Bacteria are imporant, if not essential, part of a healthy small intestine and fulfill important functions, participate in numerous digestive processes and more. However, overgrowth of small intestinal bacteria can lead to leaky intestinal syndrome and a number of other, often very unpleasant, symptoms. Find out if you also belong to a group of people who can develop SIBO.
Immoderate alcohol consumption and oral contraceptive pills (OCP) also increase the risk of SIBO
Large alcohol consumption has long been associated with the development of SIBO (3). One study also found a relationship between SIBO and moderate alcohol consumption, defined as one drink per day for women and two per day for men. Alcohol appears to affect several normal protective mechanisms, including causing damage to the intestinal mucosa cells, contributing to intestinal leakage and reducing muscle spasms. In addition, alcohol can "graze" several specific types of bacteria, contributing to their excessive growth (4).
In general, there seems to be a moderate relationship between OCP and inflammatory bowel disease (IBD), such as Crohn's disease (5). Although no studies so far correlate the use of OCP with SIBO, given the known relationship between IBD and SIBO, it is likely that this relationship is also true for SIBO. However, when patients stop taking OCP, the risk seems to decrease. .
How to recognize SIBO at home?
The number of people with SIBO in the population remains unknown. Some studies suggest that 6 to 15% of healthy people have SIBO but are asymptomatic. However, as much as 80% of people with IBS may face bacterial overgrowth of the small intestine (6).
SIBO is largely not diagnosed by doctors. This is because many people do not seek support and think that SIBO symptoms are normal digestive problems. Many doctors are not aware of how common SIBO is. The whole matter is further complicated by the fact that the most commonly used tests (breath tests measuring the level of hydrogen and methane) still have quite high rates of false negative results (which means that the test results return as negative, but you actually have the disease) (7).
The most common symptoms of SIBO are:
- Abdominal pain / discomfort
- Constipation (usually associated with methanogens)
- Gases and belching
- In more severe cases weight loss and symptoms associated with vitamin deficiency may occur
Is SIBO contagious?
Unlike many other bacterial infections of the gastrointestinal tract, SIBO is not contagious and there is no evidence that exposure to a single microorganism increases the risk of developing SIBO. SIBO occurs due to the complicated play of many different factors and is not passed between people.
Why is it so hard to recover from SIBO?
Antibiotics are often used to treat SIBO. However, studies show that despite antibiotic treatment, recurrence occurs in almost half of all patients in one year. One study comparing treatment with rifaximin (the most commonly used antibiotic for SIBO) and botanical antimicrobials showed slightly better results in the botanical protocol, but still with successful treatment in almost half of all patients after one treatment cycle.
This finding suggests that treating the growth of bacteria alone is not enough for most people. An additional part of successful treatment must take into account the underlying cause or predisposing factor.
Although there are many identified links between SIBO and other diseases as described above, bowel motility abnormalities are considered one of the most common associations. One of the studies published this month showed that patients with SIBO have significant delays during passage of food in the small intestine (the amount of time required for passage of the small intestine). This finding suggests that patients with SIBO who do not recover after standard antibiotic treatment or the botanical antimicrobial protocol (which we prefer) may benefit from the addition of a prokinetic factor that increases muscle contraction in the small intestine. Octreotide and low-dose naltreotide are two such options that are tested and can help treat some cases of SIBO that do not respond only to antibiotics.
As we continue to study SIBO, we understand better the complexity of the disease and the way in which treatment must be tailored to each individual to maximize success and minimize the risk of relapse.