment of chronic diseases. These supplements can be a major boost when it comes to restoring your gut to tip-top shape, and preventing further issues in the future.
Gastrointestinal issues can be an easy thing to ignore, as they are so common. However, if you’re having recurring symptoms, get yourself checked out by a doctor to diagnose the problem properly. Remember: all good health starts in the gut!