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If you are burping after a meal, or have abdominal bloating, pain, or even constipation or diarrhea, you could have SIBO or small intestinal bacterial overgrowth.

When we are healthy most of our gut bacteria live in our large intestine. When we have a gut condition called SIBO, the bacteria population in our small intestine rises to an abnormally high level and the result is excess gas, burping, bloating, diarrhea, constipation, and pain. These bacteria interfere with our digestion and absorption of valuable nutrients, minerals, and vitamins, causing health problems.

How do you know if you have SIBO? A standard test can be taken at home or at a doctor’s office—the hydrogen breath test. The test requires fasting 12 hours and it’s not perfect because it can only detect about 60% of Hill Climb . By evaluating your test results along with other symptoms, your doctor can determine whether you have this condition.

SIBO is associated with irritable bowel syndrome or IBS. Some researchers have even suggested that IBS leads to SIBO. It is also present in other diseases. According to one study, even 66% of patients with celiac disease (who maintained a strict gluten-free diet) tested positive for bacterial overgrowth and 43% of the people with chronic diabetes had SIBO. The incidence of SIBO also increases with aging. Adults over 61 have more than twice the frequency (15%) of those between 24 to 59 (6%).

The standard treatment for SIBO is antibiotics, but many experts now feel that probiotics should be the first line of treatment, followed by antibiotics only if necessary. Another approach is a low carb diet, such as the FODMAPs diet, which we discuss in Gut Crisis.

One of the most interesting new treatments is the use of herbal preparations. One carefully controlled study showed that several commercial herbal products were as effective as the antibiotic Rifaximin. More recent research has found that an herbal preparation called Atrantil is helpful in suppressing SIBO in patients with IBS, markedly reducing such symptoms as bloating, constipation, and abdominal discomfort in 80% of the subjects.

Ayurveda has numerous herbal preparations and purification programs designed to treat the various symptoms of SIBO and we are looking forward to clinical research that verifies their effectiveness.

References:

  1. Ghoshal UC, et al., Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy. Gut and Liver 2017;11(2):196-208. doi:10.5009/gnl16126.
  2. Pinto-Sanchez MI, Hall GB, Ghajar K, et al. Probiotic Bifidobacterium longum NCC3001 Reduces Depression Scores and Alters Brain Activity: a Pilot Study in Patients With Irritable Bowel Syndrome. Gastroenterology doi: 10.1053/j.gastro.2017.05.003.
  3. Kennedy, PJ et al., Irritable bowel syndrome: A microbiome-gut-brain axis disorder? World J Gastroenterol Oct 2014; 20(39): 14105–14125
  4. Chedid V, Dhalla S, Clarke JO, et al. Herbal Therapy Is Equivalent to Rifaximin for the Treatment of Small Intestinal Bacterial Overgrowth. Global Advances in Health and Medicine. 2014;3(3):16-24. doi:10.7453/gahmj.2014.019.
  5. Brown K, Scott-Hoy B, Jennings Efficacy of a Quebracho, Conker Tree, and M. balsamea Willd blended extract in patients with irritable bowel syndrome with constipation. J Gasterenterol Hepatol Res 2015;4:1762–1767.
  6. Brown, K et al., Response of irritable bowel syndrome with constipation patients administered a combined quebracho/conker tree/M. balsamea Willd extract. World Journal of Gastrointestinal Pharmacology and Therapeutics 2016; 7(3):463-468