What your uncomfortable bloated tummy can really mean: Small Intestinal Bacterial Overgrowth
Small Intestinal Bacterial Overgrowth or SIBO for short, is when healthy bacteria migrate from the large intestine to the small intestine, in large numbers. Forming an abundant community which likes to feed on high fiber foods.
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Wait, healthy bacteria? Why do I feel so unwell?
These bacteria ferment your non-digestible high fiber foods, and turn them into different nutrients which your body uses. This is great. The downside, is that they also produce lots of gas.
This methane and hydrogen doesn’t just cause bloating. It also can cause digestive trouble, such as constipation, loose stools, bad breath, fatigue, nausea, and non-digestive issues such as headaches, lack of focus, and muscle weakness.
Curing SIBO can be a bit of a process. In extreme cases, a medical doctor may prescribe a broad spectrum antibiotic. Antibiotics, as the name suggests, are against-bacteria. They kill bacteria overgrowth in your body.
Many people have found relief by doing this.
Another, less clinical option, is to reduce the types of foods in your diet that these bacteria like to feed on.
So how do I know what they like to feed on?
This is where it can get a bit tricky. Just like with us humans, different bacteria have different food preferences. So sometimes it is a bit of trial and error to figure out which bacteria have taken up residence in your small intestine.
The best way to figure it out, is by doing a low FODMAP diet. FODMAPS are non digestible carbohydrates that different healthy bacteria like to feed on.
Common FODMAPs include;
- Fructose: Fruits and vegetables
- Lactose: Milk and milk products
- Fructans: Grains such as wheat and rye
- Galactans: Legumes
- Polyols: Fruits, vegetables, and artificial sweeteners
Using FODMAPs to fix SIBO
Please note that you should always do this under professional supervision. Why?
Because there are quite a few foods which are going to get cut from your diet, and you could very quickly end up with a vitamin or mineral deficiency if you do not do it correctly.
Also you will be re-introducing different foods, and you need to have a good understanding of how to read your symptoms when you re-introduce.
The first stage is typically an elimination, where all high FODMAP foods are removed from your diet.
The second stage is slow re-introduction of each FODMAP group. Now some foods can be in two FODMAP groups, so it is important this is done very carefully.
If no reaction is seen, that group can continue to be eaten. If there is a reaction, then that FODMAP group needs to be eliminated for a period of time.
Do I never get to eat that food every again?!
Generally with SIBO, the aim is to kill off excess bacteria. By not feeding the bacteria the foods they enjoy, their population will slowly go down.
This means over time you can start to eat the foods in that FODMAP group again. Just small amounts at first, and then you may be able to increase a little over time. The key is to do it slowly, and monitor for symptoms.
Monash is an Australian based university who discovered FODMAP foods and their impact on bacteria in the gut.
They have a handy App which lists the food groups, as well as foods you can have plenty of. They are constantly updating and revising their information as they run their research.