A lot of people with digestive issues (anything from bloating to reflux) actually have a condition called SIBO, or small intestinal bacterial overgrowth.

In fact, studies show that over 50% of patients diagnosed with IBS (Irritable Bowel Syndrome) have SIBO. Despite this compelling evidence, it is still largely ignored by the medical profession.

What is SIBO?

The majority of our gut bacteria should be in the colon (large intestine). When they are there, they do lots of good things for us (more on that on Day 3).

However, for various reasons (see more about the causes below), these bacteria sometimes start to overgrow in the small intestine, where they should only be present in small amounts. When this happens, it causes symptoms such as diarrhea, constipation, gas, or bloating ( the symptoms you get depend mostly on the type of gas produced by the bacteria overgrowing).

SIBO is like a chronic infection in your gut. It is not that the bacteria overgrowing are pathogenic (causing disease like E. coli or Salmonella) but too many of them in the wrong location (small intestines vs large intestines) is a problem.

ACTION STEP 1: Download the questionnaire below to find out if you might have SIBO.

You did the questionnaire, and now you think you might have SIBO... and you are wondering, how on earth did you get this?

Often, people don't really know what exactly caused them to develop SIBO. It can be a combination of factors, or sometimes even just stress can be the trigger.

However, here are some of the most common causes:

• Post infectious: a case of gastroenteritis is the most common trigger. If your symptoms developed shortly after getting a 'stomach bug' (up to a few weeks or months after), it might be what caused you to develop SIBO (without going in great details, it's an auto-immune reaction which damages the small intestine).
• Over-consumption of simple carbohydrates (refined sugar, white flours, processed food, grains)
• Medications: proton pump inhibitors (very often prescribed for reflux/ GERD), morphine and other opiates.
• Stress:
  • chronic stress can decrease stomach acid output. Normal stomach acid levels are required to kill bacteria.
  • Stress also causes change in the motility of the small intestines, causing a pooling and stagnation which allows for bacterial overgrowth.
  • Stress can also affect the good functioning of the ileo-cecal valve (ICV), which can cause a backflow of the bacteria from the large intestine into the small intestine.
• Altered anatomy : malformation of the ileo-cecal valve, surgical intervention causing scarring and adhesions altering the normal anatomy of the small intestines.
• Dysbiosis (imbalance of gut bacteria...more about that in a few lessons)

Go to the next lesson to learn more about diet and what you can do to reduce your symptoms.