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    Dr. Aarti Soorya

    Dr. Soorya is a board certified Physical Medicine and Rehabilitation physician, who alongside the rest of the Natural Balance team, com... read more

Small Intestinal Bacterial Overgrowth


What is Small Intestinal Bacterial Overgrowth (SIBO)?  Do you have uncomfortable symptoms such as bloating or abdominal pain after eating? Struggling with gas, constipation, or diarrhea? You may have a condition known as Small Intestinal Bacterial Overgrowth, or commonly known as SIBO. In this condition, the bacteria, which should normally be in your colon, inappropriately move into the small intestine where they can cause a myriad of uncomfortable digestive symptoms.

Just as a quick overview, the small intestine is where food is further digested by enzymes and acid after receiving it from the stomach. The colon, which anatomically follows the last part of the small intestine, has bacteria in it that further help digest and absorb nutrients. Now if those bacteria move into the small intestine, where they are not supposed to be, the bacteria feed on the food you are trying to digest, leading to uncomfortable symptoms such as gas, pain, and bloating. That’s no good!

Unfortunately, many healthcare practitioners are unaware of SIBO, leading to incorrect treatment and little to no improvement in your symptoms. Just to give you an idea, many patients who are diagnosed with Irritable Bowel Syndrome (IBS) may actually indeed have SIBO. This can leave you feeling frustrated, hopeless and thinking you have to cope with these symptoms forever which is not true! At Natural Balance, we understand that experiencing these symptoms can have a tremendous negative impact on your day-to-day life and keep you from living life to it’s fullest. We are here to reassure you that there is hope and successful treatments available for SIBO.

How do we test for SIBO?

Comprehensive Stool Analysis- this test looks at the balance of bacteria in your gut microbiome. It provides information regarding bacterial, yeast, ova, and parasite overgrowth.

Hydrogen/Methane Breath Test- This non-invasive test is performed typically after 12 hours of fasting and requires ingesting a precise amount of sugar and measuring your breath every 15 minutes for 3 hours. If bacteria are present within the small intestine, they end up fermenting the sugar, producing hydrogen, methane, or both, which are absorbed into the bloodstream, and breathed out (which is measured).

Urine organic acids testing- This test evaluates one urine sample for byproducts of yeast and bacteria. If out of range, it can indicate yeast or bacterial overgrowth.

How is SIBO treated?

Treating SIBO is a multistep process. First, it requires the patient to decrease the foods that feed the bad bacteria including processed sugar, alcohol, and certain carbohydrates. We then kill the bad bacteria using biofilm enzymes and natural kill agents which can include a variety of herbs and spices such as turmeric, garlic, oregano, and ginger. If required, we do use antibiotics as they are a very effective way of eliminating the bad bacteria from your small intestine. The main antibiotics used are Xifaxan and Neomycin. Once we have effectively killed the bad bacteria, we want to restore the health of your gut and gut lining with multiple probiotics and healing agents.

Remodeling the gut after an infection like SIBO is no easy task and can take up to several months. The process can be difficult, but you only want to do this once and you want to do it right. Our clinic inherits a lot of patients who have previously done some work on their gut but in an ineffective manner. This unfortunately leaves them with bacteria that have developed resistance to antibiotics and certain natural kill agents. But don’t lose hope if this has happened to you. We use our advanced functional medicine testing to evaluate and formulate other appropriate agents and antibiotics choices when creating your personalized plan.

What are the symptoms of SIBO our clinic looks for?

  • Nausea
  • Bloating
  • Gas
  • Abdominal Pain
  • Abdominal Cramping
  • Diarrhea
  • Constipation (less likely)
  • Malodorous stools
  • Vomiting
  • Burping
  • Fatigue
  • Weight loss
  • Rashes
  • Rosacea
  • Depressed mood
  • Joint Pain
  • Acne
  • Allergies
  • Food Sensitivities especially to gluten, dairy, and fructose

What are some risk factors our clinic looks for?

  • Previous surgery causing structural changes in the intestine
  • Antacid use
  • Hernia
  • Faulty ileocecal valve
  • Immune suppressive medications
  • Stress
  • Celiac Disease
  • Aging
  • Chronic pancreatitis
  • Diabetes
  • Diets high in sugar, alcohol, processed foods, and carbohydrates
  • Gastrointestinal motility issues (such as with Diabetic Gastroparesis)

If left untreated, SIBO can lead to health conditions such as:

  • Depression due to improper absorption of amino acids, vitamins and minerals (all of which are required to make neurotransmitters)
  • Iron deficiency
  • Chronic fatigue syndrome
  • Leaky gut
  • Autoimmune issues such as joint pain and rashes
  • Malnutrition
  • Anemia
  • Memory Loss

If SIBO is something you think you are struggling with, please do not hesitate to contact our office and we would love to schedule an appointment with you. We have helped numerous patients successfully restore the health of their gut and we look forward to working with you. We care about you getting to the root cause of your symptoms so that you can enjoy the quality of life you deserve!