How Did I Get SIBO? Underlying Causes & How to Correct Them to Avoid Relapse
When I was first diagnosed with Small Intestinal Bacterial Overgrowth (SIBO), I know one of the first questions I asked myself was “why do I have SIBO?”
The daily emotions of shame, frustration and loneliness made it tough not to get stuck in the victim mentality mindset of “why me, why am I suffering through this and will I ever get better?”
And for the longest time I wasn’t getting better. I tried eliminating so many foods, took various herbal supplements and worked with a few different practitioners but still kept getting a positive test result.
It wasn’t until I really started educating myself on how the body worked and really understood and corrected my underlying root causes of SIBO that I started to finally see improvement and finally received a negative test result.
Preparing for a SIBO Protocol
Sometimes, the most difficult part of dealing with SIBO is actually knowing you have it in the first place!!
.…and to make matters worse many doctors aren’t even aware of what SIBO is! (shocker right?)
Here’s a little fun fact: SIBO only received an International Classification of Diseases designation recently in Fall of 2023! (meaning it wasn’t officially recognised until then)
The sad reality is that many of us have to be our own health advocate and take our heath into our own hands. If you’ve been scouring the internet trying to find out what the heck is going on with your digestive system and have been wondering “do I have sibo?”, I’ve outlined the symptoms below:
Bloating and gas
Alternating or both constipation/diarrhea or bowel movements with urgency
Nausea
Heartburn/reflux
Abdominal pain
Belching, flatulence
Leaky gut symptoms: rashes, food sensitivities, anxiety, skin issues
Steatorrhea (fatty poops! ie. pale, grey like stools)
It’s possible to have one or a combination of the symptoms above. The best way to confirm if you have SIBO is to test. The test is an at home breath test which will help you determine what type of SIBO you have (methane, hydrogen or hydrogen sulfide [US only]). If you think you have SIBO and would like to order a breath test, click below (This is to book a discovery call which is required prior to ordering)
Why it’s Important to Understand your Root Cause(s)
Understanding WHY you developed SIBO is almost just as important as receiving a diagnosis.
Once you finally find out what’s going on with your body, the next step is to not only get rid of the bacteria but address the contributing factors to developing SIBO so that the likelihood of relapsing or having it come back is reduced.
I like using an analogy to explain why the critical and most often missed step in a SIBO protocol is to ensure all the underlying causes have been addressed.
Let’s say the sink in your kitchen (your digestive system) keeps getting backed up and won’t drain properly. You keep emptying the food out each night so the water will go down (taking digestive enzymes), which helps a bit but it’s still draining slowly. Maybe you try some Drain-O to break down build up within the pipes (taking an antibiotic or herbal antimicrobial).
It helps the water flow down the drain for a week or so but then it starts backing up again (relapse). You finally call a plumber (SIBO specialist) to come check out the issue and he discovers that a kids toy was lodged half way down the pipe which has been causing the back up (an adhesion in your intestine). In order to get the water flowing down properly, the toy needs to be removed (addressing the root issue being an adhesion so the bacteria won’t build up in your intestine).
SIBO analogy
As you can see killing the bacteria is only solving half the problem. It can keep building up and returning if the reason why you have overgrowth is not being addressed. Unfortunately, standard conventional treatment for SIBO only focuses on killing the bacteria, which is why so many people struggle to get rid of it, relapse or have chronic SIBO.
It’s important to note that many holistic practitioners also don’t identify and address root issues either. In The SIBO Turnaround Method I provide and review with all clients their Root Cause Analysis & Action Plan to identify their contributing factors and what changes are to be made to address them.
To learn more about the program, click here.
Underlying SIBO Causes
There are many contributing factors that can lead to you developing SIBO. It depends on your unique body and health history. Some clients I see have as many as 10 factors while others may only have 1 or 2.
There are 4 main categories that SIBO causes fall under¹:
1. Impaired Digestion
The digestive system is a complex, interconnected system that relies on signals from other parts of the system to work optimally. I like to think of it like dominos. Once one piece at the start (higher up in the digestive system) doesn’t work properly, every domino (organ) downstream will be negatively impacted. Over time, impaired digestive processes can create an environment that allow bacteria to overgrow.
Contributing factors to impaired digestion include:
Microbiome Dysfunction can result from eating processed foods, taking antibiotics, chronic stress, nutrient deficiency, pesticides in foods.
Chronic Stress including physical (high intensity work outs, inflammation), emotional and psychological stresses.
Deficiency of pancreatic or brush border enzymes that can result from eating processed foods and sugar, smoking, alcohol, drugs, pesticides in food
Secretory IgA deficiency due to lack of diversity in pre and probiotic foods in the diet.
Poor bile flow from eating a diet high in inflammatory fats & sugar, high intake of saturated fats, low bitter vegetable intake, stress, hormone imbalances, overloaded liver
Low stomach acid from chronic stress, eating foods you’re sensitive to, eating processed foods, overuse of ant acids, antibiotics & pain killers and eating too quickly.
Poor vagal tone can impair digestive organ function including stomach acid production, motility and colon function.
Infections which can impair digestive processes like H.pylori.
2. Impaired Motility
Motility refers to the movement through your intestinal tract. This movement plays an important role in SIBO because if movement is too slow, bacteria can build up and overgrow in the small intestine where it shouldn’t be.
Contributing factors to impaired motility include:
Migrating Motor Complex (MMC) damage which can occur after food poisioning. Bacterial toxins from the bacteria can create nerve damage in the gut, impairing your ability to sweep bacteria out through the small intestine, resulting in a build up.
