Small Intestinal Bacterial Overgrowth, or SIBO, isn’t just a cute name you gave to the family hamster when you were 11 years old. This chronic and often debilitating condition can be particularly difficult to treat and rid from the body, especially in more severe cases. Even more frustrating, SIBO frequently returns with a vengeance if rigid treatment methods are not followed well past disappearance of the last symptoms. Regardless, fear of never fully eliminating SIBO from your GI tract should not prevent taking action against these intestinal hijackers. Even small decreases in the concentration of harmful bacteria can lead to big improvements in gut health, which in turn increase overall physical and mental health and well-being.
Here are seven things you can do to overcome SIBO. Many of these things are also done for leaky gut.
Step One: Remove food and chemical irritants
Dietary adjustments are essential to overcoming both SIBO and leaky gut. It is absolutely essential to eliminate all refined sugars from the diet and most starchy foods. At the least one should eliminate all grains containing gluten (wheat, rye, barley), but eliminating all grains may be required.
Dairy may also be problematic because the bacteria love to feast on the sugar in dairy, lactose. . Goat milk products and cultured dairy foods can be beneficial for some people, yet other people may have to eliminate all dairy foods.
Fermented foods are generally helpful for SIBO. These are discussed under Step Six: Restore beneficial bacteria.
There are three dietary programs that may be helpful, depending on the severity of the problem. These are the Specific Carbohydrate Diet (SCD), the Gut and Psychology Syndrome (GAPS) diet and the Paleo diet.
Step Two: Stimulate production of and/or supplement stomach acid and enzymes
There are two ways to increase stomach acid and enzymes. One is to take supplements and the other is to take herbs and nutrients that stimulate their production. With SIBO it is normally necessary to do both.
To determine how much Betaine HCl one needs you can either do a hydrochloric acid challenge test or simply come in to Robust Life Center and have one of our practitioners test for exactly how much your individual body needs. You can also use digestive bitters to stimulate digestive secretions. Bitters not only stimulate HCl secretion, they also stimulate pancreatic enzymes and bile from the gallbladder and tend to be mildly antibacterial as well. Bitters should be taken 15-20 minutes prior to meals with one to two large glasses of water. A small pinch of a natural salt can also be taken at the same time, as this also helps stimulate HCl production by providing chloride.
Bitters are contraindicated if you have digestive atrophy. So, if you have dry mucous membranes, as evidenced by a dry and withered (or shriveled) looking tongue, don’t take bitters as they dry the mucous membranes.
A lack of HCl may also be due to a lack of the following nutrients: chloride (low serum levels), zinc and thiamine. These are primary nutritional factors required for the synthesis of hydrochloric acid.
Step Three: Improve intestinal motility (if necessary)
With SIBO it is also important to make certain that there is good intestinal motility between meals to flush the intestines and clear out bacteria. One way to do this is to allow adequate time between meals. Depending on the efficiency of your digestion, you need three and five hours between meals. Ideally, you should wait until you get stomach rumblings indicating your digestive tract is clear before eating the next meal.
If motility is slow there are some supplements that may be helpful. All carminatives increase digestive motility, and many people find that a cup of ginger tea is most helpful.
Step Four: Close the ileocecal valve (if necessary)
If there is severe gas and bloating, you probably need to work on the ileocecal valve. This is done by massaging the valve to reduce swelling and inflammation and get it to close properly. The ileocecal valve is located on the lower right side of the abdomen, midway between the belly button and the right hip bones. If tenderness or sharp pains are present with or without manual pressure, massage the area a couple of times a day until the swelling and tenderness go away.
Step Five: Reduce bacterial overgrowth
If a person has signs of SIBO, they will need to take some supplements to reduce bacterial overgrowth in the small intestines. This can be done with herbal antibacterial agents (first choice) or pharmaceutical antibiotics (last resort).
For starters, one can take a digestive bitters blend with antibacterial herbs in it, instead of just plain digestive bitters. Another great remedy is enteric coated peppermint oil.
Garlic is yet another possible antimicrobial agent, but if friendly lacto bacteria are overpopulating the small intestines, it won’t work. It is effective mainly in killing gram negative bacteria. The best way to take it is to chop up or crush fresh garlic, then mix it with a teaspoon of honey to make it easier to take.
Cinnamon kills both lactic acid bacteria and yeast. It is much more active than peppermint. Use it when you are sensitive to taking probiotics.
Goldenseal may also be helpful. It not only reduces intestinal bacteria, it also tones up digestive membranes and reduces irritation. It does lower blood sugar levels, however.
Step Six: Restore beneficial bacteria
All traditional cultures used some kind of cultured foods. Vegetables were commonly cultured, but so were fruits and dairy foods. Studies have shown that it takes 10 billion encapsulated bacteria to obtain the same value to the intestines that just 100 million bacteria from food will do. Furthermore, people with SIBO often do not do well on probiotic supplements, especially if they contain prebiotics which feed the small intestinal bacteria as well as friendly flora.
Cultured vegetables are very valuable in treating SIBO and leaky gut. You can make your own cultured vegetables or you can purchase them from a health food store or some supermarkets. Here are some brands of naturally fermented vegetables:
King Asian Gourmet
Pleasant Valley Farms
Making your own cultured vegetables is quite easy. Recipes for making cultured vegetables can be found on our website or our in-office recipe collection, available to the public during normal business hours.
After eliminating dairy for six weeks, you can try slowly reintroducing cultured dairy products like yogurt and kefir and see if you tolerate them.
Step Seven: Repair gut integrity
Since SIBO always causes leaky gut, it is important to rebuild the integrity of the intestinal membranes. One of the best ways to do this is by using bone broth. Bone broth is high in glutamine and glycine, both of which are essential in healing the gut. They are emphasized in both the SCD and GAPS diet. Drink 1-4 cups of bone broth daily. You can also use it to make soups. Recipes for bone broth can be found online, in our office or in the books Nourishing Traditions and Nourishing Broths, both by Sally Fallon.
Other remedies that help heal the gut include chamomile tea, deglycyrrhizinated licorice and colostrum powder.
Though this article covers SIBO more in-depth than you may find elsewhere, it is by no means meant to substitute a formal sit-down appointment with your healthcare provider. It is important to always meet with your natural care practitioner first before beginning any supplement regimen, even those as seemingly harmless as listed in this article. Specific remedies work better with some people than others, and varying health circumstances can produce radically different results under the same exact treatment protocol. This is why we always advise clients to come in and talk with one of our practitioners about their treatment goals and expectations so that we can design the perfect individualized program suited to their specific needs.