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SIBO-(Small Intestine Bacterial Overgrowth) INFORMATIONOvergrowth) Conditions Associated With SIBO: AchlorhydriaChronic PancreatitisHypochlorhydriaChronic ABX UsePPIsIgA DeficiencyDysmotilityCeliac DiseaseMalnutritionCrohn’s DiseaseCollagen Vascular DiseaseShort Bowel SyndromeImmune DeficiencyNon-Alcoholic SteatorrheaBowel ResectionCirrhosisBariatric SurgeryFibromyalgiaAdvancing AgeRosacea/Acne (significantly higher in SIBO)Small Intestinal Bacterial Overgrowth (SIBO): Abnormally large numbers of bacteria (at least 100,000 bacteria per ml of fluid) are present in the small intestine.Signs & Symptoms:Bloating, abdominal discomfort, diarrhea, abdominal pain, belching gas, Anemia, B12 eficiency, malnutrition, reduced bile acids, steatorrhea, weight loss, food allergies, brain fog, systemic inflammation, chronic fatigue, restless leg syndrome.Also associated with micronutrient deficiencies (B12, A, D, and E, iron, thiamine, nicotinamide)SIBO Diagnosis:-Breath test for hydrogen/methane* H>20, M>3 Combo>15-Organic acids-not diagnostic-Stool test-not diagnosticDiet interventions = FODMAP Elimination:-Fermentable Oligo, D. Monosaccharides and Polyols. Family of poorly absorbed, short-chain carbohydrates :LactoseFructoseFructo-and galacto-oliogsaccharides (fructans and galactans)Polyols (sorbitol, mannitol, xylitol and maltitol) Eliminate Foods Containing Fodmaps: Excess fructose - Lactose - Fructans - Galactans - PolyolsExcess Fructose:Lactose/ GalactanFructans:Polyols: FRUIT: apple, mango, nashi, pear, persimmon, custard, canned fruit in natural juice, watermelon.SWEETNERS: fructose, high fructose corn syrup, large total fructose dose, concentrated fruit sources, large services of fruit, tinned fruit, dried fruit, fruit juicehoney, corn syrup, fruitsana.MILK-milk from cows, goats or sheep, ice cream, yogurt CHEESES: soft unopened cheeses, cottage cheeses, cream cheese, mascarpone, ricottaGALATIONS:Legumes: baked beans, chickpeas, kidney beans, lentilsVEGTABLES: asparagus, beet root, broccoli, Brussel sprouts cabbage eggplant, fennel, garlic, leek, okra, onion, shallots, spring onionCEREALS: wheat, rye, egg, bread, crackers, cookies, couscous, pastasFRUIT: custard, apple, persimmon, watermelonMisc: Chickory, dandelion, inulinFRUIT: apples, apricot, avocado, blackberry, cherry, lychee, nashi, nectarine, peach, pear, plum, prune, watermelonVEGTABLES: cauliflower, green capsicum, bell peppers, mushrooms, sweet corn SWEETNERS:sorbitolmannitolisomaltinositolmalitolxylitol Foods Suitable On a Low Fodmap Diet Fruits Vegetables Grains Milks OtherBananablueberrycantaloupe honeydew kiwifruitlemonmandarinorangepassion fruit pawpawraspberryrhubarbrock melon star anisestrawberrytangeloalfalfa, artichokebamboo shootsbean sprouts taro, sumbok choyendivegingergreen beanslettuceolivesparsnippotatopumpkin red capsicumbell pepper silver beetspinach summer squashsweet potato yamtomatoturnip zucchiniCerealsgluten-freebread or cereal.Bread100% speltriceoatspolenta OtherarrowrootmilletpsylliumquinoasorghumtapiocaMilklactose-freeoat milkrice milksoy milk (check -additives)Coconut MilkHemp MilkCheeseshard cheesesbriecamembertyogurt lactose-freeIce-creamsubstitutes:gelato, sorbetbutter subs:olive oil HerbsBasil chilicoriandermintgingerparsley lemongrassmarjoram oregano thyme rosemary sweetenerssugar(sucrose)glucose,Steviaartificial sweeteners (not ending in ‘-ol)honey substitute:maple golden syrup, molasses,treacle SIBO TreatmentMedications 10- 14 daysXifaxan 550 mg TID 10-14 days (not systemically absorbed)Metronidazole/Tinidazole or Neomycin are alternatives for methane producers.Pro-kinetic agents (Regian or domperidone) may help mobilityHerbal Treatments 4-8 WeeksBerberine up to 5 grams daily (500 mg 1500 mg BID/TID) x 4-6 weeksOregano 200mg TID x2-6 weeksGarlic (tx methane bacteria) Allimed 450 mg x 4-6 weeksNEEM Olive Leaf ExtractArtemesininMonolaurinBiofilm disruptorsProbiotics may be contraindicated because SIBO often involves an overgrowth of D-lactate producing speciesElemental Diet for 2 weeks This information is only for education purposes and is not intended for diagnoses and or treatment of any disease. Check with your physician should you have a pre-existing disease condition. ................
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