SIBO – What is the best functional medicine approach?

What is SIBO?

Small Intestinal Bacterial Overgrowth (SIBO) is a condition in which there is an abnormal increase in the number of bacteria present in the small intestine. This leads to symptoms such as bloating, abdominal pain, diarrhea, constipation, and malnutrition, which can have a significant impact on quality of life.

Why does SIBO occur?

The small intestine is normally home to a limited number of bacteria, but in SIBO, the population of bacteria grows out of control. This can be due to a variety of factors, including an impaired immune system, changes in the muscles of the small intestine that control the flow of food, or damage to the nerves that control the muscles.

SIBO is often associated with other gastrointestinal disorders, such as Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD), and Coeliac Disease. It can also be a side effect of certain medications, such as proton pump inhibitors, which are used to treat acid reflux.

How is SIBO diagnosed?

Diagnosis of SIBO is typically made through a breath test, which measures the levels of hydrogen and methane gases produced by bacteria in the small intestine. High levels of these gases can indicate the presence of an overgrowth of bacteria.

What is the treatment for SIBO?

Treatment of SIBO typically involves a combination of dietary changes, antibiotics, and probiotics. Antibiotics can be effective in reducing the population of bacteria in the small intestine, while probiotics can help to reestablish a healthy balance of bacteria in the gut.

Dietary changes are also an important part of treatment for SIBO, as certain foods can promote the growth of bacteria in the small intestine. A low-carbohydrate diet that eliminates fermentable carbohydrates, such as those found in many grains and sugars, can be helpful in reducing symptoms. In addition, increasing fibre and water intake can help to regulate bowel movements and reduce the risk of constipation.

How to treat SIBO effectively with functional medicine

The functional medicine approach to SIBO often involves a combination of appropriate dietary changes, supplements, and lifestyle modifications. Working with Samuel Maddock Health will enable you to discover the most effective functional medicine SIBO protocol for your unique needs, but here are some important principles that may feature in a functional medicine approach to SIBO.

1. Low FODMAP diet: A low FODMAP diet eliminates fermentable carbohydrates that can promote the growth of bacteria in the small intestine and worsen SIBO symptoms.
2. Ketogenic approach: A low carbohydrate diet, which is high in protein and fibre can be a successful dietary approach to the treatment of SIBO.
3. Probiotics: Probiotics can help to reestablish a healthy balance of bacteria in the gut and improve gut health.
4. Digestive enzymes: Digestive enzymes can help to improve digestion and reduce symptoms of SIBO.
5. Herbs: Herbs, such as ginger, peppermint, and fennel, can be used to support digestive function and improve the symptoms of SIBO.
6. Vitamin C supplement: Vitamin C is a great tool for cleaning the upper gut and killing microbes. Doses up to 5000 milligrams per day can be especially effective as part of a functional medicine approach to SIBO.
7. Additional Supplements: Additional supplements, such as magnesium and vitamin D, can help to support gut health and improve symptoms of SIBO.
8. Gut motility support: Physical activity, massage, and visceral osteopathic techniques can be used to improve gut motility and reduce the risk of SIBO.
9. Stress management: Mindfulness, body awareness skills, exercise, and other stress management techniques can help to improve gut health and reduce the risk of SIBO.
10. Gut permeability support: Diet, supplements such as L Glutamine, and appropriate lifestyle changes can be used to address gut permeability and improve gut health.

What is an upper fermenting gut?

The “upper fermenting gut” is a term used in functional medicine to describe the presence of bacterial overgrowth in the upper part of the small intestine. It can be considered a more useful term than SIBO in the functional medicine approach to the condition, as the term SIBO is often considered too narrow to accurately describe the clinal picture.

The small intestine is normally colonized by a limited number of bacteria, but when there is an overgrowth of bacteria, fungi or parasites in the upper part of the small intestine, it is referred to as an “upper fermenting gut.”

The underlying causes of an upper fermenting gut can include a lack of stomach acid, poor gut motility, an imbalance of gut bacteria, and damage to the gut lining.

Why can vitamin c help with the management of SIBO?

Vitamin C has several potential roles in the management of SIBO. Some of the ways that vitamin C may support gut health and help alleviate symptoms of SIBO include:

1. Boosting the immune system: Vitamin C is an antioxidant that supports the immune system, which is important for maintaining gut health and preventing bacterial overgrowth in the small intestine.
2. Reducing inflammation: Vitamin C has anti-inflammatory effects and may help to reduce inflammation in the gut, which can contribute to the development of SIBO.
3. Improving gut motility: Vitamin C has been shown to improve gut motility and may help to reduce the risk of SIBO by promoting the proper flow of food and bacteria through the small intestine.
4. Supporting the liver: Vitamin C is involved in liver detoxification and may help to support liver function, which is important for maintaining gut health and reducing the risk of SIBO.

It is important to choose a high-quality vitamin C supplement, as some forms of vitamin C can cause digestive distress in individuals with SIBO.

Additional supplements for SIBO?

