Monday, April 6, 2015

Why Am I So Bloated? (A Story of Small Intestine Bacterial Overgrowth.)

By Tereza Hubkova, M.D.

Feeling bloated lately? Have a lot of gas? Likely, you will understand why after reading on.

First, avoid all dairy (e.g., milk, cheese, butter, and even yogurt) for one week to see if you feel better. One out of four people suffers from lactose intolerance
poor digestion of milk sugar (lactose).

Another common cause of such symptoms is fructose intolerance
difficulty with digesting fruit sugar (fructose). If step one didn't help, cut back on fruit and juices for a few days to see what happens. Better yet? No? Read on...

Bloating and gas can often be due to the fermentation of other undigested or poorly digested foods—typically other carbohydrates—within the small intestine—particularly when there is an unhealthy overgrowth of bacteria in the small intestine
Normally, we have relatively few bacteria in our stomachs, but as many as a few trillions bacteria within our large intestines. The small intestine lies in between; an overgrowth of bacteria there is typically prevented by the presence of residual stomach acid and the natural movement of the intestines, which sweeps the bacteria onward.

But, if you have a condition which interferes with the digestion and absorption of nutrients (such as celiac disease, a malfunctioning pancreas, or Crohn's disease), the undigested food becomes a feast for bacteria. Subsequent fermentation creates gas, distention of the abdomen, abdominal cramps, diarrhea, and/or constipation. (Production of methane tends to cause constipation, while hydrogen usually tends to cause more diarrhea.)

If you have low stomach acid
common with aging, Helicobacter pylori infection, after gastric bypass surgery for weight loss, or you take medications to lower stomach acidyou have up to a 50% chance of developing small intestine bacterial overgrowth (SIBO).

We need stomach acid to help us digest food, and absorb such nutrients as calcium, magnesium, vitamin B12, and iron; but also to kill the bacteria that could be present in the food. Not coincidentally, the animal with the most acidic stomach in nature is the carrion eating vulture; so acidic, in fact, that it’s capable of destroying anthrax spores and cholera.

Additionally, your intestines may be moving slowly due to diabetes or a sluggish thyroid (i.e., hypothyroidism) as well as for people with certain rheumatoid conditions, such as scleroderma. These can all result in SIBO.

SIBO is not just a nuisance. It can lead  to inflammation and malabsorption. Small intestine bacterial overgrowth is a common cause of irritable bowel syndrome (i.e., IBS). SIBO has been linked to some cases of fibromyalgia, restless legs syndrome, rosacea, fatty liver, cirrhosis (from overproduction of alcohol in the gut), and even osteoporosis. By increasing intestinal permeability (i.e., leaky gut), SIBO can even contribute to or cause chronic fatigue syndrome, interstitial cystitis, pelvic pain, brain fog, as well as other conditions.

If you have the above risk factors for SIBO, and your bloating did not improve by eliminating dairy and fruit, see a physician who can perform a breath test to confirm the diagnosis. Or, if the suspicion is high enough, we simply begin treatment right away.

Treatment of SIBO starts by suppressing the excessive bacteria in your small intestine through use of an antibiotic (I prefer to use antimicrobial herbs such as oil of oregano and berberine) along with temporarily starving the bacteria by using a low sugar, low starch diet (or low FODMAP diet).

Then you have to treat the underlying condition. If not, SIBO would simply return.

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