Here is information on Irritable Bowel Syndrome and Small Intestine Bacterial Overgrowth. I have included recommended doctors, experts, and products that can help you recover from annoying to disabling gut issues.
Only recently, have I learned about this, but being a natural researcher, and a retired (but still curious) nutritionist, once I made the decision to learn about it, I went all in! I’m sharing with you some of what I’ve learned, the most important things I feel you should know, and links to leading experts on the subject should you wish to learn more yourself.
This article is in no way expected to be a substitute for true expertise, as demonstrated by Doctors Mark Pimentel and Allison Siebeck. This info reflects my personal experience and gleanings, aimed to help you begin dealing with gut issues such as IBS and SIBO should you have them.
Lower down in this article, I have lists of helpful products and resources, as well as lists of experts and their websites where you can learn useful information that can help your specific situation. While I share general information, please remember that everyone is unique. So your bowel situation, it’s ecology, and its mechanics may not fall into a “something everyone should do and use” category.
IBS (Irritable Bowel Syndrome) and SIBO (Small Intestinal Bacteria Overgrowth) have only recently been researched deeply. It was previous assumed that bowel issues were emotional, since most of the sufferers appeared to be women, and that if you have diarrhea, constipation, or gas and bloating, all you need to do is go to your local drug store and take the appropriate remedy recommended to you by your pharmacist. There, problem solved!
But it’s not “problem solved.” Taking OTC meds or seeing doctors who look for something serious and don’t see it, means that you may be stuck with a long term nuisance in your life, to say the least. So let me explain to you what these two conditions are about.
SIBO occurs when the bacteria that should be in the colon have backed up into the small intestine where they don’t belong, and formed colonies there.
They create all sorts of problems there, especially leaky gut and inflammation. And they are very demanding too, making you crave sugar and carbs to feed them.
Yes, when you are craving a sweet hit or that pizza, it’s not your body that’s hungry and needs nutrition. It’s these pesky gut critters who’ve conquered more space in your gut than the other microbes, and now dominant, are demanding you satisfy their insatiable appetites! And that’s part of why overweight and obese people often feel they are always hungry.
IBS is an expanded level up from, and more serious development beyond occasional constipation or diarrhea, but can show itself as either or both. The difference is that in IBS, you have intractable constipation, unrelenting diarrhea, or a mix of both flip-flopping that can drive you crazy! IBS and SIBO most often occur together, and many doctors believe that SIBO comes first, as if SIBO is the biological platform from which IBS launches itself. Thus, IBS can appear to be an extension or more intense expression of SIBO.
Whether you have only SIBO or you have both SIBO and IBS going on at the same time, you can have frequent or constant pain, gas, and bloating. You can have leaky gut, poor food absorption, and can load on the pounds or do the reverse, get rather thin (the starving look).
In harsh cases, your ability to poop or your unpredictable pressure to poop can run your life. Every day, you will always have to make sure you are near a toilet just in case you get explosive diarrhea or those laxatives finally hit!
Sometimes the symptoms are obvious and so a person can know which form of IBS he or she has. But if you go into treatment with a doctor, the doctor will determine your form; SIBO, and then SIBO with IBS-D (diarrhea), IBS-C (constipation), or IBS-M (mixed). He or she will do this by having you do a breath test. If your breath reveals methane, you have IBS-C. If it’s hydrogen, you have IBS-D. If you have both, it’s IBS-M.
Before you rush off to find a doctor however, please read the following. Most people may not need a doctor at all. But after you try out easy to obtain and natural remedies for this and you still have terribly debilitating symptoms, then you may have to go see a doctor. Below, I discuss both what you experience with a doctor and what you can work with on your own.
There are several causes or triggers for IBS/SIBO. Here are the ones that I know. Since SIBO can build up over months or years of bad diet, low physical activity, toxins, and such, it may not be identified until IBS shows up. So these causes or triggers are mostly focused on the IBS symptoms. Doctors can have more than these 5 basic ones, which I will briefly share later.
It often appears after food poisoning, and thus is known as “post-infectious IBS.” Women are more susceptible to food poisoning than men, so there are more women suffering from these conditions. That has led many doctors, mostly male, to assume that IBS was mostly a psychological issue of women’s. However, while emotional distress can play a role in IBS or SIBO, there are distinct physical issues that are the true cause or triggers.
Many people who have had infections, parasites, and other stresses in their intestines, have also suffered from excessive inflammation. Even when the inflammation dies down, the impact on it can remain in the form of adhesions. Adhesions are scar-like filaments that grow around and between the intestines. The small intestines make over a hundred turns and these adhesions can squeeze, distort, pull, or otherwise make transit through the intestines slow down, become difficult, or in the case of a bowel obstruction, actually come almost to a halt.
