Small Intestinal Bacterial Overgrowth SIBO

While bacteria are an essential part of a healthy small bowel and to perform important functions, for those with a condition called small intestinal bacterial overgrowth (SIBO), they have bacteria that are supposed to live in the colon (also referred to as the large intestine) trapped in the small intestine. The types of bacteria present in the small bowel differs from those found in the colon. In SIBO, there is presence of excessive bacteria in the small intestine and the type of bacteria that would be in the colon.

SIBO can negatively impact both the structure and function of the small bowel. It can have a significant interference with food digestion and absorption of nutrients. This occurs when the cells lining the small bowel (the mucosa) is damaged as a result of SIBO. Aside from poor digestion and malabsorption, these pathogenic bacteria can cause nutritional deficiencies as they will take up certain vitamins and important nutrients before our own body cells have a chance to absorb them. These deficiencies can result in issues like fatigue, weakness and damage to the central nervous system.

SIBO can lead to symptoms much like irritable bowel syndrome or IBS symptoms, namely diarrhoea, flatulence, constipation, bloating, and distention. The symptoms present depend on what kind of bacteria are running rampant in the small intestine.


What causes SIBO?

The cause of SIBO usually lies in a movement problem in the small intestine. Your small bowel initiates a ‘housekeeper’ wave for every two hours, which sweeps through the small bowel and dumps everything like residual food, bowel secretions, digestive enzymes and excessive amounts of bacteria. If something impairs the wave, the small intestine is unable to expel the bacteria. Similar to a stagnant pool, the small intestine becomes an ideal environment for pathogenic bacteria to thrive and reproduce.

Other causes include nerve damage in the gut such as from diabetes, Diverticulitis of the small intestine, any bowel obstruction and multiple courses of antibiotics. SIBO can also be the outcome to conditions that reduce naturally occurring stomach acid which are also bacteria-killing. SIBO is also possible to get from food poisoning; if it lasts beyond two weeks, any lingering gastrointestinal issues could be SIBO-related.

Home Remedies for SIBO

Identify the foods in your diet and eliminate any personal ‘gut irritating’ foods. Maintain a low carbohydrate diet and consume foods with probiotics (friendly bacteria) and digestive enzymes. Herbal supplements and gut-healing herbs can also be used to treat or kill off gut bacteria overgrowth, such as ginger tea, enteric-coated peppermint oil and apple cider vinegar.

SIBO Treatment

The patient’s report and experience is important in the first step to assess whether the personal symptoms are caused by SIBO. If the symptoms and signs add up to SIBO, testing will be carried out for a diagnosis.

gutCARE is Singapore’s leading gastroenterology group practice in Singapore which provides a full range of clinical care and services for digestive and liver disorders. Our experienced specialists are trained in gastroenterology with individual subspecialty interests to deliver state-of-the-art care.

Our specialists can diagnose SIBO with a breath test that measures how much hydrogen or methane gas ends up in your breath. These gases are both by-products of bacteria breaking down sugar in your gut. There are no blood or stool tests for SIBO.

If the breath test indicates SIBO, your doctor will look into addressing any underlying issue that may cause the problem. Clearing up the overgrowth usually requires antibiotics however, recurrences are common thus you may need repeat courses of the meds. SIBO treatment typically should include a nutritional supplements and lifestyle changes to get the body back in balance. A healing diet should be incorporated to ease inflammation, repair the intestinal lining and get rid of the bacterial overgrowth with foods rich in the essential nutrients. Avoid FODMAP foods which may end up fermenting in the digestive tract and feed the bacteria, until the gut flora is back in balance.

If left untreated, SIBO can cause potentially serious health complications. It is vital to get rid of the bacterial overgrowth as soon as possible. Talk to our specialists at gutCARE today, a leading gastroenterology clinic in Singapore.


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