bloating reasons

5 SIBO root causes you need to know for the recovery journey

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You need to know about the common SIBO root causes if you constantly battle bloating, constipation or diarrhea, low energy, and more. For many, the list of symptoms continues, and the frustration grows with the uncertainty of what to eat and how to live a normal life.

These symptoms define the everyday life of those suffering from SIBO (Small Intestinal Bacterial Overgrowth).

However, many people who experience SIBO relapse soon realize that treatment itself may not be enough to get rid of the uncomfortable symptoms.

One important thing to understand about SIBO: SIBO is not an infection!

Certain factors allowed the bacteria to overgrow; identifying these SIBO root causes is critical to healing.

Often, people think it's only one thing that is causing their issues, but typically, several contributing factors are at play. It's crucial to stop just chasing the symptoms and start identifying the root causes of imbalance. Otherwise, we would just be mopping the floor instead of turning off the sink.

What is SIBO?

SIBO, or Small Intestinal Bacterial Overgrowth, is a condition where an excessive amount or abnormal type of bacteria are present in the small intestine, where their numbers should be relatively low compared to the large intestine. (The large intestine houses the highest number of bacteria). These bacteria in the wrong place can interfere with normal digestion and absorption of food by fermenting carbohydrates and fibers and creating byproducts, like gases (methane, hydrogen, hydrogen sulfide). The overgrown bacteria can interfere with normal digestion and nutrient absorption.

This process can lead to symptoms like:

  • Chronic bloating that tends to get worse by the end of the day,
  • Changed bowel movements involving constipation and/or diarrhea or alternating bowel movements
  • Abdominal pain,
  • Nausea,
  • Burping,
  • Fatigue,
  • Muscle or joint pain,
  • Mood changes,
  • Brain fog, poor memory,

but it can also impact your skin, hormones, and other areas of the body. (1)

5 SIBO Root causes for recovery

The SIBO root causes

Understanding the SIBO root causes is crucial in its effective management. SIBO is a complex condition, and its root causes can differ from person to person. This complexity is reflected in the research on complex diseases, which suggests that a multitude of factors may contribute to the onset of such conditions.

SIBO Root Cause #1: the role of gut motility

One of the key root causes of SIBO is issues with gut motility. The movement of the digestive system is crucial in maintaining a healthy balance of bacteria in the gut. When this movement is disrupted, it can lead to an overgrowth of bacteria in the small intestine.

This cause revolves around the role of the Migrating Motor Complex (MMC). The MMC is a pattern of electrical activity that occurs in the smooth muscle of the gastrointestinal tract during the periods between meals. It's often referred to as the "housekeeper" of our gut because its function is to sweep residual undigested material through the digestive tract. The MMC operates cyclically, approximately every 90-120 minutes during fasting periods.

When the MMC is functioning correctly, it helps control the bacterial population in the small intestine by regularly clearing it out, pushing bacteria into the large intestine, and preventing any significant accumulation. However, certain conditions like stress, medications (especially opioids), certain diseases (like Scleroderma), or other underlying causes can disrupt the MMC's functioning, leading to a slowdown or stoppage of this cleaning wave. This disruption can allow bacteria to multiply excessively in the small intestine, leading to SIBO. (2)

SIBO Root Cause #2: the impact of medications

Certain medications, such as proton pump inhibitors (PPIs), often prescribed for conditions like GERD (Gastroesophageal Reflux Disease), ulcers, and other acid-related disorders, reduce stomach acid production. While these medications provide relief from acid reflux symptoms, the reduced acid levels can have unintended consequences. Stomach acid is one of your body's primary defenses against bacterial overgrowth in the upper gut. When its production is inhibited by PPIs, the risk of bacterial overgrowth increases. Furthermore, with decreased stomach acidity, the body might not efficiently break down and absorb nutrients, potentially leading to nutrient deficiencies. Regular and prolonged use of PPIs has been linked to an increased risk of SIBO, emphasizing the importance of using these medications judiciously and under proper medical guidance. (3)(4)(5)

SIBO masterclass

Are you keen to delve deeper into the intricate web of SIBO root causes? Looking for actionable strategies to tackle these triggers head-on?

