227. SIBO Solutions: How to Overcome Bloat, Constipation, and Heal the Gut - Dr. Allison Siebecker
May 8, 2023
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Dr. Allison Siebecker, a SIBO specialist, discusses symptoms and diagnosis methods of SIBO, foods to avoid, benefits of Prodigest on gut function, managing gas levels during treatment, effects of an all-meat diet on SIBO, and the connection between mold illness and gut health.
Addressing underlying causes and complications is crucial in treating Small Intestinal Bacterial Overgrowth (SIBO)
Treatment options for SIBO include pharmaceutical antibiotics, herbal antibiotics, and the elemental diet
Prokinetics play an important role in managing SIBO and optimizing gut motility
Deep dives
Causes of SIBO and the Importance of Autoimmunity
SIBO, or small intestinal bacterial overgrowth, is caused by the overgrowth of bacteria in the small intestine. The primary cause of SIBO is bacterial food poisoning, which triggers an autoimmune response that damages the nerve cells in the intestine responsible for the migrating motor complex. Other causes include anatomical obstructions, adhesions, opiate medications, and certain diseases like diabetes and hypothyroidism. Mold toxicity and environmental toxins may also slow the migrating motor complex, leading to SIBO. Autoimmunity plays a crucial role in the development of SIBO, with the immune system attacking nerve cells due to molecular mimicry with toxins produced by bacteria in food poisoning.
Symptoms and Testing for SIBO
Symptoms of SIBO mirror those of irritable bowel syndrome (IBS) and include abdominal bloating, pain or discomfort, diarrhea, constipation, acid reflux, nausea, and food intolerances. Testing for SIBO is typically done using a breath test that measures the presence of specific gases. The lactulose breath test is considered the gold standard, while other tests may be required for detecting hydrogen sulfide gas. It is essential to conduct follow-up testing to ensure that treatment has effectively eliminated SIBO and to investigate potential underlying causes such as mold toxicity or parasites. Some people may need to repeat treatment or explore additional interventions to find relief from SIBO.
Treatment Approaches and Challenges in SIBO
The elemental diet, which consists of amino acids, oil, and glucose or maltodextrin, is a common and effective treatment for SIBO. It reduces symptoms by starving the bacteria, providing rest to the digestive system, and offering hypoallergenic nutrition. However, not everyone responds to the elemental diet, and additional treatments may be necessary. Underlying causes like mold toxicity, parasites, and histamine sensitivity can hinder progress in treating SIBO. If progress stalls, it is crucial to investigate these factors and address them accordingly. Ongoing inflammation, histamine intolerance, and mixed connective tissue disorder may also impact treatment response. The elemental diet should be closely monitored, and working with a specialist who can guide patients through the process can be beneficial in ensuring treatment success.
Treating SIBO: Main Ideas and Insights
1. Treating Small Intestinal Bacterial Overgrowth (SIBO) involves different approaches, including dietary modifications, antimicrobial treatments, and addressing underlying causes. Adhesions can complicate the treatment process, as surgery, a common method to remove adhesions, is the leading cause of their formation. Physical manual therapies can dissolve adhesions, but they may require travel and cost. Systemic sclerosis, a progressive disease, is an example of an incurable condition that can cause SIBO. Addressing underlying causes like Lyme disease can eliminate SIBO and its symptoms.
2. Treatment options for SIBO include pharmaceutical antibiotics, herbal antibiotics, and the elemental diet. Rifaximin is a highly effective antibiotic for all three types of SIBO, while neomycin and metronidazole are other pharmaceutical options. Herbal antibiotics and compounds like nitazoxanide can also be used. The elemental diet, a medical beverage rich in broken-down nutrients, starves the bacteria in the small intestine. Different individuals may respond differently to treatment options, and it is crucial to monitor gas levels with follow-up breath tests.
Treating SIBO: Prokinetics, Testing, and Risks
1. Prokinetics are essential in managing SIBO, optimizing gut motility, and preventing relapse. Pharmaceutical prokinetics like prucalopride and erythromycin, as well as natural prokinetics, can be beneficial.
2. Testing for SIBO can be done using breath tests, which can be ordered by practitioners or patients themselves. Direct Lab, True Health Labs, and Trio Smart offer testing services. Following treatment, retesting is crucial to assess treatment effectiveness by evaluating gas levels. Treating SIBO with antibiotics, whether pharmaceutical or herbal, may have side effects, but the risks are generally low. Rifaximin, in particular, has shown positive properties and minimal impact on the microbiome. Adverse reactions to metronidazole, while possible, are less common in SIBO treatment.
Support your health journey with our private practice! Explore comprehensive lab testing, functional assessments, and expert guidance for your wellness journey. Find exclusive offers for podcast listeners at nutritionwithjudy.com/podcast. _____ I'm excited to sit down with Dr. Allison Siebecker. We talk about SIBO, the elemental diet and much more. Make sure to listen to the full interview to learn more.
Dr. Allison Siebecker, ND, MSOM, LAc, has worked in the nutritional field since 1988 and is a 2005 graduate of The National University of Natural Medicine (NUNM), where she earned her Doctorate in Naturopathic Medicine and her Masters in Oriental Medicine. She was the co-founder and former medical director of the SIBO Center for Digestive Health at NUNM Clinic, is the 2021 Lifetime Achievement Borborygmus award recipient, and has specialized in the treatment of SIBO since 2010.
Dr. Siebecker is passionate about education- she is Instructor of Advanced Gastroenterology at NUNM, IBS Board of Advisor & Faculty for the GI Health Foundation, Co-Founder & Curriculum Coordinator of the 2014-2016 SIBO Symposiums and teaches continuing education classes for physicians.
**DISCLAIMER: I am only here to provide support as a nutritional therapy practitioner and I am not providing medical advice. I always recommend working with a team of holistic practitioners, including your PCP and a certified nutritional therapy practitioner. Do not self-diagnose. Always seek medical guidance when you have a medical condition.
