SIBO (Small Intestine Bacterial Overgrowth) is the bacterial overgrowth in the small intestine, which can cause a picture of malabsorption and proliferation of intestinal bacteria that will not generate health. Under normal conditions, the small intestine should not harbor practically no bacteria, since it is an area dedicated to digestion and absorption of nutrients. On the contrary, in the colon we should find a rich and diverse intestinal microbiota.
All the microorganisms that live in the large intestine in a physiological and normal way, for different situations move and colonize the upper part until they reach the ileum, jejunum and even the duodenum. In addition, these bacteria will be in much higher than normal amounts, generating a less than optimal state of health and associated intestinal complications.
Some of the associated symptoms are: bloating, gas, pain due to excess gas, rumbling, abdominal distension, inflammation, indigestion, nausea, halitosis (bad breath), floating stools or diarrhea.
Situations that can give this picture of bacterial overgrowth:
- Lack of hydrochloric acid in the stomach.
- Celiac disease, Crohn’s disease or any disease that compromises intestinal health.
- Bile and gastric juice are not being secreted correctly.
- Alterations in bowel motility and intestinal transit
- Malabsorption of fructose or other compounds
- Presence of H.Pylori
- Prolonged intake of antacids
The small intestine is the main responsible for the absorption of nutrients that we ingest through our diet, so if there is a film of bacteria on the intestinal wall, they will not allow these nutrients to be absorbed properly, resulting in low levels of vitamins and minerals. In the analytical tests it can be seen with the deficit of some of them, such as vitamin B12, iron, zinc or vitamin D.
There are symptoms related to malnutrition, vitamin B12 deficiency (megaloblastic anemia), anemia, malabsorption of fats (diarrhea, constipation), kidney stones (certain bacteria, if elevated, tend to produce oxalates or do not metabolize them correctly) and osteoporosis.
In people with SIBO, it is recommended to take temporary antibiotics – prescribed by a doctor – together with a diet low in FODMAP, which are a type of carbohydrates that ferment too easily in the intestine and further promote bacterial overgrowth, accentuating the symptoms.
In addition to following this diet for 2-3 weeks until the remission of symptoms and improvement of the intestinal symptoms, we must treat the underlying cause that has triggered SIBO in the first instance. In relation to the lack of stomach acid, we can perform the Heidelberg Test, which only requires a teaspoon of sodium bicarbonate and a glass of water. The mixture is taken on an empty stomach and you time how many minutes it takes to burp; if the burp comes out before 5 minutes, it will be a sign that you have good acid levels, being more optimal.
Some functions of acid
→ Adequate absorption of many nutrients, including minerals such as iron, copper, zinc, calcium, vitamin B12, folic acid and proteins.
→ Supports the balance of bacterial flora by preventing bacteria from the colon from migrating and colonizing the small intestine or stomach (H.Pylori)
→ It sterilizes the intestine from pathogenic bacteria.
→ Promotes the proper functioning of the immune system
→ Activates pepsin, important for digesting proteins
→ Activates intrinsic factor, which is necessary to absorb vitamin B12.
If there is stomach acid deficit try taking lemon with ginger along with a glass of water on an empty stomach, lemon water before meals, Umeboshi paste or plum, unpasteurized apple cider vinegar, licorice and bitter foods – cauliflower, fennel, gentian, artichoke, endive, ruca. There is also improvement with betaine HCl supplementation.