SIBO and Candida Flashcards
SIBO
An overgrowth of non-pathogenic bacteria in the small intestine. It is the most common cause of IBS (60-70%).
SIBO: Hallmark symptoms
Bloating
Abdominal pain or discomfort
Constipation and / or diarrhoea
Flatulence.
SIBO: Other symptoms
Nausea, GORD, excessive burping, prolonged feeling of fullness, malabsorption (e.g., anaemia symptoms), insomnia and brain fog.
SIBO: Constipation or Diarrhoea
Hydrogen dominant gas production tends to cause diarrhoea;
Methane dominant gas production can cause severe constipation.
Key clinical indicators of SIBO
- Worsening of GI symptoms from probiotics.
- Fibre worsens GI symptoms.
- Chronic GI symptoms following long term broad spectrum antibiotics / PPIs / opiates.
- Chronic low ferritin / iron with no other cause.
- Developing IBS following GI infection (post infectious IBS (PI IBS).
- When a coeliac patient reports insufficient improvement from strict gluten free diet.
SIBO aetiology
- Hypochlorhydria
- Low SIgA
- Prolonged stress
- Scar tissue / adhesions from surgery
- Hypothyroidism (slows motility)
- Poor oral health (bacteria comes from the oral cavity).
- Ileocaecal valve dysfunction (related to a structural dysfunction, poor MMC functioning, etc.)
- Opioid pain medications (slows motility) and antibiotics.
SIBO Trigger
- Food poisoning
- Bacterial toxin
- Auto-immunity
- Gut nerve cell damage
- SIBO
SIBO and food sensitivities
SIBO can damage the villi of the small intestine, reducing enzymes like lactase and diamine oxidase (DAO) that are produced in these finger like projections.
* A loss of lactase = possible lactose intolerance
* A loss of DAO = possible histamine intolerance .
Dietary approach to SIBO
- Low FODMAP generally advisable to follow this for up to 6 weeks before gradually reintroducing FODMAPs.
- Specific carbohydrate diet (SCD) may be preferable to low FODMAPs, especially if there is intestinal inflammation.
- Sometimes symptoms will be more persistent / severe. It may be appropriate in some cases to combine dietary models (e.g., SCD and low FODMAP, or SCD and low histamine).
Anti-microbials and SIBO:
- Use 1-3 of the following anti microbials (or a specialised formulated herbal formula) for 4-8 weeks depending on the case.
‒ Berberine
‒ Oregano oil
‒ Allicin (extract of garlic) mostly just for methane producing bacteria.
‒ Neem
‒ Also, uva ursi and cinnamon.
Digestive support
Digestive bitters at the start of meals (e.g., greens such as dandelion, rocket, watercress herbs such as gentian, fennel, barberry bark).
– Betaine HCl, digestive enzymes, ACV.
MMC support:
‒ 12-hour overnight fast (minimum) / intermittent fasting. Meal spacing (at least 4 hours) with no snacks
‒ Pro-kinetic agents before bed, e.g., ginger root, artichoke.
‒ Practise mindful eating; diaphragmatic breathing exercises.
Other therapeutics for SIBO
- Repopulate the microflora (prebiotics and probiotics) and repair (see the 5R protocol).
- Visceral manipulation for the ileo caecal valve.
- Lion’s mane promotes regeneration of neurons if suspected autoimmune (also promotes regeneration of GI mucosa).
Biofilms
A biofilm is an extracellular matrix that can protect bacteria and fungus from our immune system. If antimicrobial protocols / dietary changes are not working, consider biofilm production.
Biofilm disruptors
NAC
Nano Silver
Serrapeptase