Traumatic brain injury can lead to chronic nervous system activation, negatively affecting the vagus nerve and nervous system in the stomach.
Hypothyroidism-poor thyroid function slows down both movement of food through the intestinal tract as well as the MMC, allowing bacteria to build up
Chronic infections like Lyme disease, Epstein bar virus .
Diabetes results in elevated glucose levels which can impair stomach and small intestinal motility, allowing bacteria to build up.
Mold can act as a neurotoxin, slowing down stomach emptying and motility of the intestines as well as reducing loss microvilli and stomach lining cells which can lead to leaky gut.
Dysautonomia diseases can negatively impact the nervous system and autonomic body processes. This includes conditions like Ehlres Danlos Syndrome, Postural Orthostatic Tachycardia Syndrome, and Mast Cell Activation Syndrome.
3. Impaired flow through the Intestines
This often happens as a result of surgery in the abdomen area. Scar tissue can form, making it difficult to clear the bacteria out, leading to an overgrowth.
Contributing factors to impaired outflow include:
Ileocecal valve dysfunction occurs when the valve between the small and large intestine doesn’t work properly. It can remain open, allowing bacteria from the large intestine to flow up into the small intestine where it isn’t normally found. This may be a result of too much scratchy fiber (vegetarian diet), adhesions, spasms from stress and low fiber diet and inflammation from constipation2.
Endometriosis is a condition where uterine tissue grows outside the uterus, usually in and around the uterus or abdominal area. Since the uterus and intestines are in close proximity and the endometriosis tissue may impact the function and/or structure of the intestines.
Adhesions that developed from abdominal surgery including laprascopy, c-section, hysterctomy, appendectomy, bowel obstruction repair, cholecystectomy, back or hip surgery or gastric bypass
4. Medications
Medications can have a wide range of side effects on various parts of the body and some impact the digestive system more than others.
Medications that can contribute to the development of SIBO include:
Opiates/narcotics (Hydrocodone, morphine, oxycodone, hydromorphone, fentanyl)
Antispasmodics (anticholinergics and smooth muscle relxanats)
Proton Pump Inhibitors (Omeprazole, Pariet, Nexium)
T4 (only medication-levothyroxine, Synthroid)
Tricyclic anti-depressants (amitriptyline, Imipramine)
In reviewing the above, you may be able to identify some of your underlying factors on your own. However, some of these factors would need to be identified by a trained professional so I suggest working with a holistic practitioner trained in SIBO to get a full analysis completed.
SIBO can develop after food poisoning
Fixing Your SIBO Root Cause
Once you understand all the reasons why you might have SIBO, the next step is to work on addressing these.
This is where working with a holistic practitioner plays an important role. Many of the supplements and lifestyle practices used to help correct these issues are not used or discussed in conventional care. It’s also important to note that these supplements shouldn’t just be taken on their own without guidance or supervision from a certified practitioner.
The following suggestion help correct or improve the following root causes:
1. Impaired Digestion
Supplements: depending on your symptoms and health history, supplements may be suggested to improve:
Stomach acid: apple cider vinegar, herbal bitters or hydrochloric acid
Gall bladder: ox bile, cholagogue herbs, phosphatidyl choline
Nutrient absorption: digestive enzymes including pancreatic enzymes, brush boarder enzymes and diamine oxidase (DAO- if suffering from histamine symptoms)
Lifestyle Changes:
Incorporate eating habits to support stress reduction around eating and improve digestion and absorption of food consumes. You can read more on eating habits in this blog post.
Implement a daily stress reduction routine focusing on meditation, deep breathing, yoga, going for a walk, spending time in nature, vagal nerve exercises, journaling etc.
Focus on eating a diet of real, whole foods including a variety of fresh fruits, vegetables, whole grains and pasture raised animal products.
2. Impaired Motility
MMC Prokinetic Supplement: a prokinetic is a supplement that can help stimulate motility of the small intestine when motility is an issue. This is a very important supplement that is often missed, which can increase your risk of relapsing, especially if your SIBO started after food poisioning.
Traumatic brain injury: this will depend on your history and type of trauma you experienced. Therapies that may be useful include cranio-sacral therapy, emotional freedom technique or neuro feedback.
Underlying diagnosis: Working with a holistic practitioner will help identify a possible other underlying diagnosis and natural approach to other illnesses that may be contributing to your SIBO development including hypothyroidism, chronic infections, diabetes, mold and dysautonomia.
3. Impaired flow through the Intestines
Ileocecal valve dysfunction can be worked on yourself at home. First you need to locate the area of the valve, about half way between your belly button and hip bone on your right side. Next you can massage the area by pushing down on the valve and rotating the leg in and out to help relax and release the valve. You can watch a video on how to do this here.
Scar tissue/adhesions or endometriosis: visceral manipulation can be beneficial as it can help to break up scar tissue. Look for an osteopath near by who is trained in visceral manipulation.
4. Medications
It’s advised to work with a doctor and/or naturopath to determine if there are alternatives or dosing options for any medication you may be on that could be contributing to SIBO.
It can be difficult to figure out if you have unpaired digestion, motility and flow on your own and any of the supplements needed to correct these issues can also only be prescribed from practitioners.
In The SIBO Turnaround Method I help you discover your root cause and put together a customized health plan to ensure your root causes are addressed while concurrently eliminating SIBO bacteria.
If you’d like to learn more about the program and if it’s a good fit for you, you can book a free discovery call below!
By Krista Znebel, R.H.N.©
April 1, 2024