There is a tendency to treat small intestine bacterial overgrowth (SIBO) like an infection. After all, it’s referring to bacterial overgrowth, right?
SIBO is not an infection
Rather, it’s a symptom of digestive dysfunction. A type of dysbiosis. Simply too many good gut bacteria that seized the opportunity presented to them. And ended up in the small intestine where they don’t belong.
Yes, antibiotics or herbal antimicrobial treatments can help lower the number of bacteria in the small intestine. But antibiotics don’t solve the root cause.
When you throw bombs into the garden, it kills everything. But the weeds grow back first. Which is why 9 times out of 10, patients get relapse SIBO.
What is the root cause?
Here’s the paradigm shift I’d love to share with you today.
To solve opportunistic overgrowth, you must think about what’s allowing these bacteria to grow. What opportunities are they taking advantage of?
Before we dive into the root cause details, here’s an analogy.
The picture below is where I live in central Idaho (high desert). We don’t get much rain here.
The picture on the left is the mountains in November.
The picture on the right is from June.
After a dry winter (read: very little snow, bad skiing conditions), we had the wettest spring I’ve ever experienced. That spring, I saw more wildflowers—and more types of wildflowers—than I’d ever seen before!
Wildflowers are opportunists. They grow when the conditions are favorable.
The same is true for opportunistic bacteria in your gut!
Treat the root cause
What conditions are allowing opportunistic bacteria to grow in the wrong place?
The root cause of SIBO is digestive insufficiency and slow motility.
Some providers think that SIBO is caused by colonic bacteria crawling back into the intestines via the ileocecal valve.
Other providers (like me) believe that SIBO is initiated by an abundance of mouth bacteria that are not killed by your digestive juices.
- Stomach Acid. The acid bath of the stomach is the first line of defense in killing microbes that get into your mouth.
- Bile is the second line of defense. Bile is created by your liver. Stored in your gallbladder. And released in proportion to the fat content of your meals. It helps you digest & absorb fats. And is also antimicrobial.
If either of these aren’t robust, those bacteria can easily get into the small intestine.
The second root cause of SIBO slow motility.
Think clear moving stream versus stagnant pond scum. Maintaining regular movement of food (and bacteria!) down the tube prevents overgrowth.
What actually works?
Yes, antibiotic or herbal antimicrobial treatment is necessary to help lower the amount of bacteria in the small intestine. But that’s not the end of the story.
I find that most clients can resolve SIBO if they’re doing these four things.
1. Improve digestive dysfunction that’s predisposing you to SIBO in the first place. Yes, you can naturally stimulate your own digestive juices and support your body’s digestive process. And when you’re able to support the digestive process this means you can tolerate more and more foods and have fewer and fewer symptoms.
2. Addressing the root cause. Which means understanding what’s causing the slow motility of the small intestine in the first place. Again, SIBO is not infection. SIBO is caused by slow motility of the small intestine. There are many root causes. And each person may have more than one.
3. Taking time to heal your gut. This includes a gut healing diet, managing stress, improving sleep, and overall just nourishing yourself. Look, I know you just want this to go away already. But know that the quick fixes can actually do more harm than good.
4. Adjusting mindset is key. I get that your symptoms are super uncomfortable and really annoying. But know that they’re telling you something: you need to slow down and pay attention. Yes, SIBO is a project. But you don’t have to figure it out alone.
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To summarize, SIBO is not an infection. It’s a symptom of digestive dysfunction and slow motility of the small intestine. While antibiotics can help reduce symptoms in the short term, there is much more that can be done to help resolve SIBO for good.
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