SIBO: What is Bacterial Intestinal Overgrowth Syndrome? Symptoms...

SIBO is based on the English name small intestinal bacterial overgrowth. It is a relatively serious condition affecting the small intestine.

Small intestinal bacterial overgrowth syndrome = SIBO

The overgrowth of inappropriate bacteria results in unpleasant digestive symptoms such as abdominal pain, bloating or diarrhea. The main risk is malnutrition, as the overgrown bacteria begin to consume the nutrients taken in.

For the cause, diagnosis, symptoms, treatment, prevention, and much more information, see the article.

SIBO disease: what is it?

SIBO is a disease affecting the human digestive tract.

The digestive tract is inhabited by hundreds of different bacteria that keep the digestive system in balance.

If the balance of this intestinal microflora is disturbed, we experience digestive problems.

If the bacterial balance is disturbed over a long period of time, serious consequences such as SIBO can occur.

When the beneficial bacteria of the digestive tract are in ideal amounts, they perform various important functions - absorption of vitamins, fermentation of substances or protection of the small intestine from harmful bacteria.

Conversely, if there is an overgrowth of bacteria in the small intestine (or an overgrowth of colon-specific bacteria into the small intestine), the balance is disturbed. The overgrown bacteria can start to destroy important food components.

This prevents physiological digestion and absorption of nutrients.

Bacterial intestinal overgrowth can be characterized as a disorder of excessive bacterial growth in the small intestine.

SIBO occurs due to the disruption of physiological protective mechanisms, which include: stomach acid, bile, secretions from the pancreas, digestive enzymes and also the immune system.

Abnormalities in these mechanisms predispose to bacterial overgrowth.

Some groups of patients have an increased risk of developing SIBO.

Risk factors include a history of gastrointestinal surgery, irritable/short bowel syndrome, cirrhosis of the liver, hypothyroidism, pancreatic insufficiency, celiac disease, gastric resection, Crohn's disease, chronic inflammatory bowel disease, diabetes mellitus (diabetes), decreased bile production, and many others.

Inappropriate lifestyle and poor dietary habits are also risk factors. Irregular unhealthy eating, highly processed foods, excessive sugar, lack of fiber, chronic stress and more.

Poor absorption of acids, fats, carbohydrates, proteins and vitamins subsequently leads to bacterial damage to the surface or conversion of nutrients into toxic metabolites. The consequence is diarrhea and weight loss.

The result is reduced function of enterocytes (cells lining the intestine) and worsening malabsorption.

Symptoms of SIBO are similar to the general symptoms of chronic digestive tract diseases, mainly bloating, abdominal pain, gas and difficulty in digestion and defecation.

Weight loss often occurs as a result of poor absorption and diarrhea. The body's immune system fights against the overgrown bacteria, leading to excessive fatigue and weakness.

Certain food components can convert the overgrown bacteria into substances that irritate the lining of the small intestine. The lining responds with increased water secretion, leading to diarrhea (watery, runny stools).

If bacteria are present in the small intestine in large numbers, they can start to compete with the body for nutrients. This leads to malnutrition and inadequate nutrient intake.

There is a risk of anaemia, malnutrition and weight loss.

Malabsorption also affects the absorption of vitamins, causing a possible deficiency - avitaminosis. In particular, this is a deficiency of vitamin B12. This often results in various neurological and psychological symptoms within SIBO.

Possible symptoms of SIBO:

• Bloating
• Bloating
• Flatulence
• Abdominal cramps
• Abdominal pain
• Nausea
• Weight loss
• Diarrhoea
• Indigestion
• Constipation
• Increased fatigue
• Reduced immunity
• General weakness
• Depression and anxiety

The symptoms of SIBO are relatively non-specific. They are similar to various other diseases of the digestive tract. Therefore, the diagnosis of SIBO can be more difficult.

The diagnosis of SIBO will be made by a gastrointestinologist in view of the digestive difficulties. After a basic examination, assessment of symptoms, taking a medical history and a blood sample, specific tests will follow.

The main diagnostic test is the breath test, which can diagnose bacterial overgrowth in the small intestine. The test is painless and uncomplicated for the patient. However, it can be lengthy.

It is based on determining the concentration of hydrogen or methane in the exhaled air.

The patient is fasted before the test. He sits still for a while and then the amount of hydrogen in the exhaled air is measured. He is then given a glass of liquid (lactulose) to drink. The exhalation measurement is repeated at intervals.

Hydrogen is produced by the fermentation of lactulose by bacteria in the small intestine.

An increase in the amount of hydrogen above a certain value means that the normally indigestible lactulose does not pass undigested into the large intestine. Instead, it is already broken down in the small intestine by the action of the bacteria present.

The product of this abnormal intestinal breakdown is hydrogen, which is carried by the blood to the lungs and then to the breath.

Furthermore, the doctor may indicate an instrumental imaging examination of the small intestine - endoscopy.

Using a special camera, the doctor examines the intestinal mucosa. With the help of an endoscope, a sample of the intestinal mucosa can be taken for laboratory diagnosis and determination of the presence of bacteria.

The course of the disease is characterised by non-specific digestive complaints as described in the section on symptoms.

Prevention of SIBO

Prevention of bacterial overgrowth of the small intestine is primarily based on lifestyle.

A regular, balanced and healthy diet that supports the balance of the gut microbiome is essential.

A complete diet full of proteins, fats, fibre and complex carbohydrates is essential. Adequate intake of essential vitamins and minerals.

If you are diagnosed with a digestive disease that is also a risk factor for SIBO, professional treatment for this disease, including dietary measures, is necessary.

Part of the prevention and early detection of various digestive tract diseases is an urgent visit to the doctor for pain and digestive problems.

Preventive tips:

• Regular balanced diet
• Regular physical activity
• Elimination of simple sugars in the diet
• Eliminate highly processed foods
• Adequate dietary fibre intake
• Adequate intake of protein in the diet
• Elimination of daily stress
• Taking probiotics and prebiotics (especially after illness)
• Urgent visit to a doctor if you notice difficulties