Looking and feeling like a hot air balloon has been inserted into your belly is uncomfortable on many levels.
Often what’s most frustrating is not being able to identify the source of bloating.
Sure, most of us can expect a bit of bloating after eating a bowl of chili or guzzling a few beers, but what about the rest of the time?
Bloating can happen for lots of reasons, but today’s post will focus on a less familiar cause, a condition known as small intestinal bacterial overgrowth, more commonly referred to as SIBO.
SIBO occurs when excessive amounts of microbes end up in the small intestine, where they don’t belong. In most cases, the bacteria migrates from the colon (aka the large bowel) which houses trillions of bacteria.
Bloating, gas and irregular bowel movements are classic symptoms of SIBO. Other common gastrointestinal (GI) features include heartburn, abdominal pain, intestinal rumbling, and mucus in the stool.
The effects of SIBO go beyond the GI tract. Many SIBO sufferers present with joint pain, headaches, brain fog, weight loss and nutrient deficiencies, notably vitamin B12.
We don’t know exactly what causes SIBO, but we suspect one or more of the following conditions play a role:
Disordered GI motility
Food poisoning, irritable bowel syndrome (IBS), intestinal scar tissue secondary to inflammation or surgery, stress, history of radiation therapy, and hypothyroidism are just some of the conditions that can contribute to disordered GI motility.
Low stomach acid
Low stomach acid can happen for a variety of reasons, including aging and acid suppressing medications, like proton pump inhibitors.
Pancreatic insufficiency, Crohn’s disease and poor diet can result in poor digestion.
Additionally, repeated insults to your gut microbiota can contribute to SIBO, including antibiotics, poorly managed stress, smoking, excessive alcohol intake and an unhealthy diet with lots of highly processed foods and added sugar.
If you suspect you have SIBO then you should talk to a gastroenterologist, integrative medicine doctor or GI nutritionist about undergoing SIBO breath testing.
Breath testing is the most common and least invasive way to diagnose SIBO. You’ll be asked to drink a fermentable solution and then provide a breath sample every 20 minutes for approximately two hours. If microbes are present in the small bowel then they should feed on the solution and produce gas, which is then exhaled through the lungs. Elevated hydrogen or methane production within a given time period is used to diagnose SIBO.
Treatment for SIBO is a multistep process usually involving medications, dietary modifications, stress management, smoking cessation, probiotics and other gut-healing supplements.
In my experience, the most popular diets for SIBO include the low FODMAP diet, the Specific Carbohydrate diet, and a low fermentation diet. All three of these approaches are aimed at starving microbes in the small bowel.
Whatever approach you choose, it’s important to eat a wide variety of whole foods and limit or avoid added sugars and highly processed foods.
Intestinal bloating isn’t just uncomfortable, frequently it's a sign something is wrong. Identifying and correcting the underlying cause(s) are important steps to managing your symptoms and improving your overall well-being.
Addressing SIBO could be a key step in your quest for flatter abs and better gut health.
NOTE: Although less common, bloating can be an early sign of various cancers, such as ovarian, uterine, stomach and pancreatic. It’s important that you tell your doctors about your bloating and any family history of cancer.