When there’s a full blockage, the urgent solution is usually surgery, although this is fairly rare. Most people who react to their adhesions have a partial blockage. These blockages create tremendous bloating and intense pain. If you suspect you have a total blockage (symptoms above) and can’t move your bowels at all, call your doctor asap!
I recommend that with any intestinal disturbance and digestive disorder, the sufferer needs to find someone who can manually break down the
adhesions. This is a painful process but brings amazing relief! And it opens up the channels for the feces to move through correctly and promptly.
3.Sacral and Lumbar Nerves
Along with the structural or mechanical limitation of #2, you can also have a break in your nerves serving your lumbar and sacrum. The “pelvic nerves” need to be addressed also with someone skilled in reconnecting them or making sure that the “messages” from the brain to the gut and to the eliminative system is in working order. The symptom of this can range from the lack of an urge, to excessive pain in your lower gut.
I have found personally, that it’s not so much that the nerves are “cut” and therefore physically not present, but that most of this “disconnect” can be addressed as a loss of nervous system communication from brain via Vagus Nerve or other nerves to the bowels.
Besides IBS symptoms, this missing information to your brain can result in walking imbalanced, having difficulty eliminating stool, dropped pelvic floor, or poor proprioception, i.e. knowing where your body is in space. A lot of my issues were handled by energetic healing done by my husband Daniel-the-Healer without the need to go to a doctor or endure surgical interventions in my body. And when he couldn’t do it, I went to a Chiropractor, the muscle-testing kind, who reconnected the network energetically with my brain too.
Perhaps a good Muscle Activation Technique (MAT) practitioner can help with this on the physical level. Some chiropractors may know how to do muscle activation, and some gifted bodyworkers may also be able to help on this front.
4.Shock and Trauma
Another cause or trigger is emotional shock, distress, and trauma. If you get stuck into total fear or anxiety, such as high stress (intense fight-or-flight situations), PTSD, or threatening life circumstances after a huge emotional or physical trauma, you can keep triggering IBS. You may eat comfort foods, increasing SIBO and thus reinforcing IBS.
And when your body is stressed, your body takes its attention off your digestion and rest, so you cannot absorb well, nor can you sleep well. It’s well known that some people, encountering a shocking situation poop in
their pants in terror. That’s the body getting that poop out of the way so it can attend to the emergency or get away.
Stress can always make symptoms worse. So you need to know how to switch from your fight-or-flight mode (the Sympathetic Nervous System) deliberately to your rest-and-digest mode (the Parasympathetic Nervous System). You should be in your Parasympathetic System most of the time, with only short forays into the Sympathetic System when actual threats present themselves.
Not everyone reacts to stress the same way. While everyone knows the “fight-or-flight” stress response, there’s a third response, called the “freeze.” This is what animals use when they are around their predators and they get totally still and unmoving. Their metabolisms shut down and they barely breathe. When the danger is past, they rouse themselves, shake their body, and then return to normal functioning. Humans can also have this freeze response to stress, and that can make SIBO and constipation so much worse. It also slows down gut transit time severely, which causes self-poisoning from retaining toxic feces for too long a time, as well as distending the large intestines that are engorged with poop into what is called “mega-colon” that has little or no responsiveness to stimulants.
What can also maintain high stress levels and the body’s fight, flight, or freeze response are feelings of shame, inadequacy, undeservingness, failure, worthlessness, insecurity, self-hatred, overwhelm, too much unrelenting pressure and demands from others, and feeling never good enough and always behind. Of course, if you have this dark emotional stuff going on, you need to get counseling and emotional healing to take care of that.
So what is YOUR reaction to high stress?
5.Dysbiosis, imbalanced Gut Ecology
Dysbiosis, or biological dysfunction, is the term given to a gut with compromised microbial balance. You see, your gut is filled with non-human cells. These are microbes, bacteria, fungi, yeast, and many other alive critters, most of whom usually help you digest your food by doing the hard work for you. Half your poop is the poop from the digestion of your food and fiber by these hard-working microorganisms!
The overall ecology of your gut is called your Biome, and in this “balance of nature,” there are also “baddies” in your gut. Baddies include excessive yeast (candida), allergens you react to (think gluten, milk, soy, etc.), toxins taken in from your environment (food, water, air) that are a hardship and load on your system such as industrial wastes and pollution, radiation (nuclear, microwave, and other EMF’s), heavy metal buildup, parasites, infectious viruses and other organisms (think herpes, Epstein-Barr), and house and garden chemicals (cleaning agents, herbicides, and pesticides).
