Top 20 Takeaways from the 2016 SIBO Summit
Australia’s first SIBO Summit was held in chilly Melbourne on 8th October 2016. I had the absolute pleasure of attending and rubbing shoulders (well, almost!) with Dr Alison Siebecker, my favourite SIBO guru from the USA, Dr Nirala Jacobi, Naturopath and creator of SIBOTest, and Dr Jason Hawrelak, our very own Aussie probiotics advisor. As an added bonus to my recent 3-part SIBO blog series, here are my top 20 takeaways from the day that I hope can help you with your healing journey.
I'm know that a lot of you who read my blog don't know whether you have SIBO (yet), but if you have a diagnosis of IBS, or if you are suffering with bloating after meals, gas, reflux, constipation or diarrhoea, then the information presented at this summit can most likely help you. So please, do yourself a favour and read on...
SIBO Summit 2016 Takeaways
On average, 60% of people who receive an IBS diagnosis actually have SIBO, but they don’t know it yet.
SIBO is an overgrowth of bacteria in the small intestine, regardless of bacteria type.
Overgrowth occurs when one or more of the following protective mechanisms fail: stomach acid, bile or digestive enzymes, the immune system, ileocecal valve, anatomy of the small intestine and the migrating motor complex (MMC).
Food poisoning is the most common cause of SIBO because of its impact on the MMC.
Post-surgical adhesions can impair the MMC and are another root cause of SIBO. These can be treated using visceral mobilisation performed by a trained physiotherapist.
A bad diet will not cause SIBO, and making changes to your diet alone will not heal SIBO.
There is no perfect SIBO diet, however you can start with: SCD/GAPS, Low-FODMAP, Cedars-Sinai, SIBO Specific Food Guide/SIBO Biphasic Diet or Fast Track Digestion. All target reduction in fermentable carbohydrates and need to be tailored to your symptoms.
Low compliance on diet is not 'make or break' but normally means more rounds of antimicrobials/antibiotics.
Staying on a low-FODMAP, or other restrictive diet indefinitely is detrimental to your microbiome and your health. These diets were created for short-term use during treatment and the following relapse-prevention period.
Probiotics will not add to your overgrowth or make your SIBO worse. They are transient and will not colonise (hang around) in your small intestine.
Probiotic strains have individualised beneficial effects as they pass through the digestive tract. Some probiotic strains can stimulate the MMC, heal leaky gut, decrease inflammation and have selective antibacterial actions.
Start probiotics when you start treatment and only use helpful strains. Others may cause you issues and are mostly a waste of your time and money.
Prebiotics like lactulose, partially-hydrolyzed guar gum (PHGG) and galacto-oligosaccharides (GOS) can help with removing the overgrowth for some people, when introduced at the beginning of treatment.
In studies, PHGG has been shown to reduce methane production, thus may be beneficial for methane dominant SIBO as a long term prevention strategy and to help with diversifying the microbiome.
Two-thirds of those with SIBO will relapse, mostly because they fail to use a prokinetic within two weeks of finishing treatment.
In cases of chronic relapsing associated with an impaired MMC, a prokinetic may be required indefinitely.
Symptom relapses within a few days of finishing treatment and confirming via breath test that the SIBO has been eradicated are likely not SIBO, but rather a large intestine issue (parasite, bacteria, yeast). Only after two weeks is it probably a SIBO relapse.
If you have SIBO, you’re at risk of also having other gut pathogens in the large intestine and/or the stomach, as well as adrenal and thyroid issues.
Faecal transplants and probiotic enemas will not heal SIBO.
Dr Alison Siebecker is writing a book on establishing the root causes for SIBO. This should be released in 2017.
Fascinating stuff right?!? If you are looking to work with a SIBO practitioner, please head to the Work With Us page to learn more about how we work online with clients in many countries to test for and treat the various root causes of IBS symptoms and other GI conditions.