SIBO: Small Intestinal Bacteria Overgrowth
Several years ago after weeks of severe, debilitating pain and a swollen stomach that resembled a 5-month pregnancy, I was diagnosed with SIBO with a simple breath test. At the time, my “cure” was atypical, in that I could only digest carbs and cheeses, where traditionally carbs and cheeses are what set off the SIBO storm in your digestive tract. I also didn’t seem to be absorbing any nutrients and actually lost some weight. Naturally, I took advantage of this and started binge eating pizza and nachos. While this all sounded like a great situation from the beginning, I was constantly exhausted. A non-stop carb comma isn’t ideal when you’re trying to work a 9-5, Monday through Friday job.
In my subsequent stints with SIBO, I have had the more traditional version of the overgrowth. The best I’ve felt is when I strictly followed the dietary suggestions of a nutritionist who knew a lot about SIBO. Any sort of medical knowledge on this has proved to be extremely rare, so I’m sharing her guidelines that are at the bottom along with notes from my personal experience. I think it’s important to follow this as a rough guide, but also listen to your body. Keep a food journal and notice what foods affect your body more than others.
SIBO – BASIC DESCRIPTION:
The 1-10 trillion bacteria that live in our colon serve a vital function and are considered by some to be the largest organ in the body by weight. The healthy bacteria (e.g. acidophilus) are critical for normal functioning in the bowel and for preventing the overgrowth of unhealthy yeast, parasites, or dangerous bacteria. The bacteria are supposed to be in the colon (large intestine). When they overgrow in the small intestine, it is called “Small Intestinal Bacterial Overgrowth (SIBO).” SIBO may also contribute to food allergies and nutritional deficiencies. SIBO is very common in CFS and Fibromyalgia, easy to test for, and responds well to proper treatment.
For me, the primary symptom is abdominal bloating and distention. During a bad outbreak, I resort to wearing only leggings and anything made out of jersey material because my body changes over the course of the day. Other symptoms include excess gas, diarrhea, constipation and abdominal pain (I know you well). When the overgrowth is severe and prolonged it can interfere with the digestion and absorption of food which can lead to weight loss. Other symptoms not related to the gastrointestinal track include body aches and fatigue. I’m also noticed my friends have become more annoyed with hearing about me speak about it, but that could just be me.
For some reason, when my stomach is distended I find myself holding it like a pregnant woman might. I say, take advantage of this! Hold your stomach and accept the congratulations from strangers. While you might not have the little nugget after four more months, you might as well reap the benefits of a fake pregnancy and allow someone else to carry a few things for you or let you cut in line.
Something my Gastroenterologist mentioned that I found interesting, was that 80% of the people with Irritable Bowel Syndrome actually have SIBO (which is very treatable). I suggest anyone who has been diagnosed with IBS see their doctor about getting a breath test. SIBO is fairly unknown, so I would hunt for a doctor who is familiar with the issue.
WHY I HAVE SIBO:
I developed SIBO in a way that is less common, in that I’ve had several surgeries on my stomach and intestines. I also am part of the small percentage of the population that forms abnormal amounts of scar tissue. These two things combined causes issues in the normal process of ridding the body of bacteria.
MEDICATION VS DIET
Over the past few years, I’ve had this reoccurring problem, and while there are medications that can be prescribed for SIBO, I’ve found that proper diet is the most effective way of managing the problem. I also resist taking antibiotics whenever possible. I think we abuse this medication, especially in America, and it’s making it less effective. Medical reports are showing our bodies are becoming more and more resistant, and we could even start dying of simple infections in the future. Read more here on the CDC website.
- Three meals a day and nothing in between. This means allowing 4-5 hours between meals with no snacks or drinks (other than water) so that the small intestine’s cleaning function can take place. For those individuals prone to bacterial overgrowth, they might have a cleaning function that is not very efficient. This is why it is particularly important that you give the intestine a break from food 4-5 hours between meals to allow the cleaning function a chance to rid the intestine of food residue and bacteria.
*I like to have smaller, more frequent meals, so this is the hardest thing for me. When I do follow this, I do feel better, but it’s just proven to be too unrealistic. When I follow most of the other guidelines, it seems to be okay though.
- Limit the following sweeteners:
- Corn syrup (fructose), mannitol, sorbitol, sucralose (Splenda), and lactulose. Glucose, sucralose (table sugar) and aspartame (Equal and NutraSweet) are okay, but only in moderation.
- Fruit juice sweetened products are acceptable, but again, only in moderation.
- Limit sugar to 40 grams a day when reading labels.
*Oddly enough, my doctor told me “fake” sugars were okay, turns out he was wrong. It’s healthier in many ways, not just for SIBO, to avoid these.
- Limit or eliminate the following “high residue” foods. These foods are difficult to digest and leave residue in the small intestine.
- Legumes (garbanzo, kidney, pinto, black beans, etc.), lentils, peas (split pea soup), soy products (tofu, soy milk), and milk (yogurt, cheese, milk).
*This is especially challenging for me as I’m a vegetarian. Where do vegetarians get protein from you ask? See the list above. I have limited my soy intake to only once a day, and have found that it helps, but it is obviously not ideal. Anytime I can stomach egg protein (which I find utterly disgusting), I try to.
- Drink 8 cups of water per day.
- Carbohydrates – Potatoes, pasta, rice, bread and cereals are acceptable. Consume these products in moderation (1/2 to 1 cup serving at each meal). You can choose between both whole grain and white breads, but avoid bread products with nuts and seeds. Avoid wild rice. These types of fibers are difficult to digest. Oat and wheat fibers are better.
*I disagree in that you can have “white” carbs; I’ve found that stirs the SIBO, but whole grains are okay. I’m not a big carb eater, and try to be gluten-free, so I like to incorporate brown rice, oatmeal and quinoa.
- Fruits – These have easily digested fibers that you need for normal bowel movements. Choose fresh, not dried fruit. You can remove the skins. Limit to 2 fruit servings per day.
*Definitely limit fruit to only two servings, and try to do low sugar fruits as well. I went on a binge with fruit recently and it wasn’t pretty.
- Vegetables – Cooked is preferable, as this is easier to digest and absorb. Avoid salads or raw vegetables as this can lead to too much residue. Remove tough parts of vegetables and cook well. Limit to two ½ -1 cup servings of cooked vegetables per day.
*I rarely eat raw vegetables anymore because it causes my stomach to blow up like a balloon. This is rough because I’m actually a vegetarian because I love vegetables in all its forms. I recently started drinking a fresh veggie juice for breakfast and that seems to be fine though.
- Dairy – Dairy products are to be avoided. Do not substitute with soy milk as soy products contain unabsorbable oligosaccharides that can contribute to bloating. Try rice milk instead. To obtain calcium, take a supplement that produces 1000mg calcium per day.
*Hard cheeses seem to be the easiest to consume, dairy in liquid form is a doozy though.
- Coffee/Tea/Sodas – Tea is the best choice. Coffee is fine 1-2 cups per day. Sodas may have corn syrup; diet sodas may have sucralose, avoid these. Diet sodas with NutraSweet may be taken in moderation. Have water instead.
*I adore coffee, but I drink it black because basically any additive will aggravate your stomach, with the exception of Rice Milk, which I find utterly useless. Why would I want more calories and more carbohydrates in a watered down substance? Pointless.