How do you heal SIBO?

What is SIBO? SIBO stands for small intestinal bacterial overgrowth, and it is where opportunistic strains of bacteria overgrow in the small intestine. This can cause a variety of debilitating symptoms, and is highly associated with “leaky gut” and inflammation or damage of the digestive tract. While many symptoms are digestive in nature, such as excess gas and bloating, constipation or diarrhea, food intolerances, etc., they can also manifest in generalized body or joint pain, cognitive or memory issues, mental health issues, overactive immune responses such as autoimmunity or mast cell disorders, and more. SIBO is considered a very tough condition to resolve. Many conventional doctors will not even acknowledge it’s existence- or if they do, will simply prescribe antibiotics, which generally does improve symptoms briefly. However, the condition tends to reoccur within a year.

Even in functional medicine and alternative medicine, most doctors or other practitioners will take a “kill first” approach, simply using strong herbal anti microbials instead of antibiotics. Unsurprisingly, the same problem occurs. People feel better for a few weeks to a few months, and then symptoms slowly start reoccurring.

Even amongst nutritionists and naturopaths, the famous low FODMAPs diet tends to be insufficient. This is a diet that restricts certain types of carbohydrates that can feed the strains of bacteria that are most commonly overgrown in SIBO. Often, naturopaths will prescribe a low FODMAPS plus anti microbial herbal protocol. This does work for some people, and almost universally reduces symptoms, but again, people tend to have symptoms reoccur within a year or two, and many people have a very difficult time adding higher FODMAPs foods back in without symptoms reoccurring. This is unfortunate because there are many very healthy, nutritious foods on the high FODMAPs list.

Many people also get caught up on the question of what they should do if they have sulphur versus methane dominant SIBO. This just refers to the types of bacteria that are overgrown in your bacteria case of SIBO. Some overgrown bacteria tend to release more sulphur, some tend to release more methane. You often know which one you have because of how your flatulence or stool tends to smell, but also sulphur dominant is associated with more diarrhea type symptoms, and methane dominant is associated with more constipation type issues. Many practitioners will tell you, for example, “don’t eat high sulphur foods” when you have sulphur dominant SIBO, which include most meat, eggs, cruciferous veggies, onions and garlic, etc. Again, these are very healthy, nutritious foods that many people with SIBO are told to limit or eliminate.

Other people get caught up on the GI tests which may show overgrowth of gram negative bacteria. This are archaic forms of bacteria that can feed on many different fuel sources, including fats. Some people with gram negative bacterial overgrowth are told to limit fats in their diet because it is supposedly feeding these gram negative bacteria and inflaming the gut as a result.

So what gives? Why are there so many different approaches promoted? Why do they seem to work for awhile, and then not work anymore? What is the real issue?

The question we actually need to be asking is: WHY is the overgrowth there in the first place?

Here are the true root causes if SIBO:

1. Neuropathy in the gut lining. We have valves in the digestive tract that are supposed to open and close at the right time as food is passing through, and need an amount of movement or “peristalsis” in the gut to keep things going. Many people have paralyzed digestive tracts due to two factors that become a terrible feedback loop: fatty acid, B vitamin and mineral deficiencies, and toxins released from the overgrown bacteria. These two issues snowball into full blown, difficult to resolve SIBO. The antidote? REFEED the fatty acids, B vitamins and minerals (sodium, potassium, and magnesium in particular for minerals, B1, B5, B6, B9 and B12 for B vitamins in particular) that are necessary for the regeneration of the nervous tissue in our gut. This means high intake of animal foods (highest in B vitamins), fatty acids (especially from animal sources, which are correctly balanced in fatty acids needed for nerve health: see ghee and butter, cod liver oil, beef and lamb fat, etc.), and a variety of seafood and vegetables for our mineral intake. Many people need to supplement on top of prioritizing these in our diet.
2. Overall immune system imbalance. If we do not have a healthy immune system, our body is going to have a hard time keeping chronic infections like SIBO in check. And guess what? A lot of the same nutrients we need for nerve health, we also need for immune health! The same focus on fatty acids, B vitamins and minerals apply to this point. In addition, I recommend focusing on healing the lining of the gut, so that “bad” bacteria are kicked out and “good” bacteria have a nice, healthy place to start nesting. This means the addition of meat stock, a lot of soft and warm meals, and eliminating complex carbohydrates (insoluble fiber) that can be very rough on the digestive tract when not broken down properly.
3. Open those detoxification pathways! People with SIBO tend to have sluggish detox pathways, which can become a feedback loop of high toxicity in the body repressing the immune system and docking into nervous tissue (which tends to attract fat soluble toxins). While we are resolving the underlying problem, it is important to make sure a bowel movement is triggered at LEAST every other day, preferably every day, through whatever means necessary. Sometimes this means taking high doses of magnesium, high doses of sodium, high doses of Vitamin C, or even doing coffee enemas. Castor oil packs, lymphatic massage, hot baths, and “mayan massages” (belly massages) can also be helpful.

Notice that this approach does NOT eliminate high sulphur foods, high FODMAPS foods, or high fat foods. Obviously, if any particular food is giving you debilitating symptoms, it makes sense to eliminate it temporarily for relief. However, many people go on diets that unnecessarily restrict for symptom reduction without ever getting to these three deeper root causes. We need to learn to look below the surface and not get caught up in the details. This approach will lead to lasting resolution, and often if this is done for at least 6 months to a year, and THEN you treat with anti microbial herbs such as oregano oil, the treatment will actually “stick” this time. Make sure you are listening to the deeper language of your body of what your symptoms are telling you.

If you want detailed meal plans teaching you how to go about rebuilding your gut-brain axis for good, make sure you check out my book and mini courses through the links above.