Small Intestinal Bacterial Overgrowth (SIBO)
What Causes SIBO?
Here are seven things you can do to overcome SIBO. Many of these things are also done for leaky gut.
1. Remove food and chemical irritants
Dietary adjustments are essential to overcoming both SIBO and leaky gut. It is absolutely essential to eliminate all refined sugars from the diet and most starchy foods. At the least one should eliminate grains containing gluten (wheat, rye, barley), but eliminating all grains may be required.
Dairy may also be problematie because the bacteria love feast on lactose, the sugar in dairy.
Goat milk products and cultured dairy foods can be beneficial for some people, yet other people may have to eliminate all dairy foods.
Fermented foods are generally helpful for SIBO. These are discussed under Step Six: Restore beneficial bacteria.
There are three dietary programs that may be helpful, depending on the severity of the problem. These are the Specific Carbohydrate Diet (SCD), the Gut and Psychology Syndrome (GAPS) diet and the Paleo diet.
2. Stimulate production of and/or supplement stomach acid and enzymes
There are two ways to increase stomach acid and enzymes. One is to rake supplements and the other is to take herbs and nutrients that stimulate their production. With SIBO it is normally necessary to do both.
To determine how much Betaine Hydrochloric Acid (HCI) you need, you can do a hydrochloric acid challenge test.
Note: do not perform this test if you have an active ulcer or a history of ulcers.
To do the test, take a capsule of PDA prior to a meal. If you notice no burning, increase to two capsules the next meal. Proceed until you notice a mild burning sensation, then immediately reduce your dose to the number of capsules that preceded the burning or heat sensation. Most people find a comfortable dose between 2-4 capsules.
If one or two capsules causes burning, you either don't have low stomach acid or your reflux is so severe that you won't be able to take HCI until you get it under control. Also, remember that the more protein you eat with a meal, the greater the need for HCI, so you can vary the dose with the size and content of your meals. Also, if you have severe digestive problems, you may also wish to take a complete food enzyme that has HCI and pancreatic enzymes.
Within 3-6 months most people feel a warmth in their stomach with the same dose they have been taking. When this happens it is time to decrease your dose and start weaning off of the PDA.
You can also mix one capsule of goldenseal powder with one teaspoon of Digestive Bitters and take this 15-20 minutes prior to meals with one to two glasses of water. A small pinch of a natural salt can also be taken at the same time, as this also helps stimulate HCI production by providing chloride.
Bitters are contraindicated if you have digestive atrophy. So, if you have dry mucus membranes, as evidenced by a dry and withered (or shriveled) looking tongue, don't take bitters because they dry the mucus membranes. Try Spleen Activator instead.
A lack of HCI may also be due to a lack of the following nutrients: chloride (low serum levels), zinc and thiamine. These are primary nutritional factors required for the synthesis of hydrochloric acid.
3. Improve intestinal motility (if necessary)
With SIBO it is also important to make certain that there is good intestinal motility between meals to flush the intestines and clear out bacteria. One way to do this is to allow adequate time between meals. Depending on the efficiency of your digestion, you need three to five hours between meals. Ideally, you should wait until you get stomach rumblings indicating your digestive tract is clear before eating the next meal.
If motility is slow there are some supplements that may be helpful. All carminatives increase digestive motility, and many people find that a cup of ginger tea is most helpful. You can also try taking 5-HTP Power twice daily. Gentle Move may also be helpful.
4. Close the ileocecal valve (if necessary)
If there is severe gas and bloating, you probably need to work on the ileocecal valve. This is done by massaging the valve to reduce swelling and inflammation and get it to close properly. This is demonstrated in Steven's video on techniques for self-correction of a hiatal hernia on Youtube.com.
5. Reduce bacteria
If a person has signs of SIBO, they will need to take some supplements to reduce bacterial overgrowth in the small intestines. This can be done with pharmaceutical antibiotics or herbal antibacterial agents. Agents that may be helpful include goldenseal, GastroHealth and Chinese Anti-Gas.
Garlic is another possible antimicrobial agent, but if friendly lacto bacteria are overpopulating the small intestines, it won't work. Use raw garlic or High Potency Garlic only.
6. Restore beneficial bacteria
People with SIBO often do not do well on probiotic supplements, especially if they contain prebiotics which feed the small intestinal bacteria as well as friendly flora. Cultured foods usually work better. Cultured vegetables in particular are very valuable in treating SIBO and leaky gut.
You can make your own cultured vegetables or you can purchase them from a health food store or some supermarkets. Making your own cultured vegetables is quite easy. Recipes for making cultured vegetables can be found in the book Nourishing Traditions by Sally Fallon.
7. Repair gut integrity
Since SIBO always causes leaky gut, it is important to rebuild the integrity of the intestinal membranes. One of the best ways to do this is by using the Bone Broth therapy.
Bone broth is high in glutamine and glycine, both of which are essential in healing the gut. They are emphasized in both the SCD and GAPS diet. Drink 1-4 cups of bone broth daily. You can also use it to make soups. Recipes for bone broth can be found in Nourishing Traditions.
If you can't take the bone broth, you can use L-glutamine, which can also be used along with bone broth. Other remedies that help heal the gut include chamomile tea (one cup three times daily), ATC concentrated licorice (1 three times daily) and colostrum powder.
Below is a list of suggested products. Those in bold are key products for the health issue explained on this page.
Herbs: Garlic, Ginger, Golden Seal and Pau d 'Arco
Herbal Formulas: Digestive Bitters Tonic, Echinacea/Golden Seal, Gastro Health and Una De Gato
Nutrients: L-Glutamine and Probiotics
Nutraceuticals: 5-HTP Power, Colostrum With Immune Factors, Food Enzymes, Melatonin Extra, PDA Combination and Small Intestine Detox
Essential Oils: Cinnamon and Peppermint
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