I have contemplated writing about SIBO for a couple of years but hesitated for many reasons. Mostly because there are a vast number of rabbit holes one can Google down when you search for SIBO information. And because I really wanted to work with more SIBO clients and relate my personal experience rather than completely regurgitate information I read. I have/have had SIBO. And, typically when I have experienced something myself I can access my inner guru and relay some clear answers.
With SIBO I don’t have many answers, and frankly no one really does as it is a relatively new pathology of the gut. However, I feel called to speak on some of the common veins that run through every single one of my clients, and myself, with regards to etiology and recovery. What I will discuss is in relation to the work I do in supporting the human body through trauma and stress through abdominal massage, breath and body awareness. And how unreleased stress and tension in the body- specifically the abdomen- will lend itself to SIBO through rapid decrease in motility function (I will explain this later).
Why I say I have/ have had SIBO is that I don’t really know if it every completely goes away. My recent test of last year was negative but then some minor symptoms crop up and I simply wonder. I talk about this with my clients who come in with desperate eyes looking for answers to alleviate some of their feelings of failure in healing SIBO. I talk about this because it opens the door to working with the body where it is at- learning to really tune in and make lasting life changes rather than thinking that there is a start and finish.
True, many do completely live symptom free and I find those are the ones who have embraced the many changes that are necessary to ensuring that SIBO doesn’t return. This is not what most want to hear because it requires deep work on the emotional level to have that self care mastery and sense of your body. And, this is where finding someone to guide you into your body to address the stress triggers can really help you walk that path. AND- it doesn’t have to look perfect which is why I also say that you may just have to deal with SIBO, on minor levels, for some time. Because stress does exist and you have to exist so there’s that dance.
Ok- so for those of you who have NO idea what SIBO is lets dive in:
SIBO is short for small intestinal bacteria overgrowth. It is a condition where large amounts of bacteria populate the small intestine causing a variety of health symptoms not only in the gut but in the entire body- because as we know, the gut is like grand central station for the majority of our bodily functions. In fact, the symptoms of SIBO are so closely related to IBS (which is only a list of symptoms and not something I consider a real diagnosis) that many doctors are calling SIBO the new IBS. A study published in the Townsend Letter found that 84% of IBS patients presented with SIBO when tested.
- Gas and bloating after almost anything you eat, especially carbohydrates.
- You take probiotics and feel worse
- Abdominal pain, discomfort, cramps
- Mood disorders
- Constipation, diarrhea, or a combination
- Nausea and heart burn
- Fatigue and brain fog
- Malabsorption of nutrients
- Systemic pain
- Unexplained weight gain or loss
- Hormone imbalances
There are also many diseases now being linked to SIBO like fibromyalgia, thyroid disorders, Crohn’s disease, cystitis, colitis, skin disorders and many more. If you have any of the above symptoms and have been diagnosed with IBS with no success in eradicating your symptoms, I highly recommend getting tested for SIBO.
Testing and Treatment
There are a couple different testing methods but the preferred is the hydrogen/methane breath test. The unwanted bacteria that populate the small intestine get really cozy and wait for you to eat anything that turns to sugar. When they feed on your pasta and wine they then produce the gasses hydrogen and methane. These gasses are not naturally produced by human cells making them distinguishable in the breath test. (the breath test is a slightly long, annoying but mostly accurate test). These gasses are what give you the uncomfortable digestive symptoms and prevent your food from being properly absorbed and passed into your colon properly. The key in treating SIBO is then to eradicate these bacteria, and this is where incredible confusion and frustration sets in for most people.
There are two main treatment options for killing the bacteria: antibiotics and a more natural approach using antibacterial herbs and supplements. I am not going to go into what works and what doesn’t because it really depends on you, how well you address the underlying causes associated with SIBO and how diligent you are with diet. Also, what I have found, as with most imbalances in the body, is that there is not a one size fits all protocol with these things. However, you must kill the buggers so choose a course that suits you. And studies have shown a 75% reduction rate in symptoms once the bacteria has been addressed. Unfortunately, many think that like other bacterial infections in the body, if you take the prescribed course of antibacterials then you are done. This just is NOT the case- sorry to say- and is how many clients end up finding me, or others who can help, to guide them in the other intricacies of SIBO that allopathic medicine falls short to address.
Alongside antibacterials, most all natural and allopathic doctors will also prescribe some sort of supplementation or prescription medication to address motility of the gut. They are now also aware that these bacteria love to make little nests in biofilm so biofilm disruptors are recommended. All of this in combination with a very rigid diet that omits most all carbohydrate intake.
