SIBO is an acronym for small intestinal bacterial overgrowth. Could this be the root
cause of all those annoying symptoms ranging from headaches, depression, muscle
aches and joint pain to restless leg syndrome? Although SIBO usually causes
bloating, constipation, diarrhea or abdominal pain, it may manifest in other ways
without gastrointestinal symptoms.
Too many bacteria in the small intestine disrupts the metabolic dance that
maintains our neurological and immune systems. SIBO happens when the bacterial
count in the small intestine increases by 100 times the normal. According to Dr.
Mark Pimentel, MD, director of the GI Motility Program and Laboratory at Cedars
Sinai Medical Center in California, SIBO often can be traced back to a food
poisoning insult. The pathogenic bacterial toxins that cause food poisoning
symptoms also damage the nerves responsible for bowel peristalsis.
Normally, peristalsis is how the small intestine contracts rhythmically to clean itself
between meals. A quiet or slow moving bowel allows bacteria to multiply and over
colonize their territory.
Food poisoning is more common in people with low stomach acid. Our stomach acid
not only digests our food, but it also kills the bad bacteria before they reach the
small intestine. Causes of low stomach acid include age, chronic antacid use or
Besides food poisoning, a structural cause of SIBO could be a malfunctioning ileo-
cecal valve allowing colon bacteria to migrate up into the small intestine.
How does SIBO cause those seemingly unrelated symptoms?
First, the microbes actually steal the vitamins, minerals, amino acids and fats
needed by the body. B12 and iron levels fall along with fat soluble vitamins A,D,E
and K. Calcium and magnesium deficiencies occur forcing the body to take these
minerals from the bones. Amino acid deficiencies lead to impaired neurotransmitter
production. Together, these deficiencies lead to the above symptoms and more.
Second, certain SIBO bacterial pathogens like Proteus and Clostridium, create an
overabundance of ammonia when they metabolize protein.
Ammonia in excess is a neurotoxin that leads to brain inflammation and impaired
neuronal function. Frightening symptoms of brain fog, mental confusion and
cognitive difficulties result.
Third, SIBO bacteria disrupt the small intestinal lining resulting in “Leaky Gut.” This
permeability leads to autoimmune disease.
The diagnosis of SIBO can often be made by a simple blood test called the
IBScheck test. It was developed by Dr. Pimentel in 2015. It identifies antibodies to
bacterial toxins. Other tests for SIBO include the urine organic acids test and the
hydrogen/methane breath test.
There are several other clues that you may have SIBO. According to Dr. Allison
Siebecker, ND, Co-founder of The SIBO Center for Digestive health in Portland,
Oregon, if a person feels much better during and after taking antibiotics, then there
is a good chance they may have SIBO. If they experience worse symptoms while
taking fiber, probiotics and prebiotics or if they don’t improve much on a gluten free
diet, they probably have SIBO. Also, a person with chronically low iron and ferritin
may have SIBO.
The treatment of SIBO involves dietary changes and antimicrobials.
I hope this little introduction to SIBO as a cause of many symptoms has been
elucidative. At IMI, we listen and find the source of your issues. If you are ready to
identify and treat the root cause, give us a call at 208-426-0052.