While normally the good ones outnumber the bad ones (80% to 20% or thereabouts), sometimes the bad ones can get out of bounds and throw your gut into a battle for breeding room. This can create a lot of physical stress and distress, because you can have difficulty digesting and absorbing food.
Plus, most of your immune system that gives you resistance to infections and disease is in the gut. With imbalances of the gut bacteria, your immunity can suffer and you can get ill easily. This is compounded when you are exposed to toxins in your food, in your water, and in your air. Allergies can off-balance your immune system in your gut and aggravate symptoms.
6.Other metabolic factors
Functional Medicine doctors (see more on them below) will also consider other factors that may not look associated with IBS directly but are indirectly a strong support for SIBO buildup and body reactivity. These additional factors include genetic/inherited mutations in the DNA, cellular issues such as mitochondrial dysfunction, nutritional deficiencies, poor overall detoxification, difficult response to oxidation and inflammatory factors with subsequent poor cellular repair, and hormonal imbalances.
Your Discovery and Choosing your Healing Path
The treatment of any imbalance requires first, an understanding of what specifically is creating it and how it got this way. Most importantly, if you can identify the triggers and causes, you can then systematically and consciously remove them!
But then always comes the experimentation, with your body as the laboratory. We are all unique and very very complex! What works for one
person will not work for everyone else. Even if you go to a Functional Medicine Doctor or one of the experts I’m listing below, the answer to your condition and the best workable protocol will only be revealed as you try out this or that. I think that’s part of why a Doctor calls his or her business a “practice!”
Now you can begin by educating yourself and seeing what products may help you, discovering what imbalances you have, and taking steps on your own to get back in balance. This works if you are, like I am, naturally curious about biochemistry, healing, and the mysteries of the body. I have read professional, in-depth books explaining protocols for conditions I don’t even have because of my fascination!
This approach also works for you if you are desiring to be totally conscious and responsible for your life and healing processes, and are also willing to dismantle any myths you carry with you, or personal “stories” about how things are for you. It works for you too if you are willing to create and manifest a new life in the emotional, mental, and spiritual levels, if you wish to create a New Life of healthy vitality for yourself and your loved ones (who have to bear with all your difficulties!). If you are not a metaphysician and being your own guru in life does not interest you, you will not want to pursue this direction on your own.
If this learning process appeals to you, or you’re willing to try some simple solutions out first before consulting experts and doctors, then check out the resources I provide lower down in this article that should enable you to get a jump start on your education, or even decide what expert or doctor you may want to see. Even if you like to educate yourself on your own and be self-sufficient, your biome and biochemistry is a huge, detailed and unique world. To navigate it, you’re going to need help in the form of input from those who know more than I do.
But if you’re a beginner on this journey and see body function issues as total drags you’d rather never think about, then I suggest you ask a real expert to guide you through this. And that’s DEFINITELY NOT ME!!!
So first, I’ll explain what you can expect from an expert, so you can get an idea of what’s involved.
Find a Doctor
To find a doctor who can help you through the process, you can look in two places. One, you can read about the doctors I have listed here in this article. Several of them use antibiotics and medications. But there are many who don’t. The more natural approach to healing the body and its functions are addressed by practitioners of Functional Medicine. Functional Medicine is a medical practice or treatments that focus on optimal functioning of the body and its organs, usually involving systems of holistic or alternative medicine. Because it looks into natural remedies and protocols, traditional medicine practitioners sneer and laugh at it. But it is rapidly gaining ground because it focuses on the interactions between the environment and the gastrointestinal, endocrine, and immune systems, and is therefore more integrative. Functional Medicine doctors sometimes refer to what they do as “Integrative Medicine.”
If you prefer to work with someone locally, you may be able to find a Functional Medicine doctor near you. Google Integrative Medicine or Functional Medicine doctor and see what comes up. If that doesn’t yield results for you, the Institute of Functional Medicine has a listing where you can search for a Functional Medicine doctor near you.
When you go to a doctor, your imbalance is first identified as being either Methane Dominant (SIBO and IBS-Constipation) or Hydrogen Dominant symptoms (SIBO and IBS-Diarrhea), or both. Once that is known, a doctor will often put you on a program with an antibiotic that works to kill out a lot of bacteria in the gut. There are several antibiotics that don’t mess up the whole body but target the organisms PRIMARILY in the gut.
Detox the Baddies
During the time that you take an antibiotic, you don’t take probiotics or restorative bacteria, as they feed bacteria in your gut. The idea is that if you kill off a lot of microbes, this makes room for new, better bacteria to replace them later, improving the good-bad balance. When the antibiotic cycle is over, then you replenish your gut with probiotics that build your new, improved biome.
