Have You Heard of SIBO?

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.

For a more detailed report about the SIBO conference, check out the following terrific blog posts by Kate Scarlata, RD and Patsy Catsos, MS, RD.

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3 thoughts on “Have You Heard of SIBO?

  1. Very interesting, Lauren. And, good information. I wonder how many people we see have SIBO. Maybe more than we think? What is the differential dx besides IBS and do you think more GI MDs test for it now?

  2. Would you be able to come up with a diet/menus for post SIBO treated clients? I was treated with Antibiotics for SIBO. I was given Cedar Sinai diet and LowFODMAP by my Dr. It is hard to know eating right thing and come up with meal plans, especially waiting 4 hours between meals. Thank you for any suggestions.

    1. Hi Marcy, I suggest you take a look at Kate Scarlata’s low FODMAP cookbook and meal plans. I contributed quite a few recipes to the cookbook and it’s a great resource.
      http://blog.katescarlata.com/fodmaps-basics/my-low-fodmap-cookbook/
      http://blog.katescarlata.com/fodmaps-basics/21-days-of-successful-low-fodmap-menu-plans/

      It can definitely be challenging! I suggest you work with a dietitian that specializes in GI/SIBO. He or she could help you with ideas and meal plans. I would be happy to do a Skype or phone consult with you if you don’t live in Boston. Or I can recommend a dietitian in your area.

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