SIBO (Small Intestinal Bacterial Overgrowth) has many potential underlying causes which are different in each individual. Not addressing these increases the chance of relapse, and SIBO is already a condition with a high rate of relapse! This is why it's so important to work with a qualified healthcare professional trained in SIBO treatment.
There are many potential causes of SIBO and some people have more than one. They fall in to various categories such as anatomical variations, infections, co-morbid conditions, digestive weaknesses and lifestyle factors.
Treating SIBO is like peeling back the layers of an onion because SIBO is the end result of these underlying causes, which also have their own underlying causes to be addressed. This is why it's crucial to work with an expert who can determine what caused your SIBO and help you with a comprehensive, individualised approach. If you need help, find out more about working with me.
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Anatomical variations or dysfunction
- Ileocecal valve dysfunction
- Adhesions - eg. from abdominal surgery such as hysterectomy, caesarean section
- Endometriosis
- Damage to the Migrating Motor Complex (MMC) - nerve damage, either post-infectious or other
- Type 2 diabetes - neuropathy
- Ehlers Danlos Syndrome (EDS)/Connective tissue weakness
- Ileocecal valve dysfunction
Infections
- Generally speaking, infections are the main cause of MMC dysfunction due to the development of post-infectious IBS which involves antibodies being produced that target the cells involved in MMC functioning. This is one of the main causes of relapsing SIBO.
- Food poisoning and traveller's diarrhoea
- Giardia infection
Co-morbid conditions
- Hypothyroidism and Hashimotos Thyroiditis (including poorly treated)
- Crohn's Disease
- Scleroderma
- Traumatic Brain Injury - which can either be an obvious injury or something more subtle, even falling on to the tailbone down stairs
Digestive weaknesses
- Exocrine Pancreatic insufficiency - we release enzymes as part of the MMC
- Brush border enzyme deficiency
- Hypochlorhydria and achlorhydria
- Bile sludge
- Gallbladder dyskinesia
- Gilbert's syndrome
- MMC impairment
- Gastroparesis
Other factors
- Acid base balance
- Chronic stress, affecting parasympathetic tone ("rest and digest")
Lifestyle factors
- Eating too often/snacking interferes with correct MMC functioning. So, in general it's best to avoid snacking, keeping food intake to discrete meals that are 5 hours apart with nothing between except no-calorie drinks such as water, black tea or black coffee. Eating enough at each meal is essential for sticking to this schedule. There are some situations where this might be difficult, such as with breastfeeding, in chronic fatigue syndrome and also gastroparesis
- Lack of movement
Medications
- PPIs (eg. Nexium)
- Opiates/narcotics
- Anti-spasmodics
- Tricyclic antidepressants
Work with me
Struggling with chronic digestive symptoms? Have a tough case of SIBO? Relapsed after treatment? I'm here to help you. Find out more about how I treat SIBO as a Naturopath and Nutritionist.
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