Now, if your gut issueslife-threatening life threatening and severe, you can consider avoiding the antibiotic or meds (some of us don’t handle them well
at all!) and doing your gut healing more naturally and slowly. You do this by going on a good low carb diet with lots of good nutrition and good healthy organic foods. Along with this, you can also detox baddies slowly through using several gentle products.
Unless you are doing a focused “kill the baddies” process, you can continue to take good probiotics. I can’t take you through all the options here. There are many variants on this detox, clean-out, and replace theme. This is where more info from experts comes into play.
Along with this antibiotic, parasite cleanse, or detox the baddies process, you go onto one of two types of diets. I don’t particularly recommend the first one, but there seems to be a lot of enthusiasm around it online. It’s known as the “Elemental Diet,” an extreme diet intended to starve the microbes in the latter part of the small intestine that are the SIBO. So you eat only things that are quick to digest and absorb, in the earlier part of the small intestine; foods such as white bread and potatoes! You don’t gain weight on this diet because it simply does not supply all the nutrition you need but you risk getting a very nasty candida infection.
This diet is also NOT for hypoglycemics as blood sugar can soar and crash, exhausting you. As you can imagine, this diet is controversial! Until you know a lot and are adequately prepared, I don’t recommend that you even remotely consider this. I just put it here because if you do research, you’ll come across this and the theory is very tantalizing!
There are other diets that go along with the antibiotic and also what you can do for yourself even without the antibiotic for good results. These diets reduce the food supply to the bad bacteria living at the tail end of the small intestine, albeit more slowly. Of course, you already have guessed by now that you’ll have to give up sugar and starches, junk food, refined food products, snacks and chips, etc. You’ll want to eat organic where you can and drink pure water and exercise. This can keep SIBO and IBS from getting worse, although it doesn’t get rid of it.
To do more, you need a SIBO diet. A list of what you can eat and what you can’t can be found on Dr. Allison Siebecker’s website along with other great resources on IBS and SIBO. Check out http://www.SIBOinfo.com for lots of info and here’s the link to the page with all the info on the diet.
https://www.siboinfo.com/diet.html While you can find food lists on various websites, I like the thoroughness of hers.
A common feature in SIBO diets is that it is “Low FODMAP.” High FODMAP diets are ones in which there is a lot of foods eaten that are high in fermentable ingredients. Fiber, for example, cannot be digested by human cells, so the microbes do it. Too much fiber or sugars, as they ferment very well, and you have a greater risk of SIBO or you expand and increase the SIBO you already have. The gums used in so many protein powders and supplements are high FODMAP. So, to reduce the food to the baddies, you have to go low FODMAP. You’ll see this term explained on Dr. Siebecker’s site and referred to again and again when you read about SIBO diets.
Overall, a good low FODMAP healing diet will be similar to Paleo, Weston A Price diet, Atkins Diet, the GAPS diet, or the “Carbohydrate Specific Diet,” i.e. a low carb diet with high protein and fat.
However, you may find biome success with a popular diet mostly oriented towards losing weight and gaining energy. One is the Gundry Diet from Dr Steven Gundry (read his book The Plant Paradox, and learn from him at https://gundrymd.com/gundry-md/). Another is the Medical Medium diet (Anthony William is the Medical Medium, a more vegan approach, see https://www.medicalmedium.com/).
And then you may find something else that magically drops into your lap and works for you. If you do, please let me know about it and I’ll look into it and perhaps share it with everyone.
Probiotics and more
You may not want to do the medical trip, and prefer self-help by using recommended probiotics. As you probably already know by now, probiotics provide your gut with friendly bacteria that can help balance your gut ecology. Normally, probiotics are supplements, capsules taken with food. Many of them do not hold well at room temperature, so make sure which kind you are getting. Some will die at room temperature and you have to keep them refrigerated. Since probiotics are generally not cheap, you’ve wasted your money!
A few years ago, there were very few probiotics available and few people thought about gut issues. I had a severe food poisoning and my gut went
nuts after I ate a moldy cashew. I ended up in the ER with Atrial Fibrillation. There was a heart doctor that saw me, but no gastroenterologist was available! When I asked the cardiologist what caused AFib, he said nobody knew. I wasn’t going to cross him, but I secretly suspected cashews. Now, after discovering how the gut affects EVERY system and organ, I suspect that a LOT of patients in the ER that night were probably there due to their gut issues. But medical people don’t think of the gut, only about the organ or system affected.
Now there are a lot of probiotics available in the market place. In the past few years, researchers have isolated several strains of bacteria that can do great healing for the gut and can address specific gut imbalances. A few doctors are now offering to help their patients heal the gut.