In brief the standard protocol is:
- Take antibacterials
- Follow one of the many recommended diets (Gaps, FODMAPS, SCD, Elemental)
- Take prokinetics for motility
- Biofilm disruption (I won’t go into this but is necessary)
Looking at this seems pretty straightforward, unless you have SIBO and know the path is not that linear. What the above protocol fails to recognize is what impairs gut motility in turn impairs digestive enzyme production, transit of food, absorption of nutrients and so on.
How did this happen?! And the one common denominator- STRESS
SIBO isn’t something you just wake up with. It creeps in over time unfolding symptom after symptom which makes it difficult to really pinpoint when the story began. I have found that for most with SIBO they already had a compromised digestive system for some time. I hear from a lot of my clients that they have lived with minor digestive issues for so long that it became a normal state. This alone triggers a constant stress response in the body which over time impairs motility. The main causes of SIBO are also some of the main causes of many other intestinal disorders.
- Improper diet and lifestyle
- Parasitic infections
- Food poisoning
- Antibiotic use
- Long term medication use- including birth control pills
- Abdominal surgeries
- Excessive stress leading to reduction in digestive enzymes and gut motility
If current stress levels are not addressed then motility and in turn digestive enzyme production, nutrient absorption and so on have a very difficult time in being restored. Even if we start to heal the lining of the gut through supplementation and diet, there is still no guarantee that SIBO stays at bay until the motility function of the digestive system is restored. And, gut motility functions properly in your parasympathetic “rest and digest” state. It relies on your parasympathetic and enteric nervous system to fire the communication signals to the body that it is safe and to unwind the contracted intestinal tract.
An important protective mechanism against SIBO is proper small intestine motility via the migrating motor complex because stasis promotes bacterial overgrowth. – Allison Siebecker, MD ‘Townsend Letter’
If your abdomen and intestinal motor function stay in contraction then you will continually perpetuate the pile up of bacteria in your small intestine rather than it travelling to your colon where it belongs or can be dealt with. If your body stays in your stressed flight or fight mode then your system signals digestion to slow and reduces enzyme production. Digestive enzymes and healthy levels of stomach acid are necessary not only for breaking down our food for absorption, but stomach acid is a first line of defense against more incoming bacteria on our food. But, coming back to the point of stress, even if you supplement with digestive enzymes, which I encourage in the beginning, if the motor function does not move your food through properly then you will still fight the SIBO back up. Ok, I think you get the point.
When we think of stress we think of the daily grind of work, family, finances etc. We often overlook that the body registers improper diet, toxic environments, toxic thoughts and an unbalanced lifestyle as stress. If we truly want to understand how to heal and what our body needs we have to listen to it. Unwelcome bodily symptoms and disease are literally signals from our beloved bodies that it needs help. But rather than slow down and listen and tune in, we create more chaos by constantly seeking “the little blue miracle pill” and we never actually heal.
Deep down we ALL know what is needed to create balance in our lives. Deep down we KNOW that most of our stress is self created. Deep down we all FEAR what it takes to really face our reality and take care of ourselves. But, I will tell you from experience, and from witnessing my clients’ recoveries, the more we come back to the our bodies and listen, the more we allow our fears to surface and address the stress trapped in our bodies, the easier actually taking care of ourselves is. It is really a big ol’ prescription of self-love and it is very human to fear that path- you are not alone.
Ok- mini tangent. What were we talking about? Oh, yes, SIBO…
As I said, the SIBO world is tricky to navigate and there is no miracle cure. But I can guarantee that the more you return to your body and reduce the stressors that keep the SIBO cycle going, the more you are going to be able to hear your own cues to heal and awaken your own inner gut guru. How do we return? We seek guidance and support that can help the body remember how to go with the flow. I have personally found abdominal massage and breathwork to be the most profound in assisting the enteric and parasympathetic nervous systems as both healing modalities address the abdomen directly. Reach out to practitioners who can hold witness to your stress and help you release it in a way that serves your body. Get some coaching. I have also found that most of my clients need someone to help them navigate the protocol their doctors have prescribed. But most of all, trust your body, trust yourself that you are strong enough to balance your own system and… trust your gut.
Are you curious about how abdominal massage and breath can help? Do you need help finding someone to support your journey? Want to know more about SIBO and my personal protocol? I am here…
Schedule a Coaching Session Now where you will get my insights. Additional sessions will include at home abdominal care and guided healing breathwork to help you release the stress in your belly.
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I realize I just barely touched on all the mechanisms of SIBO as that was not the intent of the article. I have included links below to some highly intelligent doctors and specialists in this area that can elaborate.
www.chriskresser.com | www.siboinfo.com