What Causes SIBO Bloating, And How To Overcome SIBO Permanently
Does your stomach bloat so much after eating that you feel the need to un-button your jeans, or even think you could look three months pregnant? Or maybe you’ve noticed that you rest for the night and when you wake up your stomach feels more flat in the morning but by the end of the day the bloating is back and you could look almost pregnant again.
If you struggle with bloating and gas, you already know how uncomfortable, embarrassing, and even painful bloating can be. Bloating interferes with your daily life, social interactions, can affect your self image, and could mean your health is off track especially if remains not properly addressed.
The truth is, any amount of bloating is a sign of inflammation in your gut. In my almost 2 decades of practice, I find the number one cause of bloating to be is a gut infection known as SIBO, or small intestinal bacterial overgrowth. When you overcome SIBO by tackling it with the right steps using my 7 step plan, you can say goodbye to discomfort and bloating and start feeling your best!
What Is SIBO?
SIBO or Small Intestinal Bacterial Overgrowth is an imbalanced condition that happens in the upper intestine condition when bacteria overgrow.
Your gut is home to trillions of microorganisms that include bacteria called your microbiome. These bacteria play a central role in your health affecting all systems in your body including your digestive, immune, brain, mood and metabolism. Under healthy circumstances, most of the bacteria in your gut are located large intestine, with a much smaller amount in the upper small intestine.
But under circumstances that cause imbalance in the healthy gut bacteria called dysbiosis, and circumstances that take the natural healthy balance of your gut off track, bacteria can overgrow in the small intestine where they are not supposed to under healthy circumstances, resulting in the condition small intestinal bacterial overgrowth or SIBO. This is an abnormal condition for the body and not only causes you to not feel well and have unpleasant symptoms but can negatively affects the health of your entire body. SIBO is correlated with chronic disease meaning those with more serious chronic disease are likely to have SIBO.
SIBO is under diagnosed and under treated conventionally and even when diagnosed is challenging for most physicians and even famous centers and hospitals with gastrointestinal motility centers to treat and treat successfully.
There are many people who are suffering from SIBO and are misdiagnosed and mistreated with medications like antidepressant drugs when the problem is actually SIBO. They are told that they are depressed or what they are feeling is ‘just in their head’. They have symptoms and they may have a colonoscopy which did not show bleeding or cancer (which is what a colonoscopy usually looks for) so the doctor concludes there’s nothing wrong.
Unfortunately when it comes to chronic health conditions conventional medicine misses the target. They are not looking at the details. They look for end stage gross abnormalities they can visibly see like tumors or bleeding. These can happen as later sequelae when the gut is off track long enough. How the gut tell you is off track is with your symptoms, so you and course correct and prevent future disease.
Functional Medicine doctors know that imbalanced gut bacteria and bacterial overgrowth can happen in the small intestine and have a higher index of suspicion for SIBO and this helps us not miss it.
The good news here is that SIBO is treatable. However the bad news is that it is not easy to treat especially when the appropriate treatment protocol is not implemented.
Even when SIBO is treated it is known to easily come back even when eliminated once. This is where expertise in treatment protocols that are individualized and customized come in. When SIBO is treated properly and the entire health of the body and gut is addressed SIBO is much less likely to come back.
Let’s talk about the symptoms of SIBO and what causes SIBO next.
What Are The Symptoms Of SIBO?
Knowing the symptoms of SIBO can help you identify that there may be a deeper problem and make sure you are properly tested and properly treated for your symptom.
23 Symptoms Associated With SIBO
Below are the most common symptoms associated with SIBO
- Loose Stool/Diarrhea
- Alternating constipation and Loose stool
- Abdominal distention
- Abdominal pain
- Fullness even with small meals
- Frequent burping
- Brain fog
- Joint pain
- Skin problems (Rash, dermatitis, eczema, acne, rosacea)
- Food Intolerance (ex gluten, dairy, lactose, fructose, histamine)
- Vitamin or mineral deficiency (ex low B12, Iron, D, Mag, zinc)
- Diagnosis of irritable Bowel Syndrome (IBS)
- Diagnosis of a chronic disease ( Chronic fatigue Syndrome, Fibromyalgia, Autoimmune Disease, metabolic syndrome etc)
- Fat Malabsorption (floating, clay colored, flaky stool)
- Intestinal permeability (Leaky Gut)
- Low Stomach Acid
- Low pancreatic enzymes
What Causes SIBO?
I shared above that SIBO is an abnormal condition that happens in your small intestine where imbalanced bacteria overgrow in an area where usually has smaller numbers of good bacteria, as a result of negative insults to your gut or gastrointestinal health.
So why do some people develop SIBO or other gut health problems and others don’t? Gut health begins even before birth, in utero, continues through the birth process, to the early days, months, and years of life and continues onward. There are things that should happen to favor healthy gut development and insults that can cause imbalance or predispose a person to imbalances in the gut.
For example when you are born by natural vaginal delivery, that is the first place the gut is inoculated with bacteria which is a natural healthy part of gut health development.
If we are born by C-section for example, the sterile environment does not allow for this natural process and this itself can predispose an individual to gut problems especially if insults continue. Being breast fed helps healthy gut bacteria while being bottle fed does not.
Antibiotics especially before the age of 2 also seriously impair healthy gut bacteria and cause imbalance. So these are some early ways an individual can be set up for gut imbalances.
This goes on during the course of life where there can be favorable things that happen from the environment that can nourish and favor the growth and balance of healthy gut bacteria and there can be things that can cause imbalanced gut bacteria and kill off good bacteria.
I explain it as SIBO occurs when your gut is off track, rebalancing the health of the entire gut helps eliminate SIBO, rather than focusing on just the SIBO, we have to focus on the health of the entire gut and all the events and insults to the gut that occurred to get you here
Causes Of SIBO Include
- Antibiotic use or overuse, causing changes in the healthy microbiome
- Poor Digestion caused by low stomach acid, causing increase in undigested food that can cause bacteria to overgrow
- Oral Contraceptives
- Acid-blocking drugs
- Hypothyroidism or low thyroid function which can cause a slowing of digestive processes increasing bacterial overgrowth when food sits
- Diets high in sugar, alcohol, and carbohydrates (which feed the bacteria)
- Chronic Stress can impair healthy digestion and cause imbalanced gut microbes (dysbiosis)
- Physical blockages caused by surgical scarring or diverticuli or Inflammatory bowel disease like Crohn’s can cause bacterial buildup
- Slowed motility caused by diabetes, autoimmune disease or or neurological disease like multiple sclerosis or Parkinson’s
What Causes SIBO Bloating And Gas
When your digestion is off track, and there’s a deficiency of digestive enzymes and incomplete digestion, food particles do not digest properly and foods sits around feeding the small amount of bacteria in the small intestine that grow as a result. Carbohydrates especially feed the bacteria and the carbohydrates get fermented producing hydrogen gas.
We have a single celled organism in our gut as part of our microbiome known as archaea. Hydrogen feeds archaea and it produces methane gas.
That is how those with SIBO have higher levels of hydrogen or methane gas or both in their intestines. This excess gas made of hydrogen and or methane is what is responsible for the bloating, burping, gas that those with SIBO suffer from. This kind of bloating is what can get in the way of enjoying an evening out to dinner with friends, or suddenly finding your stomach distended and painful that you can’t enjoy yourself anymore due to the stress and discomfort.
Although SIBO can be difficult to diagnose and treat for many physicians, the good news is that you can overcome SIBO when we restore balance to your digestive system and repair your gut health thereby eliminating SIBO for good and the bothersome symptoms that go along with it.
How Do You Diagnose SIBO
It can be difficult to diagnose SIBO and like we discussed above, SIBO is under diagnosed and under treated and more common than expected. One of the most important factors in correctly identifying SIBO is having a high index of suspicion for the problem especially when some of the symptoms or associated conditions are present. In the past the gold standard of testing to identify SIBO involved an invasive intestinal biopsy
Luckily today we have an easy way to assess for small intestinal bacterial overgrowth. It involves breath testing to measure amount of gas produced by the intestinal bacteria in your gut after drinking a specific solution of either glucose or lactulose. Then the levels of hydrogen and methane production by the intestinal bacteria are measured in a 2-3 hour period. The amount of increase in the gases is used to determine if small intestinal bacterial is present or likely or not.
Comprehensive SIBO Treatment
When they are able to suspect and diagnose SIBO, conventional medicine uses antibiotics to treat it. The conventional medicine thought is to kill the bacteria. The problem is that almost everyone develops it again despite being treated or the treatment does not work in some cases. I was one of them. In the past before I was a functional medicine doctor, like most when I took the conventional treatment of antibiotics for SIBO, my symptoms temporarily slightly improved but returned as soon after.
That is why I always ask why and how did the disease happen, not just identify symptoms and treat symptoms. In functional medicine this is referred to as upstream medicine vs conventional medicine that practices downstream medicine.
Upstream medicine refers to identifying and addressing events that occurred years or even decades before the disease happened leading to thee disease that then has symptoms or sequelae downstream. If we only treat the downstream effects, like the overgrowth of Bactria in the small intestine, and not ask the important questions of how and why did we get here and address those as well, it is common sense that we will likely not be successful for long because the root causes are not addressed.
