Gut Health

Best Nutrients for Fighting SIBO

January 01, 2022

Your gut plays an important role in your health. Trillions of microorganisms in the gut, known collectively as the gut microbiome, support your digestive function, immunity, hormonal health, mental health and much more. When the gut microbiome has a friendly balance of gut bacteria, it allows the bacteria in the gut to carry out their many functions. When there is an imbalance, however, it can allow other pathogens to grow out of control and can lead to conditions like small intestinal bacterial overgrowth (SIBO).

What Is SIBO?

SIBO stands for “small intestinal bacterial overgrowth.” It refers to a condition in which the bacteria that live in your small intestine grow beyond normal levels and begin to interfere with your normal digestive functions.

According to Cleveland Clinic: "SIBO is an imbalance of the microorganisms in your gut that maintain healthy digestion. When too many bacteria, or the wrong kind, populate the small intestine, it can lead to uncomfortable symptoms such as gas and diarrhea. It can also inhibit your ability to digest and absorb nutrients from your food."

Essentially, SIBO occurs due to an imbalance in your gut microbiome that allows the small bacteria to grow beyond healthy levels. When there is an imbalance in the gut microbiome, or the digestive system is impaired, it is unable to keep bad bacteria in the gut under control. As a result, they grow and cause an infection.

Enzyme deficiency, low amounts of gastric acid, or low levels of bile can all contribute to sluggish digestion, which not only impairs nutrient absorption, but also gives bacteria in the small intestine more time to breed.

What Causes SIBO?

SIBO commonly results occurs due to an imbalance in the gut microbiome, or when a disease or abdominal surgery slows the passage of food and waste in the digestive tract, providing an environment for bacteria to breed.

SIBO is commonly caused by a complication of abdominal surgery, and in this case, surgery is often needed to correct the problem. In other cases, however, a round of antibiotic treatment is typically used to get rid of SIBO.

Some of the primary causes of SIBO include:

Low stomach acid (hypochlorhydria). Stomach acid plays a key role in moderating bacterial growth. When stomach acid is low, it is less effective at fighting off bacteria that enter the body with food.

Structural issues. Structural problems in the small intestine can interfere with the clearing of bacteria and can create extra pockets for bacteria to accumulate. These issues can be caused by complications of surgery or by gastrointestinal diseases.

Small intestine dysmotility. Small intestine dysmotility means that waste is held for too long in the small intestine before emptying into the colon. This gives more time for small intestine bacteria to grow and multiply.

Overuse of certain medications. Certain medications, such as antibiotics, narcotics, and gastric acid suppressants, can upset the normal balance of intestinal flora.

How Common Is SIBO?

It is unknown exactly how common SIBO is. Many healthcare professionals consider SIBO to be generally underdiagnosed, and the prevalence among healthy people is not known. However, some studies indicate that up to 80% of people with irritable bowel syndrome (IBS) have SIBO. Mild cases of SIBO may not have any noticeable symptoms, while moderate cases often have symptoms that resemble other digestive conditions, such as Inflammatory Bowel Disease.

What Are the Symptoms of SIBO?

Common signs and symptoms of SIBO often include:

Abdominal pain
Pain in stomach after eating
Bloating
Excess gas
Digestive issues
Loss of appetite
Nausea
Diarrhea and loose stools
Unexpected weight loss

How Do You Treat SIBO?

Often, SIBO is caused by complications in abdominal surgery that allow for outside bacteria to grow in the small intestine. Doctors will try to correct any surgical issues that may be causing SIBO whenever possible. In other cases, treatment focuses on eliminating the bacterial overgrowth and restoring balance in the digestive system and microbiome.

Most people treat bacterial overgrowth with antibiotics, powerful compounds that kill bacteria. In the short-term, antibiotics can significantly reduce the number of abnormal bacteria. In the long run, however, antibiotics also kill off the beneficial bacteria in your gut, which can lead to many other digestive issues. Therefore, it is critical that after a round of antibiotic treatment you replenish your gut bacteria with beneficial probiotics.

Even herbal antibiotics for SIBO can kill beneficial bacteria, so if you take herbal antibiotics for SIBO it is also recommended to supplement with probiotics after.

Making sure your body is getting the essential nutrients that it needs is also an important part of treating SIBO. SIBO can cause obstructions in the small intestine that make it more difficult for your body to absorb nutrients from the food passing through. This can lead to malnutrition and weakened immunity. Correcting the nutrient deficiencies caused by SIBO often includes taking nutritional supplements like vitamin B-12, calcium, iron, and other vitamin supplements.

It is important that the bacteria is eliminated, however, so that one can utilize the nutrients from their vitamin supplements and can effectively correct any nutritional deficiencies they may have.