Then, join the SIBO Root Cause Masterclass to get equipped with the right tools to move on with your healing journey.

Learn more

SIBO Root Cause #3: structural abnormalities in the gut

The physical structure of your gastrointestinal system can significantly influence the growth and movement of bacteria.

Here's how:

  • Small Intestine Diverticula: These are small, bulging pouches that can form in the lining of the digestive system, primarily in the small intestine. These pouches can collect food particles and slow down transit time, allowing bacteria to grow and potentially leading to SIBO.
  • Post-surgical Changes: Surgeries, especially those related to the digestive tract, like gastrectomies or bowel resections, can change the anatomy and movement of the gut. Such changes can create areas where food and bacteria stagnate, leading to bacterial overgrowth.
  • Adhesions are bands of scar tissue that can form between abdominal tissues and organs, typically after surgery (C-section, endometriosis surgery). Adhesions can cause parts of the intestines to stick together, leading to blockages or slow transit times, promoting SIBO.

Other types of obstructions in the gut can also increase the risk of developing SIBO. (6)

SIBO Root Cause #4: reduced digestive juice production

Your body produces various digestive juices, from stomach acid to bile and digestive enzymes. These juices help break down food and also play a role in keeping bacterial growth in check. Factors like aging, certain medications, or other conditions can reduce the production of these juices, facilitating bacterial overgrowth. (7)

SIBO Root Cause #5: poor lifestyle choices

Your daily routines, habits, and choices are pivotal to your health. The gut, often called your "second brain," is no exception. Poor lifestyle choices alone may not directly cause SIBO, but they can contribute to the development of this condition.

Here's how your lifestyle can impact the gut:

  • Dietary choices: the food you consume has an immediate effect on your gut health. Diets high in sugar, processed foods, and unhealthy fats can feed harmful bacteria, promoting their growth.
  • Chronic stress affects your body in numerous ways; the gut is no exception. Persistent stress can weaken your gut lining, reduce stomach acid production, and alter gut motility, creating an environment for SIBO to flourish.
  • Lack of physical activity: Sedentary lifestyles can slow down gut motility, creating an environment where bacteria can overgrow. On the other hand, regular (moderate) physical activity can boost metabolism and encourage healthy bowel movements.
  • Alcohol consumption: Excessive alcohol intake can damage the gut lining and disrupt the balance of beneficial bacteria. It can also decrease stomach acid production, making the small intestine more susceptible to bacterial overgrowth.
  • Inadequate sleep: Your body needs adequate rest for repair and regeneration. Consistently missing out on restful sleep can weaken the immune system, making your body and gut more vulnerable to imbalances and infections.

Your path to recovery

If you suspect you have SIBO, requesting a SIBO breath test to get a diagnosis is crucial. You may need a tailored treatment plan based on the breath test result. Given the individual-specific nature of SIBO's root causes, it's vital to approach treatment on a case-by-case basis. Recovery often involves a combination of dietary changes, antibiotics or natural antimicrobials, and possibly prokinetic drugs to improve gut motility while addressing any root causes.

 

SIBO, while challenging, is manageable. With the right knowledge and tools at your disposal, recovery is not just possible – it's probable. Take the first step towards your gut health transformation and join the SIBO Root Cause Masterclass today. We will break down the five most common root causes of SIBO, going beyond the surface to understand the underlying mechanisms and how they affect your gut health. Armed with the knowledge of the root causes, the next step is a solution-oriented approach. The masterclass offers practical, actionable strategies tailored to each cause, ensuring you have a toolkit to combat SIBO. By deeply understanding the common root causes of SIBO, you're better equipped to prevent and manage this condition.