That’s why I have one of the most successful SIBO treatment protocols and have success with my patients even if they have been treated for the problem elsewhere before only to find it returning.
Treating is SIBO is not as simple as just take this antibiotic for 14 days. Aside from rebalancing the entire health of the gut, optimizing digestion, repairing gastric and intestinal lining and eliminating not only bacteria but the biofilm (layer bacteria create to hide under that can make them hard to kill with antibiotics) we have to assure thyroid health is optimized so digestion is not sluggish, and the body has good detoxification support and eliminate toxins that can add to SIBO development.
Although it is common and attractive to see 3 steps to eliminating to SIBO, the truth is there is more than 3 steps to eliminating SIBO.
How To Overcome SIBO Permanently
Once we suspect SIBO based on symptoms, we can make a definitive diagnosis with the right test. But paying close attention to symptoms we can highly suspect and even diagnose SIBO. Once we identify SIBO as the cause of bloating and discomfort I follow a 7 step approach to treating SIBO for good. These steps will help get your entire gut health back on track and help eliminate the overgrowth of bacteria in your small intestine.
The Seven Steps To Overcome SIBO Permanently:
Step 1: Stop Feeding The Imbalanced Bacteria
Right away we can begin the healing process by removing foods in the diet that feed the overgrown bacteria in the small intestine. Foods that feed SIBO are sugar, carbohydrates and alcohol. If you want to optimize and speed up your healing process with SIBO you want to remove obvious carbohydrates and sugars like sweets, cookies,
cakes, baked goods, sandwiches, breads, tortillas, cocktails but also eliminate beans and grains because they break down to sugar in the gut and feed the bacteria just like plain sugar does.
Instead, opt in for high quality proteins like eggs, grass-fed meats and eat plenty of green leafy vegetables, healthy fats, and small amounts of berries like blueberries while minimizing other fruit due to sugar content.
Step 2: Optimize Your Digestion
Step 1 already helps start this process because grans and beans are high in lectins and hard to digest while high in anti-nutrients. Most people with SIBO are deficient in digestive enzymes, for some that’s part of the how and why they developed SIBO in the first place. Adding the right amount and kinds of digestive enzymes is a key part of healing SIBO and one reason so many fail to do so in the long run.
My Health Restore SIBO Clear Kit includes the right kinds of Digestive enzymes to help you be successfully at eliminating SIBO in the long run. The right amount Digestizyme Betaine HCL and Digestizyme Supreme are key to eliminating SIBO in the long run and optimizing your absorption of vitamins and minerals, while improving your digestion of food particles and decreasing the chances of bacterial overgrowth, leaky gut and autoimmunity which can be triggered by poor digestion.
Step 3: Heal Gastric Lining
This is another step that is missed by almost everyone out there, conventional and contemporary SIBO specialists. Most people with SIBO have a degree of inflammation in the stomach lining known as gastritis, and which came first the gastritis or SIBO can vary.
Nevertheless supporting gastric lining and healing the inflammation is a key factor to eliminating the most bothersome symptoms that include bloating, burping, feeling fun after small meals and stomach pain. Healing the lining of the stomach also helps you absorb vitamins and minerals better a common problem see in anyone suffering from SIBO. I love Gut Repair, I have tremendous success with this specially formulated type of zinc along with carnosine both personally and in all patients suffering from symptoms of stomach lining inflammation, bloating, burping, pain, fullness and anyone with reflux.
Step 4: Kill Off Bad Bacteria
Most doctors who address SIBO use the antibiotics Xifaxan (Rifaximin) and Neomycin to try to treat it. In my practice I do use these at times after a clear discussion with my patient of the pluses and potential minuses of doing so. Xifaxan is more effective against hydrogen-dominant SIBO, and Neomycin tends to be more successful with methane-dominant SIBO.
The problem is that although symptoms may decrease temporarily after using the antibiotics, the problem almost always returns in anyone suffering from SIBO, because using the antibiotics addresses the symptoms of SIBO (bacterial overgrowth) but not the cause of how and why we got here! The other problem is that it is possible to create resistant bacteria with using the antibiotics, as it is not uncommon for patients with SIBO to take them multiple times.
Studies have demonstrated that alternative herbal preparations are as effective if not more effective in the long run compared to antibiotics and they work great.
I’ve helped numerous people successfully treat SIBO with comprehensive gut health restoration treatment plans. You can do a lot for yourself by implementing parts of this plan at home with great success. For self-treating, I recommend Candibac Clear and Berbemycin Lean. They include potent, targeted, natural ingredients that help eliminate overgrowth of bacteria and yeast and as a bonus Berbemycin Lean has numerous metabolic benefits.
