SIBO Facts and Diet.docx

SIBO Facts and Diet.docx

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SIBOFactsandDiet

SIBOFactsandDiet

FEBRUARY12,2016 BY MARCSEWARD LEAVEACOMMENT

BRIEFFACTSABOUTSIBO

SIBOortogiveititsfullname,smallintestinalbacterialovergrowthisanintestinalcomplaintwhichisoftenlinkedtoanotherunderlyingillness.Duringtheearlystageofthecondition,symptomstendtobenon-specificbutmayincludeabdominalpain,indigestion,bloatinganddiarrhea.

However,whenthediseaseprogressesfurther,thebodybecomesincapableofabsorbingthenutrientsfromfoodwhichcanleadtovitamindeficienciesandmalnutrition.

Diagnosesareoftendonebyexclusionbutsometimesbiopsies,bloodtestingortissuesamplesarerequired.

THECAUSESOFSIBO

Inhealthypeople,thesmallintestineiskeptrelativelyclean.Foodisreceivedinthestomachwhereitismixedwithacidandotherdigestivejuices,whichtransformsyourfoodintoacleansubstance.Thisslurrygetspushedthroughthesmallintestinewherethebodyabsorbsnutrients.Thewastegetsdumpedintoyourlargeintestinewhereitabsorbswatermakingthefecesmoresolidbeforetheyareexpelledfromthebodyinabowelmovement.

Ourgutisfullofbacteria,muchofwhichisgoodforus,thisintestinalfloraisvitaltotheefficienthealthyworkingsofthedigestivesystem.IntestinalflorahelpsustodigestimportantvitaminssuchasvitaminKandfolicacidwhilealsoprotectingtheintestineagainstinvasionbyharmfulbacteria,thetypeofbacteriathatcausesdisease.

However,ifnormalintestinalfunctionsarecompromisedthenanovergrowthofbacteriacanoccur.Thereareseveralreasonswhythiscouldhappen;itmaybecausedbyinsufficientstomachacidorresultfromintestinaldamagefromalcoholortoxinsforexample.Itcouldalsobecausedbythesmallintestinetransferringwastematerialtothelargeintestine（orcolon）lessefficiently.

RISKFACTORS

AsImentionedintheintroduction,SIBOisoftenlinkedtounderlyingillnesseswhichaffectthewayinwhichthesmallintestinefunctions.Bacterialgrowthisgenerallykeptincheckthroughanumberofbodilyprotectivemechanismssuchasintestinalmobilityi.e.thewayinwhichitmovescontentsthroughthedigestivesystem,andalsostomachacidity.Ourbody’sbilecontentalsohindersbacterialgrowthwhileourileocecalvalvepreventsstoolsfromrefluxingoutofthecolonintothesmallintestine.

Anillnessoradiseaseofsomekindwhichharmsthebody’sdefensivemechanismcanputapersonatagreaterriskofSIBO.However,itismostoftenamotilityproblemoftheintestinesthatleadtoapersondevelopingSIBO.Examplesofthisincludecomplicationsfollowingagastricbypassoperation,tumorsandbowelstricturesoradhesions.

CertainneurologicaldiseasessuchasParkinson’sdiseaseandmyotonicdystrophymayalsoaffectbowelmotilityascandiabeticneuropathy.

OtherdiseaseslinkedtoanincreasedriskofSIBOare:

∙Celiacdisease

∙Crohn’sdisease

∙Diverticulitis

∙Alcoholabuseandlivercirrhosis

∙Achlorhydia（achronicinflammatoryconditionwhichpreventsthestomachfromproducingacid）

∙Leukemia

∙Lymphoma

∙Scleroderma

SYMPTOMSANDDIAGNOSIS

ASIBOdiagnosisisdifficultbecausetherearenoactualspecificsymptomsthatcanleadtoadirectdiagnosis.Instead,SIBOisconsideredasoneofavarietyofunspecificsymptomswhichputtogethercanleadtoadiagnosis.

INITIALSYMPTOMS

Theinitialsymptomsaffectingthedigestivesystemandstomachincludeoneormoreofthefollowing:

∙Abdominalpain

∙Diarrhea

∙Indigestion

∙Bloatingandflatulence

LONGERTERMSYMPTOMS

Astheconditioncontinuestoprogress,theovergrowthofbacteriapreventsthebodyfrombeingabletoeffectivelyabsorbthenutrientsfromfood.Thiscanleadtoarangeofproblemssuchasproteindeficiencies,vitamindeficiencies,electrolyteimbalanceandproblemswithabsorbingfat.

Thebody’sinabilitytoproperlyabsorbvitaminB12canleadtoavarietyofsymptomsassociatedwithanemiaincludingperipheralneuropathyanddecreasedredbloodcellnumbers.AreducedlevelofvitaminAcancausenightblindnesswhileadeficiencyinvitaminDcancausemetabolicdiseasesthatleadtospasmsandbodilytwitches.

ThemalnutritionsymptomaticofSIBOislikelytoresultindramaticweightlossandmusclewasting.Thebody’sdifficultyinabsorbingfatsfromthedietcancauseaconditioncalledsteatorrhea,aconditioncharacterizedbyanexcessoffatinyoufeceswhichinturnleadstooilyandfoulsmellingstoolsandpossibleanalleaking.

SIBODIET

SIBOiscommonlytreatedwithantibioticsbutantibioticsalonetendtobeveryineffectiveintreatingthedisease.SufferersofSIBOmayrequiremanyantibioticroundstogaincontrolovertheirintestinalbacteriallevels.Indeed,evenaftercompletingseveralroundsofdrugs,SIBOmaystillreturn.Itispossibleforbacteriatorepopulatetheintestinewithinafewweeksofcompletingthecourseofantibiotics.

