Small Intestinal Bacterial Overgrowth, or SIBO, is a disease where large amounts of bacteria invade the small intestine. SIBO is often tied to other digestive diseases, such as Inflammatory Bowel Disease, Celiac’s, and Inflammatory Bowel Syndrome. Symptoms can include bloating, gas, constipation, diarrhea and more.
The digestive system is covered with bacteria that help the body break down and absorb food while discarding the waste. This healthy, protective bacteria also prevents other harmful bacteria from taking root. When the digestive system is functioning normally, we don’t notice any problems. It’s when we either clear out good bacteria using antibiotics or eating foods that remove bacteria or introduce larger quantities of bad bacteria by taking the wrong probiotic or the wrong foods that we can create problems. And since every person is built differently, they need different levels of various bacteria to achieve their healthy “normal” state.
SIBO can also have adverse effects throughout the body. Patients who receive a diagnosis of rheumatoid arthritis are often suffering from SIBO, even if they aren’t suffering any digestive symptoms. Anxiety and depression have also been linked to digestive issues as well. The digestive tract is responsible for the creation and transportation of neurotransmitters. Neurotransmitters are responsible for sending information and chemicals throughout the brain. So it stands to reason that a digestive issue such as SIBO would affect the body’s ability to create neurotransmitters, causing a change in mental health.
SIBO Prevention
The best tools we have for natural SIBO prevention are annual lab tests that measure our bacteria levels. Dr. Brody offers a Hydrogen Breath Test that analyzes the levels of hydrogen in our breath. Certain harmful bacteria create hydrogen gas as a byproduct when breaking down nutrients, which the Breath Test can measure. Another option is the microbiome analysis, which tells you the breakdown of which bacteria you have in your digestive system. The microbiome test creates a detailed picture of which bacteria you have, and how they may need to be altered.
Bacteria living in the small intestines can also produce two other gases, methane and hydrogen sulfide. If your Hydrogen Breath Test comes back negative and you still have digestive symptoms, Dr. Brody can recommend a test for methane-producing bacteria. There are currently no tests for hydrogen sulfide, so if both the methane and hydrogen tests come back negative we can safely assume you have hydrogen sulfide producing bacteria. Generally speaking, hydrogen-producing bacteria tend to have loose stools as a symptom, hydrogen sulfide-producing bacteria cause more foul-smelling burps and gas, and methane-producing bacteria usually cause constipation.
Diet is also important, as the foods we digest can increase or decrease levels of different bacteria. By making dietary changes with the help of Dr. Brody, we can make sure we’re eating what our body needs to run at maximum capacity and reduce the number of harmful bacteria we consume.
In-House Testing
To begin, Dr. Brody will have patients take a Hydrogen Breath test. This is a simple test that looks for certain levels of bacteria throughout the digestive system by measuring the level of hydrogen in someone’s breath over the course of two hours. The bacteria typically found in SIBO and other digestive cases produce hydrogen as a byproduct of breaking down a drink given at the start of the test. By measuring these hydrogen levels over a two hour period, Dr. Brody can track where the bacteria are in the digestive system. Insurance typically covers this test.
Indican Testing
The Indican urine test is a great test to partner with the Hydrogen Breath test to study levels of bacteria. The body struggles to break down an essential amino acid called tryptophan. Tryptophan is often found in remnants of food that aren’t able to be broken down and rot inside the body. Typically, the body converts tryptophan to indole in its attempts to dissolve it. The liver converts this specific indole into indican. Afterward, it is transported through the bloodstream to the kidneys where it is excreted.
Indoles do occur naturally in the body. However, the body is able to break down and excrete these indoles in solid waste. The presence of indican in urine is a great indicator of bacteria in the small and large intestines. Higher levels of indican in urine can be an indicator of bacterial overgrowth. The Hydrogen Breath test – in tandem with Indican testing – can rule out other diseases that create high levels of indican, such as gangrene and abscesses.
It is possible to have high levels with no symptoms, or low levels with multiple symptoms. This can depend on which bacteria are in the digestive system, so Dr. Brody often uses a microbiome analysis to narrow down the possibilities. Insurance typically covers this test.
The Indican test is an easy test to perform that can determine an issue in the digestive tract. While a positive result cannot diagnose a problem by itself, it is a great tool to determine the overall state of the gastrointestinal system.
Zonulin Testing
In the ideal digestive tract, the tight junctions between cells prevent any contents from passing through the walls of the digestive tract and into the rest of the body. However, there are some situations – such as an individual with Celiac’s consuming gluten – that can create higher levels of zonulin in the digestive tract. This can cause the tight junctions to break apart, allowing zonulin into the bloodstream and creating intestinal permeability. Because of this, testing for zonulin gives doctors an insight into the strength of the intestine’s walls. Zonulin is also reversible, giving doctors a valuable marker to track the progress of treatment plans.
SIBO Treatment Plan
The goal of Dr. Brody’s treatment plan is to remove the harmful bacteria and create an environment that prevents it from being able to take root again. While the allopathic community typically uses antibiotics, naturopathic physicians follow the four “R’s” of treatment. They Remove bad bacteria, Repopulate the good bacteria, Restore the integrity of intestinal cells and walls, and Replace any digestive enzymes or minerals that may be causing symptoms. This method of restoration allows the digestive tract to both fully heal and function properly.
With SIBO treatment plans, there are often digestive symptoms that appear early in treatment. When removing bad bacteria, the disease enters a “die-off” phase that can cause either an increase in symptoms or a change in symptoms. This can catch patients off-guard, but it is a standard side-effect of beginning treatment.
SIBO is also a chronic disease. Due to the high possibility of relapsing, it is crucial to undergo re-testing to make sure the disease doesn’t return. Multiple rounds of treatment are often necessary to fully cleanse the body of SIBO.
To read about other digestive conditions that Dr. Brody works with, please click here.
To schedule an appointment, please contact the front desk at the Personalized Natural Medicine Clinic, located in a beautiful Victorian house in the heart of Newtown, Connecticut.