The ingredients kill off imbalanced bacteria and yeast naturally. Anytime we aim to kill bad bacteria we will likely affect some of the good bacteria as well. But when we do this with natural antimicrobials, we affect the healthy bacteria to a much lesser effect as harsh broad spectrum antibiotics for example. Candibac Clear and Berbemycin Lean is a much more gentle and natural approach.
Obviously treatment is more precise and targeted when you work with a functional medicine physician who treats SIBO. Then we would identify exactly what type of SIBO we are dealing with and if we are dealing with both methane and hydrogen then there are specifically formulated botanicals we use in addition to the above to target it. But a great deal can be addressed the self treating correctly at home if you follow the correct steps to repair and rebuild your gut with the 7 steps.
Step 5: Address Bacterial Biofilm
Biofilms are a protective layer of slime like substance that groups of microorganisms like bacteria, fungus, or parasites form. Bacteria form biofilms by clumping together to make them more difficult to find and eliminate. Once they form, it makes them much more difficult to remove without help from biofilm disruptors.
This is one reason why infections can resist antibiotics, because they are hiding in a slimy film, making them a thousand times harder to kill than if they were not in a biofilm. This can cause confusion for our immune system allowing them to remain active or dormant in human cells.
Removing biofilm can be challenging and conventional medicine mainly ignores biofilms thinking bacteria are always free floating ready to be killed which is not the case. In the case of SIBO we have to address biofilm to improve our success rates. I like to use BioFilm Max Defense taken on a totally empty stomach it helps break down bacterial and yeast tough biofilm layer making them easier to kill with antimicrobials.
Step 6: Support Healthy Bacteria
Although there is an overgrowth of imbalanced bacteria in SIBO, supporting your body with beneficial healthy gut bacteria will help support your immune system, balance inflammation, promote healthy intestinal motility and help restore a healthy microbiota, replacing the bacteria causing SIBO. A meta-analysis summarizing 18 clinical trials concluded that probiotics are an effective treatment for SIBO. Occasionally some may feel temporary increase in bloating which has been reported but this is less frequent and most people feel better when supporting their body with probiotics.
In those who feel that symptoms increase temporarily the probiotics are still beneficial addressing and helping improve overall digestive health. Whenever using a probiotic it is very important to know that all probiotics are not created equal and making a probiotic that is effective is not the norm in the general marketplace.
For probiotics to be affective they have to be formulated to withstand stomach acids and remain viable as they passthrough the digestive system, meaning they have to actually be alive and stay alive which is not always the case with marketed probiotics from the general marketplace. They also have to be high in colony forming units (CFU). That’s why I love and use especially formulated Therbiotics Supreme Daily DF which is a high CFU, acid resistant, heat resistant probiotic formula.
Step 7: Heal intestinal Lining
As part of restoring health to the digestive system we want to support health of the intestinal lining in the large intestine. Most people with SIBO also have a degree of intestinal permeability or leaky gut, which feeds the SIBO by adding to inflammation.
Leaky gut occurs when food particles and microbes that are normally unable to cross the intestinal epithelial barrier escape into the systemic circulation due to loss of integrity in the intestinal lining that causes increase in space between the tight junctions that under normal healthy circumstances keep toxins, microbes and undigested food out of the systemic circulation avoiding inflammation and autoimmunity.
Factors that can contribute to leaky gut, include stress; eating pesticide-laden foods; and an overgrowth of bacteria in the small intestine (SIBO). Aside from improving digestion and eliminating common allergens, microbes, yeast and toxins we support the healing of the intestinal lining with specific targeted nutrients like those in Leaky Gut Restore that help nourish and support the lining which is a smooth muscle to regain integrity.
I would mention an added precaution step would be assuring there is normal daily bowel movements. I use Colon Clear Factors in those with constipation initially to help things move along and make sure toxins are not being reabsorbed and food is not sitting around increasing chances of bacterial overgrowth.
I also always address thyroid health. Many patients with SIBO do not have optimal thyroid function and this can contribute to sluggish digestion and bacterial multiplying as food sits around. I do the correct comprehensive advanced thyroid tests and treat with active thyroid hormones if needed while we are healing the digestive system.
So this is my 7 step process for SIBO treatment for good. Most people have great success when they follow the steps in the protocol. For some the best treatment is to work with a functional medicine physician who treats SIBO for more in depth work to make sure all root causes are addressed like toxins and hormone imbalances and thyroid problems and specifically identify types of SIBO and monitor progress.
Suffering from a health problem like thyroid disease, metabolic problems involving weight or autoimmune disease is hard and challenging to deal with. Dr. Rashel Tahzib is a certified Functional Medicine Physician and her personalized customized treatment plans have helped thousands of people to optimize and take back control of their health and well-being.