It is common to learn that our patients have been struggling with digestive symptoms – sometimes for many years. And despite great effort, they have not been able to find relief, and are usually unable to even find an answer as to why they have these symptoms, let alone what can be done about them.

SIBO is a great example of what is often missed in assessing digestive symptoms. SIBO stands for Small Intestinal Bacterial Overgrowth, and is a type of imbalance in the gut microbiome (the bacteria that live within our guts) and where too many bacteria accumulate in the small intestine.

Why is this a problem? A healthy bacterial ecology in our gut is critical to good health, but when SIBO develops, bacteria begin to ferment our foods – creating gas, and leading to the primary symptoms of SIBO, which include:

– Bloating – where the stomach is pushed outward from gas

– Excessive passing of gas (flatulence)

– Excessive burping

These symptoms are quite common, and can easily be dismissed when they are mild, but they can easily build into a much more significant clinical picture.

For example, SIBO often underlies Irritable Bowel Syndrome (IBS) with symptoms of:

– Chronic loose stool or diarrhea

– Chronic constipation

– Alternating between these two

SIBO can also trigger other digestive problems including:

-Nausea

– Heartburn

– Various types of abdominal pains or cramping

– A sensation of fullness or slow digestion

If SIBO is the underlying reason why these symptoms exist, it only makes sense to first resolve the SIBO in order to fully resolve the resulting symptoms. The doctors at Vive Integrative Health have years of experience treating SIBO and digestive conditions of all kinds. You can trust us to to the bottom of your symptoms and have them addressed properly.

How do we test for SIBO and other digestive conditions?

Our doctors generally begin to suspect SIBO during the course of discussion and with a careful patient history can begin to extrapolate important details that further point in that direction. It is important we remember that other conditions can lead to similar symptoms and we are mindful to look for certain clues to suggest some of these other conditions as well. SIBO and any other suspected causes of symptoms are each assessed further with appropriate testing.

In the case of assessing for SIBO, the gold-standard test is a Lactulose Breath Test (LBT). This test detects the presence of certain gases in the breath – Hydrogen and Methane – which signify the presence of the bacteria that lead to SIBO.

If we suspect another type of gas is present – Hydrogen Sulfide – then we may also suggest a stool test to identify the type of H2S producing bacteria present.

How do we go about resolving SIBO?

Treating SIBO is not “one-size-fits-all”. Instead we tailor treatment according to he nuances of each person’s case.

The most significant factor guiding the course of treatment are the types of gases present. Hydrogen, methane, and hydrogen sulfide-types of SIBO are each approached differently, and often more than one type of gas is present.

Treatment for the bacterial overgrowth generally begins with natural antimicrobial agents. Vive Health has vast experience with a variety of sophisticated and high-potency antimicrobials. Often we will combine and rotate between these from visit to visit.

The Elemental Diet is another treatment option. We like this approach as it’s very effective but we usually reserve this option until we have first observed the effect of natural antimicrobials.

In this phase of treatment, we are aiming to correct the overgrowth of bacteria in the small intestine, and as progress is made, symptoms begin to diminish and ultimately resolve. Often the response occurs readily and without difficulty, but other times the process is less straight forward. Factors that may make the process more difficult include: duration of symptoms, severity of symptoms, and other overlapping conditions, including:

– Bile acid inadequacy

– Stomach acid inadequacy

– Biofilms

– Yeast or mold overgrowth

Recognizing and treating these alongside SIBO can greatly simplify the process of resolving SIBO and its symptoms. There are certainly cases of SIBO that are more difficult to resolve than others. Factors beyond those described above can make the process even more difficult in rare cases. When we suspect that may be the case we try to make our assessment and expectations for treatment clear from the beginning.

Sometimes treatment of SIBO is a really smooth process, and sometimes we encounter ups and downs or big obstacles that take time to overcome. But either way, with diligence, successful treatment of SIBO IS possible!!