Gut Feeling Holistic Nutrition 

 

Small intestinal bacterial overgrowth(SIBO)is a chronic bacterial infection of the small intestine. The infection occurs when bacteria that normally live in the lower gastrointestinal tract have abnormally migrated and overgrown in the small intestine. Bacteria are normally present throughout the entire gastrointestinal tract, but in varied amounts. Relatively few bacteria normally live in the small bowel, less than 10,000 bacteria per milliliter of fluid, compared with the large bowel which has at least 1,000,000,000 bacteria per milliliter of fluid.

 

Additionally, the types of bacteria normally present in the small bowel are different from those that are in the colon. The typical beneficial bacteria that are a necessary part of a healthy small bowel perform important functions. These beneficial microorganisms help protect against pathogenic bacteria and yeast that are ingested. They help the body absorb nutrients and they produce several nutrients such as short chain fatty acids and vitamins like folate and vitamin K. They also help maintain the normal muscular activity of the small intestine.  

 

The body has several different ways of preventing small intestinal bacterial overgrowth from occurring. These include gastric acid secretion which maintains an acidic environment, waves of bowel wall muscular activity created by the migrating motor complex, immunoglobulin's in the intestinal fluid, and a valve that normally allows the flow of contents into the large bowel but prevents them from refluxing back into the small bowel. This is called the ileocecal valve because it’s located between the ileum, or terminal end of the small intestine, and the cecum, a pouch forming the first part of the large bowel. In some cases, for temporary periods of time, the ileocecal valve gets periodically stuck open. This allows bacterium to flow in the opposite direction in the small intestine.

 

Typically, the cause of small intestinal bacterial overgrowth is complex, and it more than likely affects more than one of the protective mechanisms listed above.  

Symptoms include but are not limited too: 

• Abdominal pain

• Acne

• Anxiety

• Asthma and/or other respiratory symptoms

• Belching

• Bloating

• Brain fog

• Brain symptoms (e.g. Autism)

• Constipation and/or Diarrhea

• Cramps

• Eczema and/or other skin conditions

• Depression

• Fatigue

• Fatty stools

• Flatulence 

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Why natural treatment of SIBO is preferred over just a round of antibiotics. 

 

According to the NIH, more than 80 percent of human bacterial infections are associated with bacterial biofilm.  While planktonic bacteria can become antibiotic resistant through gene mutations, a biofilm is often antibiotic resistant for many reasons including physical, chemical, and genetic. Treating illnesses associated with biofilms using antibiotics alone is an uphill battle.

 

One reason conventional therapies (standard antibiotics) are not working is because they are not addressing the long-term habitat of biofilm in the small intestine. Most people think of bacteria as single cells floating around, releasing toxins, and damaging the host. However, most bacteria do not exist in this planktonic form in the human body, but rather in sessile communities called biofilms. To form a biofilm, bacteria first adhere to a surface and then generate a polysaccharide matrix that sequesters calcium, magnesium, iron, or whatever other minerals are available to them.  Within a biofilm, one or more types of bacteria share nutrients and DNA and go through changes to elude the immune system. Since it requires less oxygen and fewer nutrients and alters the pH at the core, the biofilm is a hostile community for most antibiotics. In addition, the biofilm forms a physical barrier that keeps most immune cells from detecting the pathogenic bacteria.  Biofilm formation begins when free-floating microorganisms such as bacteria meet an appropriate surface and begin to put down roots. This is partly why someone who has undergone SIBO treatment retests, and their tests come back negative, in reality the bacteria may be still there, just “hiding”, so in the future it looks like there was a recurrence.

 

According to the Center for Biofilm Engineering at Montana State University the first step of attachment occurs when the microorganisms produce a gooey substance known as an extracellular polymeric substance.  An EPS is a network of sugars, proteins, and nucleic acids, such as DNA. It enables the microorganisms in the biofilm to stick together.  For treatment to be successful the biofilm needs to be dissolved at the same time as actually “killing” the bacterium that lives inside it. Additionally, these microorganisms can communicate with one another via cell signaling which causes the same types of cells to form colonies together. This mechanism is known as quorum sensing. Quorum sensing allows the microorganisms to work as a group, changing and adapting to their environment. Quorum sensing allows the bacteria to evade antibiotics. 

 

Fortunately, there are many natural therapeutics that address all aspects of the condition.  

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