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 Is it SIBO (Small Intestinal Bacterial Overgrowth)?

Or is it Something Else? 


by Nancy Russell, M.D.


Many people are being diagnosed by conventional physicians with SIBO or small intestinal bacterial overgrowth. This diagnosis is generally made by a "breath test”.

You are given a sugar solution to feed the bacteria in your gut and a certain gas is released that can be measured as you exhale. If you have a positive breath test, then the treatment is to put you on antibiotics. This is sometimes helpful but can lead to other gut issues such as candida yeast overgrowth or the bacterial can return or become a more resistant type of bacteria.    

The symptoms of SIBO are similar to those of (IBS) or irritable bowel syndrome. These symptoms include abdominal pain and bloating, diarrhea or constipation, alternating bowel habits, achy muscles, fatigue and excessive gas. Rectal itching is sometimes associated and skin rashes. SIBO is much more common is people with hypothyroidism or low thyroid. A medical study showed that 54% of those with hypothyroidism also had SIBO, compared to 5% of those without thyroid problems. Low thyroid function can slow peristalsis or movement by intestinal muscles to move food through the digestive tract. When food is stalled, bad bacteria can thrive, and you can end up with SIBO. 

The reason SIBO can happen in the first place is because of a leaky gut so bacteria, yeasts, foods and even parasites get through the gut lining. The gut lining usually protects you from these infections and food sensitivities. The reason you can get leaky gut is from taking prescription medications such as antibiotics, proton pump inhibitors, birth control pills, steroids and NSAIDS (non steroidal anti inflammatory drugs) such as Ibuprofen and Aleve. The gut can also be affected and even damaged by the food we put in our bodies when the food has pesticides, insecticides, antibiotic residues, and hormones. 

So finding out what kind of dysbiosis (out of balance in the gut) is very helpful in treating symptoms of gut imbalance. Comprehensive digestive stool analysis from special functional medicine laboratories can evaluate digestion (pancreas), absorption (small intestine), metabolism (liver), inflammation markers, for blood in the system, and do a microbiology test for bacterial overgrowth, beneficial bacteria, candida and other yeast and parasites. 

This dysbiosis and any other abnormalities can be addressed by taking supplements or medications to correct the problems. For instance, you may need digestive enzymes, probiotics, and a bacteria, yeast, or parasite treatment. Some people need digestive enzymes long term and others just for a short time. Most functional medicine practitioners will treat any parasites first, then the bacteria and candida last. A follow up stool test can assess if further treatment is needed. Most treatments will last from 6 to12 weeks. 

Cleaning up your diet is also very important by eliminating foods that you have become sensitive or intolerant to, eliminating processed and refined foods, and sugar. Sugar is our biggest enemy for not being able to heal the gut. 

After the treatment for the dysbiosis, then it is time to repair the leaky gut and prevent more damage. The diet is most important and several supplements and special foods can be helpful. L-glutamine, an amino acid, comes in many forms but the powder is usually the most effective and needs to be taken for about six months. Other supplements that can be helpful are collagen, bone broth, and bovine colostrum. 

Avoiding other the counter medications as much as possible is also beneficial especially NSAIDS, PPI’s and prescription steroids, birth control pills and antibiotics. Sometimes those medications are needed so other precautions can be taken. 

So if you get diagnosed with SIBO, realize there could be other associated infections and problems that can be addressed by a functional medicine practitioner. SIBO may not be the whole issue and you must get to the root of the problem and find all the pieces of the puzzle of dis-ease. Holistic principles to follow are: look at each person as an individual, get to the root of the problem and partnership with a  knowledgeable person to achieve optimal health. 

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Nancy Russell, M.D. has been a holistic Internal Medicine physician in the Kansas City northland for over 30 years at 5140 N. Antioch Road in Kansas City, MO.


Her phone number is 816-453-5545 and website is where you can get more information. Dr. Russell is board certified in holistic medicine and is a member of the American Holistic Medical Association and a prior board member.

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