Probiotics can heal your gut if you use them correctly. A lot of probiotics advertise high amounts of bacteria but most of them are killed in the stomach by your stomach acid. Spore based probiotics are capable of making it past stomach acid, so make sure at least one of your probiotics is spore-based. Sporbiotic and Thrive are two like this.
Now if you have low stomach acid, you are vulnerable to having not only the good probiotics get through to the gut, but also baddies that hitch a ride to their new hunting grounds through your stomach. You need to make sure that you have enough stomach acid. This will help your digestion immensely.
You can use probiotics therapeutically and many people have gotten rid of all their symptoms using probiotics. When used correctly, probiotics can push out the bad bacteria and establish themselves in the same space. This is called “competitive exclusion,” and you want a lot of it to heal.
Gradually over time, this competitive exclusion results in the healthy gut balance you want as the good guys become more dominant again. Then your system can function smoothly and correctly.
Besides probiotics, there are supplements that can help reduce bloating and gas, inflammation, and pain. And you can find supplements that specifically address and help relieve chronic diarrhea as well as others that address and relieve stubborn constipation. I’ll share some of these below.
Motility; Peristalsis and the MMC
Along with the biome and all the microbial mix you want in your gut, you need for your gut to move all the debris and trash along to your colon so you can get rid of waste products effectively. A lot of people with SIBO who have the bacterial overgrowth in the latter part of their small intestine will have trouble clearing out the refuse.
So a key part of healing from SIBO as well as from all forms of IBS is to effectively stimulate the muscles of the intestines to clean and clear out stuff. Now we generally think of this as peristalsis, but I’ve learned recently that peristalsis, for the most part, just sloshes stuff around in the small intestine so it will absorb into the villae and provide you with nutrition. It’s the Migrating Motor Complex (MMC) that is responsible for moving stuff along to the colon. This movement is called motility.
A lot of SIBO/IBS people have slow motility, sluggish bowels, slow metabolism, low energy and poor mitochondrial activity, viruses and other baddies that interfere with or slow down the cleanout. So there has been some research into what can speed up motility to normal levels and reduce the overgrowth and sluggishness. Other, often overlooked influences on SIBO buildup is anesthesia and pain medications, as they slow down the gut transit time, and thus doesn’t allow the small intestine to flush out waste. Dr Pimentel noticed this in his gastroenterology practice.
All this info on the MMC was initially promoted by Dr. Mark Pimentel, the pre-eminent gastroenterologist who is focusing on IBS and SIBO research at his clinic in Cedars-Sinai hospital, Los Angeles. His book, “A New IBS Solution: Bacteria, the Missing Link in Treating Irritable Bowel Syndrome” goes into what he found and is now being accepted by Functional Medicine doctors and gut specialists everywhere.
One of the most popular motility encouragers is ginger. Ginger tightens the blood vessels and raises blood pressure slightly and gives you a sense of pep. It also picks up the pace of the Migrating Motor Complex (MMC) so you can clear out stuff.
If you are sluggish, this feels good. However, after a while with ginger (and it varies from person to person), the “pep up” feeling stops and you can have a collapse, the blood vessels relax, and you get low blood pressure. For me, this is enough for me to be dizzy. If you have high blood pressure, you
may not want more ginger. And then again, with HBP you may not be sluggish in your bowels!
Here’s a place where there are several pro-motility supplements, and some are not ginger. I’ve used MotilPro already and a little goes a long way for me since it has ginger.
Fecal Transplant, the Last Resort
If you are the victim of a particularly vicious bug and the probiotics and antibiotics and meds don’t work, like in the case of Clostridium difficile, and you’re in total despair, don’t give up! There is one more treatment option; Fecal Transplant.
It’s known as fecal bacteriotherapy or Fecal microbiota transplantation (or FMT). FMT is the process of restoring the bacteria commonly found in the digestive tract with an infusion of feces (stool) from a donor. The donated biome can repopulate your biome and save your ass (maybe literally? )!
Here’s a brief link to info on that; https://www.healio.com/gastroenterology/therapeutics-diagnostics/news/online/%7Bcda68b65-bf6d-4acf-a482-0a1af9c0e71f%7D/fecal-transplant-shows-promise-in-ibd-other-chronic-conditions
Stool samples are carefully vetted from healthy and strong young people and then are made into either a rectal transplant using liquid or made into a pill you swallow. FMT can not only knock whatever devastating infection you may have, but it’s known to galvanize your immune system and gut and get you back on your feet. It’s controversial and you’re at risk for getting some weakness not spotted by the doctors in the stool sample. But as I said, it’s a last resort!