SIBO is associated with increased levels of anxiety and depression
Proton pump inhibitors are a common cause of SIBO
Treatment typically involves killing the bacterial overgrown bacteria in addition to gut restoration therapies such as probiotics, prebiotics, and herbal therapies.
SIBO stands for Small Intestinal Bacterial Overgrowth, which is a condition characterized by an overgrowth of bacteria in the small intestine. Normally, the small intestine contains a relatively low number of bacteria, as most of them are found in the large intestine. However, in people with SIBO, the bacteria that are normally found in the large intestine start to grow in the small intestine. In this article we are going to explore common questions about this overgrowth including:
What is SIBO?
What causes SIBO?
What are symptoms of SIBO?
How does SIBO affect mental health?
How long does it take to treat SIBO?
What are the best treatments for SIBO?
What causes SIBO?
It can be caused by a variety of factors, including:
Decreased motility: The muscles in the small intestine help move food and waste through the digestive system. If there are issues with motility and if the muscles are not working properly, it can lead to an accumulation of bacteria in the small intestine.
Structural abnormalities: Structural abnormalities in the small intestine, such as strictures, adhesions, or diverticula, can create pockets where bacteria can accumulate and grow.
Impaired immune function: The immune system helps regulate the growth of bacteria in the small intestine. If the immune system is compromised, it can lead to an overgrowth of bacteria.
The symptoms can vary from person to person, but some common symptoms include:
Abdominal pain and discomfort
Bloating and distention
Diarrhea or constipation (or alternating between the two)
Gas and flatulence
Nausea and vomiting
Malnutrition and weight loss
Fatigue and weakness
Joint pain and muscle aches
Skin problems, such as rashes and acne
Iron deficiency anemia
These symptoms can be similar to those of other digestive disorders, such as Irritable Bowel Syndrome (IBS). That’s why it’s important to work with a healthcare professional who can properly diagnose SIBO through tests like a breath test or a small intestine aspirate or biopsy.
It’s also worth noting that some people with this overgrowth may not experience any symptoms at all, while others may have more severe symptoms. The severity of symptoms can depend on factors such as the type and amount of bacteria in the small intestine, the health of the gut lining, and the individual’s overall health and immune function.
2 Key Ways SIBO Affects Mental Health?
There is a complex relationship between the gut and the brain known as the gut-brain axis, and disturbances in the gut can affect mental health and contribute to anxiety and other mood disorders. SIBO can disrupt the gut microbiome and cause inflammation, which can activate the immune system and trigger an inflammatory response throughout the body.
Inflammation and immune dysregulation have been linked to anxiety and other mood disorders, and studies have shown that individuals with SIBO are more likely to experience anxiety and depression. Additionally, some of the symptoms, such as abdominal pain, bloating, and diarrhea, can be stressful and contribute to anxiety.
Another factor that may contribute to anxiety in individuals with SIBO is the impact of the condition on nutrient absorption. It can lead to malabsorption of important nutrients, including magnesium and vitamin B12, which are important for the health of the nervous system and have been linked to anxiety.
It’s important to note that while there appears to be a link between SIBO and anxiety, not everyone will experience anxiety, and not everyone with anxiety will have Small Intestinal Bacterial Overgrowth. If you’re experiencing symptoms of anxiety, it’s important to speak with a healthcare professional who can help you identify the underlying cause and develop an appropriate treatment plan.
How do you test for SIBO?
The most important step towards getting well is getting to the root cause. There are a few different tests that can be used to diagnose Small Intestinal Bacterial Overgrowth. The most common tests include:
Breath Test: A common and non-invasive test for SIBO is a breath test. The test involves drinking a solution of lactulose or glucose and then measuring the levels of hydrogen and methane gas in your breath over the course of several hours. Elevated levels of these gases can indicate the presence of Small Intestinal Bacterial Overgrowth.
Stool Test: This test can identify the presence of excess bacteria in the small intestine by analyzing a stool sample. (Inside the Holistic Wellness Collective, members get access to order my favorite stool test)
Small intestine aspirate and fluid culture: This is the most reliable test for diagnosing SIBO. The test is done by a doctor, who passes a long, flexible tube (endoscope) down your throat and through your upper digestive tract to your small intestine. A sample of intestinal fluid is withdrawn and then tested in a laboratory for the growth of bacteria including the types of bacteria present.
