Treating SIBO involves a unique process that requires fine-tuning. It took me lots of testing, discomfort, and change in practitioners to find the support that I needed, AND I am always checking in and re-evaluating what works and doesn’t work for me.
The goal of the treatment comes in threefold:
1. Provide nutritional support
2. Correct the underlying cause
3. Treat the overgrowth
Below are the three ways often used by health practitioners to treat SIBO and a bit about my journey through them. Remember, everyone is different and there is no “right way” or “wrong way” to treat SIBO.
Antibiotic-therapy for SIBO
The current go-to SIBO treatment remains antibiotic therapy. Antibiotics have been used to eliminate or reduce the overgrowth of bacteria and reverse inflammation of intestinal mucosa linked to malabsorption and overgrowth. In the last few years, many antibiotics have been suggested to eradicate SIBO. Because overgrowth may occur either by a combination of anaerobic and aerobic bacteria or only by aerobic flora, an effective antibiotic that can fight a number of bacteria species must be used.
Rifaximin is a derivative of rifamycin with antibacterial activity that can inhibit bacterial synthesis of RNA. It is effective against gram-positive and –negative bacteria, includes anaerobes and aerobics. Because less than 0.1 percent of its oral dose is absorbed, administration of rifaximin is associated with minimal side effects.
Based on a recent study that aims to assess the effectiveness of rifaximin treatment on SIBO, fifty children with irritable bowel syndrome symptoms were enrolled. All underwent lactulose hydrogen/methane breath test (LBT) to check SIBO before and a month after the treatment of 600 mg rifaximin daily for one week. Results revealed the normalization of breath test by 64 percent. No relevant side effects were noted during the treatment. And the SIBO and IBS symptoms strongly improved. It was concluded that Rifaximin was highly effective and safe in the treatment of SIBO as well as IBS symptoms.
The thing with antibiotic treatment, is that even if you are lucky enough for it to work - it is a bandaid and NOT a solution. If your diet remains unchanged, your symptoms will return and be triggered over and over again.
Gut Motility Therapy for SIBO
Gut motility is the measure of the body’s ability to pass food through the digestive tract. A lot of issues may surface from poor gut motility, resulting from the body’s inability to properly absorb nutrients. The body could also have an issue absorbing medications, which makes it hard to completely resolve and treat SIBO.
Below are the signs and symptoms of a compromised gut motility:
· Chronic constipation
· Abdominal distention
· Severe abdominal pain
· Recurring obstructions
· Gastroesophageal reflux disease
While there are several connections between SIBO and other diseases, abnormalities in gut motility are still identified as one of the most common connections. Based on this study, patients with SIBO were found to have significant delays in their small bowel transit time, which is the duration it takes for food to move through the small bowel. Such findings reveals that patient with SIBO, who don’t respond well to a standard course of antibiotics, may benefit from using a prokinetic agent, which can increase the muscular contractions of the small intestine.
Octreotide, along with low dose naltrexone are the options being investigated as they may help treat certain cases of SIBO that do not respond to antibiotics alone. Low dose naltrexone has been my saving grace, and stopping my daily prescription of it after I beat SIBO the first time was thought to actually cause my relapse. My body was still struggling with poor gut motility even though I had “beat SIBO”, but once I stopped the Naltrexone, I began struggling and relapsed quickly. I am still on low dose naltrexone today.
Again, eating a diet rich in the nutrients you need to keep your digestion flowing is critical in supporting this treatment.
Which brings us to...
Dietary Guidelines for SIBO
The dietary approach for SIBO is to consume foods that are easily digested to ensure that most of the nutrients can be absorbed at the earlier part of the intestine, away from the bacteria.
Foods that aren’t well absorbed must be minimized, if not altogether eliminated from the diet, as they are good source for fuel for the bacteria living at the end of the small intestine.
We break all of the dietary treatments for SIBO down in a separate post.
Finding a Practitioner
When it comes to dealing with SIBO, diet and lifestyle are the foundation. However, when you keep experiencing remission, it makes perfect sense to seek professional help. Unfortunately, not all practitioners are the same. So, how do you find a good one? When you are about to spend money and time in trying to recover and heal, you want to find someone who can truly help.
Patient-centered care is a way of providing care to clients or patients that is responsive and respectful to their needs and preferences, with clinical decisions guided by patient’s values.
Seek out someone who actively listens, not someone who tells you you’re crazy. However, you, as the patient, have the right to clarify something you don’t understand. Start with something that really concerns you the most and guide the conversation. It can be helpful if you’re able to tell your chief symptoms as this focuses the discussion.
A good doctor checks in with you, sees how you are responding and makes adjustments accordingly. DO NOT accept one blanket treatment with no check-ins. It’s important to make sure that your treatment is working for YOU.
Keep in mind that this is a partnership. Be empowered – speak up, express concerns, make requests and ask questions. Once you have decided to work together on a treatment plan, commit to it.
You can do this!
Want to know who I recommend? Click here to learn more about Nanci Tunley with Revive and Thrive