TheSIBOrecurrencerateisveryhigh;around44%ofsuffererswilldevelopanovergrowthwithin9monthsoftreatment.Toensurethatyougetridoftheconditionentirelyandtohelpitstayawayforgood,itisvitalthatyouaddressanyunderlyingproblemsthatleadtothecondition.Oneofthemostimportantthingstoconsiderisyourdiet.

Itishighlylikelythatyouneedtomakedramaticalterationstoyourdietinordertopreventarecurrenceofthesickness.Thereareanumberofpotentialdietsbuttheyallhaveonethingincommon….youneedtodiscouragethebacteriabystarvingit.

SOCOULDYOURDIETBECAUSINGSIBO?

Thebacteriathatinhabitourgutisnotalwaysharmful.Thereareahostoffriendlybacterialstrainsoftenreferredtoasintestinalflorawhichperformanumberofimportantbodilyfunctions.Theserolesincludearangeoffunctionsfromaidingthedigestiveprocesstoregulatingyourmood.Andlikeanyotherlivingorganism,bacteriumneedstonourishitselfandfeedoffsomethinginordertosurvive.Andthestufftheyprimarilyliketofeedoffiscarbohydrates

.

Thestandardmodernwesterndiettendstobefullofcarbohydratesandnotjustanycarbs,buttypicallysimplecarbohydrateslikestarchyandsugaryfoods.Yourintestinalflorawilldineoutontheseexcesscarbohydratescausingthemtothrive,proliferateandcausingyoutohaveanovergrowthissue.

Anotherproblemwiththestandardwesterndietidthatitisrichininflammatoryfoodsuchasglutenwhichcandamagethestomach’sliningandreducethelevelofstomachacidnecessarytoregulatebacteria.

AsImentionedearlier,thereare5generallyaccepteddietsforSIBOwhichallaimtostarvethebacteriaandpreventitfromovergrowinginthesmallintestine.

1.THELOWFODMAPDIET

ThisisaverypopularandeffectivedietforSIBOwhichwasoriginallydesignedtotreatirritablebowelsyndromebutcaneasilybeadaptedforthepurposesofSIBO.

Thedietisbasedongettingridofthefoodthatcontributestowardsfermentationintheintestines.

BecauseitwasdesignedforIBDandisalsoanexcellentchoiceforIBD,thelowFODMAPplandoesnoteliminateeitherpolysaccharideordisaccharidecarbohydratesourcessuchasstarch,grainorsucrose.InmostpeoplethesetypesofcarbohydratesareeasilyabsorbedbutinthecaseofSIBOtheyshouldalsobeeliminatedfromyourdietasbacteriaenjoyfeedingoffthem.

AcomprehensivelistonfoodallowedandnotallowedonalowFODMAPdietcanbe foundhere, butrememberitwillneedtobeadaptedforSIBO.

THESCDDIET

TheSCDdietwasoriginallycreatedtotreatCeliacdiseasebeforebeingpopularizedinabookwrittenbyElaineGottschall.SCDisanacronymforSpecificCarbohydrateDietandliketheFODMAPSdiet;itisdesignedtostarvebacteriatopreventthemfromtakinghold.

TheSCDdietrestrictscomplexcarbohydrates,sucrose,lactoseandothermanmadeproducts.ThesetypesofcarbohydrateareconsideredtobegenerallyunhealthyandevensomebodywithoutSIBOwoulddowelltofollowittoacertainextent.

Carbsofthiskindencouragebacteriatofeedandcanleadtobacterialaswellasyeastovergrowthandotherinflammatoryconditions.

TheSCDisaverypopularandeffectivedietwithexcellentsuccessrates.Estimatesfromsurveyssuggestthesuccessrateisover75%fromfollowingthisdiet.

EXAMPLESOFFOODNOTALLOWEDONTHESCDDIETINCLUDE:

•Grainsandcereal

•Cannedvegetables

•Cannedfruit

•Processedmeatproducts

•Potatoes

•Dairyproducts

•Favabeans

HOWEVER,DONOTDESPAIR,THEREAREPLENTYOFALLOWEDFOODSTHATALLOWYOUTOHAVEANINTERESTINGANDVARIEDDIETINCLUDING:

•Freshmeatproducts

•Spices

•Kaleandlettuce

•Mushroomsandpeppers

ELEMENTALDIETFORSIBO

Thisisafarlesspopulardietandforgoodreason;itisintendedonlytobeusedintheshorttermforSIBOtreatment.Itisdefinitelynotadietthatlendsitselfwelltothelongtermbecauseitstarvesthebacteriainthemoststringentmanneryoucanimagineandleavesnoroomforpleasure.

Basicallyyoustarvethebacteriabystarvingyourself.Youdonotactuallyeatathing;insteadyouhavetotakeaspecificliquidcontainingthenecessarybasicnutrientstopreventstarvation.Itiseffectivelyafeedingformulawhichyoutaketokilltheovergrowthbutjustaboutsustainyourbody.WhileitshouldnotbedismissedasamethodoftreatingbothCrohn’sdiseaseandSIBO,itiscertainlynotaneasynotalongtermsolution.

THEGAPSDIET

GAPSisanacronymmeaningGutPsychologySyndromeandwasfirstdesignedbyDr.NatashaMcBride.TheideabehindtheGAPSdietisthatnearlyalldiseasesbegindeepwithinthegutanddamageorimbalancesinintestinalfloramayleadtoavarietyofcomplaintsrangingfrominflammatorycomplaintstoautisms