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If you have been battling with IBS, you may have tried pre & probiotics unsuccessfully – for some they can really help a lot, but for many they just seem to aggravate the situation. A lot of people with IBS-D (more diarrhoea) find that they get worse bloating, discomfort & loose motions when they take pre & probiotics & eat fermented foods like yoghurt & sauerkrout etc. People with IBS-C (more constipation) may feel even more bloated, blocked & uncomfortable. But why…?
IBS sufferers will often test positive for ‘SIBO’ (small intestinal bacterial overgrowth), which is where you have plenty of ‘good’ bacteria – but for some reason they are hanging out in the wrong place. We want these microbial helpers to prolifically populate the large intestine, but not the small. When you have SIBO, your misplaced gut bugs break down & ferment the carbohydrates that you’ve eaten in your small intestine instead of the large. This causes excess gas production, as well as the resulting gut disturbances (bloating, discomfort, diarrhoea, constipation, irregularity). It can also cause leaky gut & all the problems that occur when you get things leaking through the damaged gut-lining into your bloodstream (ie allergies / intolerances & autoimmune problems to name a few). Depending on the balance of microbes you have populating your small intestine – you’ll have different gases produced, & you may have more constipation or more diarrhoea.
Different Bugs = Different Gas = Different Symptoms.
This is where it gets really interesting. Bacteria produce hydrogen gas when they ferment carbohydrates. Hydrogen gas is enough to make you feel bloated & give you diarrhoea, but then there are other microbes called ‘archaea’ which feed on the hydrogen produced by the bacterial carb-fermentation. The archaea produce another gas from this process – methane. Having high methane levels in your gut is associated with constipation. So if you have lots of the bacteria in your small intestine (but not the archaea), you’ll likely have bloating / gas / diarrhoea predominant IBS. If you also have the archaea, you’re more likely to be constipated. Remember also that the gut symptoms are only the tip of the iceberg – SIBO sufferers may also have immune system problems, mental / emotional disturbances, poor energy, joint inflammation, skin trouble – your gut can impact every single body system & when it is not balanced, everything else will struggle too.
So…what to do ?
Starve the critters out!
Remove The Bugs, Improve The Symptoms?
The bugs (both bacteria & archaea) depend upon you supplying the easily fermented carbs to survive in the small intestine. If their food supply dries up, they’ll gradually die off / migrate back to the bowel. So many people have great success eliminating their IBS symptoms by starving the SIBO organisms out, & there are some who have success using antibiotics too (these will apparently kill the bacteria, but not the archaea).
Will They Come Back Again?
IBS symptoms are not fun, but neither is permanent dietary restriction! You can definitely improve your symptoms by starving out the bugs, but as soon as you reintroduce their favourite carbohydrate food sources back into your diet, they’ll be back with a vengeance – won’t they? Normally, yes. But if you can figure out & understand ‘why did I end up with too many bacteria in my small intestine in the first place?’, you’ll have a good chance of keeping things from getting that bad again. When you eat, don’t just consider the nutrition you’re feeding yourself, also consider the gut microbial impact – you need to eat in a way that helps support a balanced ecosystem. And this can vary a lot from person to person!
What Could Cause SIBO In The First Place?
- Low stomach acid – this makes the small intestinal environment more welcoming to the bacteria
- Stress – your gut bugs are linked to your brain & emotions, in a 2 way communication. Stress can also effect stomach acid production & intestinal movement.
- Impaired Intestinal Motility – the gut movements don’t ‘flow’ as they should due to nerve / muscular problems or medication, illness, being sedentary for long periods.
- Gastro infections – acute damage to your gut lining & resulting disturbances in your microbial populations can start overgrowths.
- Dietary choices – excess refined carbohydrates, sugars, alcohol, & other gut irritating foods i.e. gluten.
- Antibiotics & other medications i.e. acid blockers – changing the gut environment & creating imbalance.
- Excess pre & probiotics / probiotic rich food & drink – you can sometimes have too much of a good thing. If the small intestinal environment is out of whack to begin with, the influx of bugs & their fave foods can make things much worse. Your tummy will let you know if these caps / foods / drinks don’t agree!
How Can I Get Rid of SIBO?
If you suspect that your gut symptoms may be caused by SIBO, you should get tested. Ask your health professional for a ‘SIBO breath test’ to determine wether you have high levels of hydrogen & / or methane on your breath (sounds gross, but the gasses produced in your gut actually end up in your blood stream & you excrete them via your lungs (& of course out the other end when you fart!) Anyway – first step is to get the test to see if you have high levels of hydrogen & / or methane.
**Get breath-tested by a professional – & if you test positive for SIBO, it is best to work under the guidance of somebody experienced with a SIBO-suitable diet & treatment protocol**
What Is The SIBO Diet & Treatment Like?
You may find following a SIBO friendly diet is all you need to heal your small intestinal lining & reduce the overpopulation of bugs. Or you may need some extra assistance with antimicrobial herbs or even an antibiotic. Symptom relief can happen very quickly but long-term normalisation of the gut will take much longer, this is not a magic bullet!
There are a few diets (& many variations & combinations of them) that can be used for SIBO treatment, The Low FODMAP diet, the GAPS diet, the SCD diet & the Cedars Sinai Diet are all worth exploring – but to get good results with these, please seek the guidance of a professional! You may end up disappointed & rule them out as ‘useless’ just because you aren’t experienced enough to get the best out of them.
If you & your health professional aren’t getting the results you’d like with your gut symptoms, look into the possibility of SIBO, especially if you’re one of those people who can’t tolerate probiotics.
*There are some different types of probiotic that seem to be better tolerated / beneficial for SIBO. While many of the typical formulas tend to aggravate – here are a couple that should be ok for most.
Saccharomyces boulardii – this organism is available from many brands. Just ask in the healthfood store / chemist for an ‘SB probiotic’. It is a yeast which can help crowd out the baddies, & it is also really great to use with antibiotics as a preventative for the all-too-common post AB candida overgrowth.
‘Prescript Assist’ – this is a shelf-stable, broad spectrum (29 strains), soil-based-organism probiotic formula that many with SIBO report having success with. We’ve added it to our website for purchase as it’s hard to find in stores & I get so many people asking for a good probiotic! We’ve read a lot of positive reviews & even done a few internal trials here ourselves, it seems to be a winner!
Click here to try some ‘Prescript Assist’
If you have any specific questions on Probiotics, just send me an email and I’ll try and help further.