Small intestine bacterial overgrowth (SIBO) is commonly found in patients with dysautonomia. Of the patients we treat for autonomic dysfunction at Autonomic Specialists, most test positive for SIBO. Because it is so prevalent in our patients, we’ve had to establish a treatment program specifically to address this problem.
SIBO – Symptoms and Complications
SIBO is chronic infection of the small intestine. It can be seen with a number of conditions but is most strongly associated with irritable bowel syndrome (IBS). In fact according to Dr. Pimentel, SIBO is the cause of IBS. It is not necessarily an infection in the sense of a build up of pathogens, rather it is simply a build of bacteria in an area of the body that is normally free from bacteria.
SIBO can lead to IBS symptoms such as bloating, pain, constipation, diarrhea or both. Malabsorption may also occur in the presence of SIBO. Perhaps the biggest issue caused by SIBO is intestinal permeability, otherwise known as leaky gut. Intestinal permeability may lead to activation of the immune system which can result in food sensitivities. Fatigue, altered cognition, pain and other neurologic symptoms may also occur as a result of intestinal permeability.
Risk Factors for SIBO
Achlorhydria is a predisposing factor for SIBO as is extended antibiotic use. Dysautonomia is also a risk factor for SIBO. In fact in our practice most patients with dysautonomia are found to also suffer from SIBO. Several publications demonstrate a strong connection between SIBO and fibromyalgia.
Testing for SIBO
Diagnosis of SIBO is often confirmed by breath test. This involves the ingestion of a sugar solution followed by collection of the gases breathed out of the lungs over time. A rise in hydrogen or methane gas shortly after eating, indicating fermentation occurring in the small intestine, is indicative of SIBO.
SIBO Treatment at Autonomic Specialists
Successful treatment of SIBO can be challenging. However, treatment is important for more than just relief of IBS symptoms. SIBO is often present with other conditions, some of which are autoimmune or chronic inflammatory illnesses. Correction of intestinal permeability in those circumstances is particularly important.
We take a multi-pronged approach to treating SIBO using antimicrobials, pro kinetic agents such as low dose naltraxone (LDN), and low FODMAPS or elemental diets.
If you are a patient or know someone with SIBO and are interested in more information on treatment options at Autonomic Specialists, please contact us at (949) 247-8877 or through our web form.