Foods to Fight SIBO

People treating SIBO often choose to follow the SIBO diet. The SIBO diet is a gradual elimination diet that is meant to reduce inflammation in the digestive tract and bacterial overgrowth in your small intestine.

In some cases, eliminating only sugars can ease symptoms. Doctors also often suggest incorporating a diet low in FODMAPs, which are difficult-to-digest carbs that are fermented by gut bacteria in the colon. When carbs can’t break down, they sit in your gut and can cause symptoms such as diarrhea and bloating. In addition, if there is bacterial overgrowth, the small intestine bacteria begin to ferment the carbs too early, causing many symptoms.

The SIBO diet is more focused on what not to eat than on exactly what to eat. It suggests eliminating high FODMAP foods in order to prevent fermentation in the gut and the proliferation of intestinal bacteria. High FODMAP foods to avoid include:

high-fructose corn syrup
agave nectar
honey
soda and soft drinks
garlic
onions
asparagus
butternut squash
cauliflower
artichokes
beans
peas
barley
rye
grains
apples
dried fruits
sausage
flavored yogurt
ice cream
sweetened cereals

While the list of foods you should avoid can be restrictive, there are still a number of foods you can enjoy while on this temporary diet. A SIBO diet should focus on foods high in fiber and low in sugar. Some of the acceptable foods for a low FODMAP diet include:

meat
fish
eggs
crackers, gluten-free
oatmeal
unsweetened cereal (made from low FODMAP grains)
spaghetti squash and summer squashes
broccoli (heads only, less than 3/4 cup)
leafy greens
carrots
rice or gluten-free noodles
olives
peanuts
potatoes
pumpkin
quinoa
seeds
some fruits (blueberries, grapes, oranges, and strawberries)

Herbs to Fight SIBO

In addition to following a low FODMAP diet, certain herbs may also be able to help kill the overgrowth of bacteria in the small intestine. For example, pomegranate peel extract has incredibly potent antimicrobial effects, with an extremely broad range of action against multiple pathogens. A tincture including pomegranate peel may help to kill bad bacteria and prevent them from overpopulating the small intestine.

Black Walnut is another antimicrobial herb that has been used for centuries to kill pathogenic bacteria and parasitic organisms and to detoxify the colon. Black Walnut is also useful for helping maintain an internal condition that is unfavorable to fungi and pathogenic bacteria.

Other useful herbs for treating a SIBO infection include:

Grapefruit seed extract
Oregano oil
Garlic
Berberine, found in goldenseal and Oregon grape root
Olive leaf extract

Best Probiotic to Fight SIBO

One of the best things for helping fight off SIBO is to introduce the right kind of probiotic. Probiotics are beneficial bacteria that help to maintain a healthy balance in your gut microbiome. When supplementing with a probiotic, it will help to correct microbial imbalances over time, especially when taken after a cleanse that helped to eliminate the overgrowth of pathogenic organisms.

The best probiotic to choose is a multi-strain probiotic that has been 20 and 50 culture forming units (CFUs). A probiotic with multiple strains will better help to colonize the intestinal tract, helping to kill off the overgrowth of bad bacteria and restore a regular balance in the gut.

Summary

This condition can lead to many uncomfortable symptoms such as:

Abdominal pain
Pain in stomach after eating
Bloating
Excess gas
Digestive issues
Loss of appetite
Nausea
Diarrhea and loose stools
Unexpected weight loss

Some people try to treat SIBO naturally by focusing on diet and herbs. A diet low in FODMAPS, which are difficult-to-digest carbs that are fermented by gut bacteria in the colon, is usually recommended. When carbs can’t break down, they sit in your gut and can cause symptoms such as diarrhea and bloating. In addition, if there is bacterial overgrowth, the small intestine bacteria begin to ferment the carbs too early, causing many symptoms.

A low FODMAP diet can be followed while also using powerful antimicrobial herbs to kill SIBO as an alternative to prescription antibiotics. Some of the best herbs for fighting SIBO include:

Pomegranate peel
Black walnut
Grapefruit seed extract
Oregano oil
Garlic
Berberine, found in goldenseal and Oregon grape.
Olive leaf extract
Pau d'arco

As with any medical condition, it is recommended to speak with your doctor about the best way to diagnose and treat SIBO. In addition to treatment, it is also important to focus on prevention by maintaining proper gut health, as well as by following a healthy diet and lifestyle.

References:

https://www.ncbi.nlm.nih.gov/books/NBK546634/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386065/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6884350/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030608/

https://pubmed.ncbi.nlm.nih.gov/24891990/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748159/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966170/

https://pubmed.ncbi.nlm.nih.gov/31947991/