Blood Tests: Blood tests can be used to check for elevated levels of antibodies to certain types of bacteria that may indicate Small Intestinal Bacterial Overgrowth, however this can be less reliable.
It is important to note that none of these tests are 100% accurate and that a diagnosis of SIBO but can be a useful starting point.
What are the best treatments for SIBO?
While antibiotics are often prescribed to treat Small Intestinal Bacterial Overgrowth, there are also natural treatments that can be used to help manage symptoms and promote gut health.
Antibiotics are often used to treat SIBO, and several types of antibiotics have been shown to be effective in reducing bacterial overgrowth in the small intestine. Some examples of antibiotics commonly used to treat Small Intestinal Bacterial Overgrowth include:
Rifaximin: Rifaximin is a non-absorbable antibiotic that is often used as a first-line treatment for SIBO. It has been shown to be effective in reducing bacterial overgrowth and improving symptoms of SIBO, with few side effects.
Neomycin: Neomycin is an antibiotic that is also used to treat SIBO, particularly when methane-producing bacteria are present. It works by reducing the number of bacteria in the small intestine and improving symptoms of SIBO.
Metronidazole: Metronidazole is an antibiotic that is sometimes used in combination with other antibiotics to treat SIBO. It works by targeting anaerobic bacteria that may be present in the small intestine.
It’s important to note that antibiotics are not always necessary or appropriate for treating SIBO, and they may not be effective in all cases. Additionally, antibiotics can have side effects and may contribute to antibiotic resistance, so they should be used judiciously and under the guidance of a healthcare professional.
Natural treatments such as dietary modifications, probiotics, and herbal remedies may also be effective in reducing bacterial overgrowth and improving symptoms of SIBO.
The best natural remedies for SIBO include:
Diet: The low FODMAP diet can be helpful for reducing symptoms by limiting the intake of fermentable carbohydrates that feed the overgrowth of bacteria. This diet involves avoiding certain foods such as wheat, dairy, and beans, and increasing the intake of non-starchy vegetables, low-sugar fruits, and protein sources.
Probiotics and prebiotics: Probiotics are beneficial bacteria that can help restore a healthy balance of gut bacteria. Prebiotics are non-digestible fibers that feed beneficial bacteria. Both can be found in certain foods such as fermented foods like kefir, sauerkraut, and kimchi, as well as supplements.
Herbal remedies: Certain herbs, such as oregano, berberine, and garlic, have been shown to have antimicrobial properties and may be helpful for reducing bacterial overgrowth. It’s important to work with a healthcare professional who is knowledgeable about herbal remedies to determine the most appropriate treatment for you.
Digestive enzymes: Digestive enzymes can help improve digestion and reduce symptoms by breaking down food and reducing the amount of undigested material in the small intestine.
Stress management: Stress can worsen symptoms. Relaxation techniques such as guided imagery, meditation, deep breathing, and yoga can be helpful for reducing stress and promoting gut health.
How long does it take to treat SIBO?
The duration of treatment for SIBO can vary depending on the severity of the condition, the type of treatment used, and the individual’s response to treatment. In general, treatment can take several weeks to several months.
Antibiotic treatment for SIBO typically lasts for two to four weeks, depending on the specific antibiotic used. After completing the course of antibiotics, it’s important to follow up with a healthcare professional to determine if the Small Intestinal Bacterial Overgrowth has been successfully treated or if further treatment is needed.
For natural treatments such as the low FODMAP diet, probiotics, and herbal remedies, the duration of treatment can vary. Some individuals may see improvement in symptoms within a few weeks, while others may need to follow the treatment plan for several months to see significant improvement.
It’s important to note that successfully treating SIBO may also involve addressing underlying factors that contribute to the development of the condition, such as poor gut health, food sensitivities, or immune dysregulation. This may require ongoing lifestyle changes and maintenance to prevent recurrence.
Ultimately, your success with identifying and treating SIBO will depend on getting the right tests, using a holistic and integrative treatment that includes changes in lifestyle and diet, supporting gut healing with herbs, probiotics and botanicals. Treating the gut is often the most important step in treating your mood.
This article is for educational purposes only and is not intended as medical advice. Whenever considering changing your protocol whether it includes a change of medications, supplements, diet or lifestyle, always speak with your primary care physician first.
Dr. Nicole Cain is an advocate for empowering people around the world to help themselves via her educational free resources, online courses, and membership group. You can receive the tools you need to find the root cause of your symptoms and feel healthy again.