SIBO, Acne, and IBS

I talk all about digestion in an earlier blog post, but in today's post, I am focussing on a common ailment that often contributes to acne. A frequent symptom of poor digestion in the small intestines is SIBO or Small Intestine Bacterial Overgrowth.  An imbalance to your intestinal (gut) microbiome can result in an overgrowth of normal bacteria that grows excessively into the small intestines. This is commonly due to digestive dysfunction further north in the digestive tract (such as hypochlorhydria or lack of enzymes).

You are going to learn what SIBO is, what causes it, and how to handle it.

Small Intestine Bacterial Overgrowth

The small intestines are an essential part of digestion and health. If your body was the universe, your small intestines are at the center. Spanning on average 20 feet long, the small intestines are where the majority of nutrients are absorbed into the body. Scientists believe its surface area to span the area of a tennis court!

The small intestine walls also contain patches of lymphatic tissue and neurons that contribute to your immune system's health and mental wellbeing. All nutrients except for fats are absorbed into the bloodstream through the walls of the small intestines lined with small hairbrush like bristles called villi.  Fats are broken down into small lipids from bile at the beginning of the small intestines, in an area called the duodenum. These small lipids are absorbed through the small intestine walls and enter the lymph system.

Impaired digestion allows undigested food to ferment in the colon and feed excessive growth of certain bacteria which then move into the small intestines, where they are NOT supposed to be. SIBO is all about the location of the bacteria.  Though most of the bacteria of your microflora reside in the colon at a concentration of 10^12 CFU/mL, the small intestines range from 10^1 to 10^7 CFU/mL.  The small intestine environment is designed to contain fewer bacteria because of its acidity, and peristalsis.

SYMPTOMS OF SIBO

The excess bacteria in the small intestines disrupt proper absorption of nutrients, damage the lining of the intestinal walls, and can lead to abdominal pain, bloating, gas, belching, neurological issues, and immune system overload. 

Symptoms of SIBO include:

• constipation and/or diarrhea

• bloating

• gas

• abdominal pain

Sound familiar? These are common digestive complaints and can overlap with many other digestive diagnoses. Check out the SIBO expert, Dr. Allison Siebecker's complete list of symptoms here.

TESTING FOR SIBO

There may be other potential co-infections or disorders that also cause similar symptoms, which can make diagnosing SIBO a challenge (e.g. parasite/pathogenic causes). Symptoms alone are not enough to diagnose SIBO.

If you or your doctor believe you have SIBO. There are a few ways to test but Dr. Allison Siebecker recommends doing a 3 hr lactulose breath test (LBT) because of the challenge to test overgrowth in the last 17ft of the small intestine with a Glucose Breath Test (GBT).

Testing is important prior to treatment and retesting is also important to make sure there are no relapses. I recommend working closely with a medical provider to do this.

DIET AND LIFESTYLE FACTORS

Diet and lifestyle have a huge influence on our digestive health. I am always reminding clients that digestion can only happen when in a relaxed state.

If, after changing your diet and following an anti-bacterial protocol numerous times, you are still relapsing with symptoms you might need to assess these two factors:

• structural impairment

• or motility impairment

Motility impairment could be a slow migrating motor complex (MMC) and structural impairment could mean anatomical changes to the ileocecal valve or large intestines affecting the small intestine bacterial overgrowth.

Before addressing these concerns you can gain a lot of healing and many find resolution following these first steps:

1. Eliminate sugar, refined flours, High FODMAP foods, coffee & alcohol.

2. Adopt gut healing foods into your lifestyle (e.g. follow the Full GAPS PDF food list or Low FODMAPS diet).

3. Use a course of herbal anti-bacterial/anti-fungal supplements during the kill phase.

4. Take a therapeutic dose of pro-kinetic.

5. Reinoculate your micro-biome with a GAPS Intro protocol and therapeutic dose of probiotics. 

If symptoms, do not regress or improve. Retreating the overgrowth using a different method might be required. It is always best to follow these steps alongside a practitioner who might have further recommendations to improve your digestion through supplementation or lifestyle.