Stomachaches can put a burden on beautiful moments. Brain fog, fatigue, bloating, gas, abdominal pain, diarrhea and/or constipation could be symptoms of a condition known as SIBO. SIBO stands for Small Intestinal Bacterial Overgrowth. Normally, the bulk of our gut microbiome resides in the large intestine. In SIBO, we see an overgrowth of bacteria (even otherwise healthy bacteria) in the small intestine, where they are not usually present to such a high degree. That bacteria is then able to act on poorly-digested, fermentable carbohydrates.
Nutrient deficiencies can also arise as the bacteria consumes some of the ingested foods. For example, B12 and iron deficiencies can lead to anemia and deconjugation of fatty acids. The latter of these comes from bile that reduces absorption of fat-soluble vitamins. Patients with SIBO also tend to have altered secretory IgA values, demonstrating that SIBO directly alters immune activity in the gut. If you’ve been following Health Connection long enough, you know that one of our first questions is always, “What’s the underlying cause?” So, let’s look at some of the underlying causes of SIBO.
Underlying Causes of SIBO
- Hypothyroidism: A low-functioning thyroid can reduce activity within the gastrointestinal tract, slowing the migrating motor complexes that trigger peristalsis.
- Depressed immunity: Various immunodeficiency syndromes have been associated with increased risk for bacterial overgrowth.
- Diabetes: High blood sugar can damage the nerves that regulate and control intestinal migrating motor complexes.
- Chronic stress: When the body enters the sympathetic fight-or-flight state, gastric function is altered. We are not in the rest-and-digest state anymore. This also affects the enteric nervous system that controls the migrating motor complex.
- Stealth infections: Gut dysmotility has been associated with infectious agents including varicella zoster, Epstein-Bar virus, and Lyme disease.
- Abdominal adhesions: Scar tissue, which can arise from chronic inflammation (e.g. Crohn’s Disease), infection, or surgery, can create an obstruction or distortion of the intestines. This might also impair the enteric nervous system’s migrating motor complex. All of these issues can predispose patients to SIBO.
- Excess estrogen: Estrogen-induced gallstones are a common form. Excess estrogens can inhibit the excretion of bile salts from the liver into the intestines. Since bile salts have antimicrobial activity, their deficiency can be a predisposing factor for SIBO. Estrogen also delays gastric emptying and motility.
We should always be thinking about the root cause, regardless of the condition we’re trying to address. SIBO is no exception to this rule of thumb. If you are experiencing brain fog or gut issues, you may want to consider taking a holistic approach at our office.