Normally when we eat food, enzymes will break down our food and our gut moves the food through our digestive tract from the stomach to the small intestine and then to the colon. In a healthy microbiome, the bacteria’s get passed through our digestive tract along with food to the colon. However with SIBO this process does not exactly occur and some causes of that can be:

• Damaged nerves or muscles – diabetes mellitus and scleroderma can both affect the muscles in the gut, leaving room for SIBO to develop
• Physical obstructions in the gut – scarring from surgeries or Crohn’s disease and diverticula (tiny pouches that can form in the wall of the small intestine) can collect bacteria instead of passing it on to the colon, where it belongs.
• Medications – medications can disrupt the normal gut flora including antibiotics, acid-blocking drugs, and steroids.
• Nutrition – a diet high in sugar, refined carbohydrates, alcohol, and other high-carb foods you eat or drink.
• Chronic constipation – lengthened transit time and any stagnancy can create a build up of bacteria in the small intestine
• Shorter transit time – if food passes through the bowel too quickly it can also be problematic because it does not allow for proper digestion and absorption
• Digestive enzymes – if someone does not have enough stomach acid, bile and enzymes to keep bacterial levels in check than too much bacteria can begin to flourish

It is important to understand what type of SIBO you have before you begin treatment. This means you will need to take a test to identify if you have hydrogen or methane based SIBO and the quantity of the overgrowth. There are a few testing options to identify your SIBO: breath test, organix dysbiosis test (urine-based) or a comprehensive stool test. Once you have identified the type of SIBO generally practitioners will want to “starve” the bacteria by removing foods that feed the bacteria like sugar, alcohol and carbohydrates.

Many people will go on a LOW-FOD map diet in which the usual inflammatory gut foods are removed like: bread, cookies, cake, cocktails as well as complex carbohydrates such as grains and legumes. Any sugar will ultimately feed the bacteria. A SIBO diet generally consists of lots of non-starchy vegetables, lean proteins, healthy fats and low glycemic fruit. After you have starved the bacteria usually natural antibiotics or regular antibiotics will be used to kill off the bacteria. Xifaxan and Neomycin are a common combo to kill off methane based SIBO. Xifaxan is more effective with hydrogen-dominant SIBO and Neomycin with methane-dominant SIBO. When it comes to alternative medicine blends with berberine are usually used. Lastly, you will restore you gut with good bacteria by finding a SIBO suitable probiotic because some probiotics will make SIBO worse.