This past weekend I attended an entire symposium dedicated to SIBO, which stands for Small Intestinal Bacterial Overgrowth. This symposium was put on by the SIBO Center for Digestive Health at the National College of Natural Medicine in Portland, Oregon. I wasn’t lucky enough to be there in person, but attended the entire symposium via webinar.
SIBO occurs when bacteria from the large intestine creep up into the small intestine. Because the small intestine is so narrow and the bacteria shouldn’t be there, it causes bloating, gas, and other digestive issues. It is UNCOMFORTABLE, to say the least.
Dr. Mark Pimentel, an expert in this field, hypothesized that more than half of people with IBS have bacterial overgrowth. If you experience extreme bloating and gas, I highly suggest you get yourself to a gastroenterologist to be tested for SIBO. The practitioners at the symposium agreed that a lactulose breath test that measures both methane and hydrogen gas is the best way to measure SIBO. The treatment will depend on the results of the breath test. For more information about treatment, I recommend Dr. Allison Siebecker’s website: www.SIBOinfo.com.
Diet is also important for SIBO and very individualized. There are no clinical studies on diet and SIBO, but there are a few diets that work well to control symptoms: the low FODMAP diet, the specific carbohydrate diet (SCD), a combination of SCD and low FODMAP, and Dr. Pimentel’s Cedar Sinai Low Fermentability Diet. These diets all have conflicting advice, so it gets confusing. We certainly need more research in this area!
If you do have SIBO, one important thing to remember is to space meals 4-5 hours apart to allow your body’s migrating motor complex (also called cleansing waves) to work. The cleansing waves occur in the small intestine every 90 minutes in between meals. Grazing during the day limits those cleansing waves. So remember that goûter I wrote about? If you have SIBO, you may want to skip the goûter, or have it in the late afternoon and eat a late dinner.