Other commonly recommended supplements for SIBO include:

1. Probiotics: To help re-balance the gut bacteria and improve digestion.
2. Digestive enzymes: To help break down food and improve nutrient absorption.
3. Hydrochloric acid (HCL): To help increase stomach acid and improve digestion.
4. B vitamins: To support energy production and gut health.
5. Magnesium: To help reduce symptoms such as bloating and constipation.
6. L-glutamine: To support gut healing and reduce inflammation.
7. Zinc: To help improve gut immune function and reduce inflammation.
8. Antimicrobial herbs such as garlic, berberine, and oregano oil: To help reduce bacterial overgrowth and improve gut health.

Here is a sample functional medicine food plan for SIBO:

1. Start the day with a warm lemon water: To stimulate digestion and alkalize the body.
2. Eat protein-rich breakfast: Include eggs, organic poultry, or a protein shake.
3. Avoid processed foods: Choose whole, unprocessed foods such as vegetables, fruits, nuts, and seeds.
4. Eliminate FODMAPs: Foods such as garlic, onions, beans, lentils, and fructose-rich fruits should be avoided.
5. Include fermented foods: Sauerkraut, kefir, and kimchi are great sources of probiotics and can help repopulate the gut with beneficial bacteria.
6. Avoid gluten: This can trigger inflammation and worsen SIBO symptoms.
7. Focus on low-carb foods: Low-carb ketogenic diets have been shown to improve SIBO symptoms.
8. Incorporate healthy fats: Coconut oil, avocado, and olive oil can help reduce inflammation and improve gut health.
9. Consider herbal supplements: Ginger, licorice root, and peppermint oil can help alleviate symptoms and improve gut health.
10. Stay hydrated: Drink plenty of water to help flush out toxins and keep the gut moving.

Note: It is always recommended to consult a certified functional medicine practitioner before making any dietary changes.

Functional medicine SIBO top tip: Change your usual bread for linseed bread. (Also know as PK Bread).

Why choose linseed bread to help SIBO?

Linseed bread is high in fibre and provides a good source of essential fatty acids, such as omega-3 and omega-6, which have many health benefits including reducing inflammation. Linseed bread is also gluten-free and low in carbohydrates, making it an ideal choice for those following a low-carbohydrate diet as part of a functional medicine approach to the management of SIBO.

Linseed (also known as flaxseed) is believed to be beneficial for SIBO (Small Intestinal Bacterial Overgrowth) because it is a good source of soluble and insoluble fibre. Soluble fibre can help to slow down the transit time of food in the gut, which may help to reduce symptoms of SIBO. Insoluble fibre is not digested by gut bacteria and therefore may help to reduce the overgrowth of bacteria in the small intestine. In addition, linseed is also high in lignans, which have been shown to have an antimicrobial effect on gut bacteria.

Is rice a fodmap food?

1. Rice is a high FODMAP food, meaning it contains fermentable carbohydrates that can cause digestive symptoms like bloating and gas in people with sensitive gut.

Is a jacket potato a high or low fodmap food?

1. Jacket potatoes are considered low FODMAP as long as they are served plain and with limited toppings. Toppings like cheese, butter, and sour cream can be high FODMAP, so it’s important to check the ingredients.

Is there any association between high fodmap foods and arthritis and psoriasis?

1. There is limited research on the relationship between high FODMAP foods and arthritis and psoriasis, but some studies suggest that a low FODMAP diet may help alleviate symptoms of IBS, which is often associated with these conditions. However, more research is needed to establish a definite link.

What food is low on fodmap?

1. Some low FODMAP foods include leafy greens, carrots, tomatoes, cucumbers, chicken, turkey, salmon, and gluten-free grains like quinoa and rice. It’s important to check the FODMAP content of specific foods, as different varieties and cooking methods can affect their FODMAP levels.

Are carrots a low fodmap food?

1. Carrots are considered low FODMAP in moderate serving sizes. A serving size of 1/2 cup or approximately 70g is considered low FODMAP.

Can high fodmap foods cause stuffed up nose and coughing?

1. High FODMAP foods can cause digestive symptoms like bloating, gas, and diarrhea, which may also lead to secondary symptoms like a stuffy nose and coughing. It’s important to identify the specific foods that trigger your symptoms and limit or eliminate them from your diet.

What alleviates gas and bloating due to high fodmap foods?

1. A low FODMAP diet and probiotics can help alleviate gas and bloating due to high FODMAP foods. It’s important to work with a healthcare provider or registered dietitian to determine the best course of treatment for you.

Are eggs low fodmap food?

1. Eggs are considered low FODMAP in moderate serving sizes. One large egg is considered low FODMAP.

Is vinegar a high fodmap food?

1. Vinegar is low FODMAP in moderate serving sizes. A serving size of 1 tablespoon is considered low FODMAP.

What foods are listed on fodmap diet?

1. FODMAP diet includes a list of high and low FODMAP foods. High FODMAP foods include garlic, onions, apples, peaches, dairy products, wheat, and barley, among others. Low FODMAP foods include leafy greens, carrots, tomatoes, cucumbers, chicken, turkey, salmon, and gluten-free grains like quinoa and rice. It’s important to work with a healthcare provider or registered dietitian to determine the best course of treatment for you and develop a personalised FODMAP diet plan.

Discover the root cause of your SIBO. Contact us today to learn more about how the SMH Gut Resolution functional medicine package can help you.