Crohns & Colitis
Gas & Bloating
Irritable Bowel Syndrome
Leaky Gut Syndrome
Polycystic Ovarian Syndrome
Frequent Colds & Flu
Small Intestinal Bacterial Overgrowth
Over the last three decades, there has been growing recognition for the role of gut bacterial in the health of the gastrointestinal tract. It has been found that anywhere between 17 - 85% of cases of irritable bowel disease may in fact be attributed to an underlying overgrowth of bacteria into the small intestines, called SIBO (small intestinal bacterial overgrowth). It is important to note that this is NOT an infection, but an overpopulation of bacteria in a location not meant for such high concentrations.
Common symptoms include:
- gas (belching or flatulence)
- stomach pain
- diarrhea, constipation, or both
- in extreme cases, weight loss
The small intestine's role is primarily that of nutrient absorption, and therefore overgrowth in this area allow the bacteria to rob you of essential nutrients. Vitamin D, K, iron and b12 deficiencies are popular among these patients.
The inflammation produced by the endotoxins of the bacteria are also an attributing cause to leaky gut syndrome and the development of multiple food sensitivities. Furthermore, SIBO can inhibit nutrient absorption and lead to carbohydrate intolerance, malabsorption/malnutrition, anemia, weight loss, and so on.
Successful eradication of SIBO has been shown to reduce bloating, gas, diarrhea, and abdominal pain in patients, even more successfully that most conventional treatments for IBS. Patients with gastrointestinal distress may benefit from SIBO testing, especially those with a history of chronic constipation, diarrhea, weak stomach acid, or generalized maldigestion.
SIBO Breath Testing
Gold Standard for diagnosing SIBO involves a Lactulose Breath Test, where a lactulose substance is administered after 24 hours of a non-fermentable diet. Breath samples are assessed every 20 mins for 3 hours following administration of the substance, and hydrogen/methane gas is measured in each sample. A steep rise or overall elevation of either of these gases indicate that bacteria is fermenting the sugar, and is deemed positive for SIBO.
Treatment with Dr. Holmberg involves a series of steps to ensure complete resolution of the overgrowth.
The first step involves resetting the terrain of the digestive tract utilizing natural or pharmaceutical antimicrobials in combination with dietary and nutraceutical therapies to repair the gut and minimize risk of recurrence.
Remember... the bacterial strains in our guts are not just a collection of individual organisms, but an ecosystem that operate as one!
You can't cut down the rainforest and expect it to regrow in a day. Probiotics have been shown to only repopulate the gut for up to 21 days following discontinuation, so ensuring survival of the original beneficial organisms in essential. Furthermore, while Specific Carbohydrate/FODMAPs diets have been shown to be helpful, one must remember the problem lies not in the food itself, but what your ecosystem is doing to the food, and therefore diets should never be the long term solution. If they are, you haven't corrected the problem.
The key approach that differentiates Dr. Holmberg from other practitioners treating SIBO is her focus on maintaining the beneficial bacteria! Emphasis is placed on saving butyrate, proprionate, and acetate producing beneficial bacteria (lactobacillus and bifido bacterial strains), all while eradicating the bacterial overgrowth.
Once the terrain reset and repopulated, associated conditions that may have been attributing to symptoms are then address, all while ensuring chance of recurrence is minimized.
The goal of treatment is to address the underlying overgrowth and resolve symptoms for good.
If you have any further questions, feel free to contact Dr. Holmberg here: