Are you prone to tummy upsets and cramps? You might dismiss it as indigestion, but here’s something to consider – you could have a condition known as small intestinal bacterial overgrowth (SIBO).
Normally, the small intestine does not have a large number of bacteria, but people with this condition experience excessive proliferation of bacteria in the small intestine, which can be harmful (exceeding 105–106 organisms/mL).1
When these bacteria break down food, substances that damage the lining of your small intestine can be released, making it difficult for you to absorb nutrients. Moreover, the bacteria present in your small intestine can also use up the food you consume, depriving your body of much-needed nutrition.2
Symptoms Of SIBO
The symptoms can vary from person to person. The kind of microorganism in your small intestine could play a role in the symptom that you experience. For instance, bacteria that convert bile salts to insoluble compounds may lead to diarrhea, while those that convert carbohydrates into short-chain fatty acids and gas may produce bloating without diarrhea.3
But common symptoms seen due to SIBO are as follows:
- Flatulence: Bacteria can ferment carbohydrates in the small intestine and increase the production of gas.
- Bloating and abdominal fullness: Accumulation of increased gas can stretch your abdomen and make you feel uncomfortably full.
- Abdominal cramps and pain: Excess gas, which causes abdominal distension, can result in discomfort and pain, too.
- Diarrhea: When bacteria ferments food, toxic byproducts that irritate the lining of your small intestine and lead to diarrhea can be released. Bacteria can also break apart bile salts, which can then stimulate water secretion in the colon and cause diarrhea.
- Constipation: The presence of microorganisms that lead to the production of excess methane can cause constipation.
- Fatty stool: Some bacteria may make it difficult for your body to absorb fats, leading to the excretion of excess fat in your stools.
- Weight loss: Because the bacteria in your small intestine consume the food you eat, you may not get sufficient calories and lose weight.
Advanced cases of SIBO can also cause malnutrition, dehydration, liver disease, problems with blood clotting because of vitamin deficiency, and poor bone health (osteoporosis or osteomalacia).
Your doctor will be able to provide a definitive diagnosis by performing various tests (such as blood tests, small intestine x-ray, fecal fat test, and hydrogen and methane breath tests) for SIBO.4
What Causes SIBO?
Various conditions can result in the overgrowth of bacteria in your small intestine:
- Pouches or blockages in the small intestine, which can develop due to surgery or some conditions like Crohn’s disease
- Short bowel syndrome, which is caused when a part of the small intestine is removed surgically or is missing
- Problems with movement in the small bowel, which can result from diseases like scleroderma (where the immune system attacks healthy tissues by mistake) and diabetes
- Small bowel diverticulosis, a condition where small sacs develop in the lining of the intestine, allowing the growth of large numbers of bacteria
- Irritable bowel syndrome (IBS), a disorder where your gastrointestinal tract doesn’t function properly
- Problems with the immune system caused by conditions like immunoglobulin deficiency and AIDS
How Do You Treat It?
Your doctor may prescribe antibiotics for treating the bacterial overgrowth or medicines that deal with motility (intestinal movement) problems. Nutrition and fluids may also be administered intravenously if required.
Some herbal remedies have been found to be useful in dealing with microorganisms in your intestines.
- Oil of oregano and horsetail can kill microorganisms in the intestine.
- Indian barberry root extract has antimicrobial and anti-inflammatory properties and help with diarrhea, too.5
Reducing carbohydrates from your diet can also be useful.
|↑1, ↑3||Dukowicz, Andrew C., Brian E. Lacy, and Gary M. Levine. “Small intestinal bacterial overgrowth: a comprehensive review.” Gastroenterol Hepatol (NY) 3, no. 2 (2007): 112-22.|
|↑2||Small bowel bacterial overgrowth. National Institutes of Health.|
|↑4||Ghoshal, Uday C., and Deepakshi Srivastava. “Irritable bowel syndrome and small intestinal bacterial overgrowth: meaningful association or unnecessary hype.” World J Gastroenterol 20, no. 10 (2014): 2482-2491.|
|↑5||Chedid, Victor, Sameer Dhalla, John O. Clarke, Bani Chander Roland, Kerry B. Dunbar, Joyce Koh, Edmundo Justino, Eric Tomakin, and Gerard E. Mullin. “Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth.” Global Advances in Health and Medicine 3, no. 3 (2014): 16-24.|