 

This post is only for informational purposes and is not meant to diagnose, treat, or cure any disease. I recommend always consulting your healthcare practitioner before trying any treatment or dietary changes.

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3 reasons why you have constant bloating: SIBO and more

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Bloating is a discomforting and often embarrassing symptom frequently attributed to overeating or diet. However, the causes of bloating can be much more intricate, primarily when related to Small Intestinal Bacterial Overgrowth (SIBO) and other chronic gut issues. Today, I'll explore the phenomenon of bloating, common triggers, and potential root causes behind this symptom. I'll also share some short-term solutions to manage bloating symptoms effectively.

Understanding bloating: what's the norm and the exception

Bloating is a sensation of fullness or swelling in the abdomen that may be accompanied by increased flatulence (gas). It's an uncomfortable feeling and a struggle when you have a pregnant belly look and your jeans feel tight around your belly. You may feel discomfort from trapped gas in your abdomen that can't leave your body, sometimes contributing to abdominal pain.

It's essential to differentiate between occasional, normal bloating and chronic bloating, which might indicate underlying health issues.

normal vs chronic bloating

You might occasionally experience bloating after a hearty meal or consuming gas-inducing foods like beans, cauliflower, or too many raw vegetables in one sitting. Bloating is almost guaranteed if you overeat, don't chew your food thoroughly, or drink carbonated drinks with your meal. These could be normal if bloating resolves on its own and subsides within a few hours or maybe a day.

However, suppose you're constantly feeling bloated even during fasting periods or after every single meal or your bloating is accompanied by other symptoms like nausea or changed bowel movements interfering with your daily activities. In that case, it's not normal and needs to be investigated.

Triggers for bloating

While diet and eating habits are often blamed for bloating and gas, these factors might not be the only primary culprits in chronic bloating cases. For instance, overeating, consuming fatty foods, or drinking fizzy beverages are known triggers for bloating. However, these factors generally cause temporary discomfort.

Continual bloating symptoms often indicate underlying health issues. Stress, anxiety, and lack of physical activity are frequently blamed, but these usually exacerbate the existing problem rather than cause it directly.

Three reasons behind constant bloating: a deeper dive

Several functional reasons could contribute to chronic bloating. Here are some of the main ones:

Insufficient digestive juices

Several glands in the digestive system secrete digestive juices to aid in digestion. These juices contain enzymes that help break down food into smaller parts and different nutrients. The organs that release digestive juices include the salivary glands, stomach, liver/gallbladder, pancreas, and small intestine. (1) These digestive juices also serve as your body's natural defense barrier against infections.

Here is a short overview of some of the digestive juices, their functions, and possible issues:

Salivary glands

Digestion starts in the mouth. When you take a bite of food, enzymes in your saliva, called amylase, start breaking down carbohydrates. Poor oral health, including gum disease, cavities, and missing teeth, can disrupt this critical step, leading to less effective digestion and potential gut issues.

Stomach

Glands in the stomach lining make stomach acid and enzymes that break down food. Muscles of the stomach mix the food with these digestive juices. The stomach secretes proteases to function as the initial site of protein digestion. The stomach has a very acidic environment, with a pH ranging from 1.5 to 3.5. (2)
The higher the number goes, the more alkaline it becomes, which we don't want because an adequate level of acid is required for:

  • Protein digestion
  • Activating pepsin (enzyme)
  • Proper sphincter function (so the valve stays closed and food doesn't reflux back)
  • Stimulating other digestive juices to be released further down your digestive tract
  • Mineral absorption
  • Killing unwanted bacteria and parasites in the food (preventing SIBO or food poisoning)
  • Activating intrinsic factor that is needed for vitamin B12 absorption (3)

Stomach acid production can be negatively impacted by chronic stress (4), Helicobacter pylori infection (5), chronic inflammation, autoimmune disorders (6), and aging (acid levels decrease as we get older). (7) Proton pump inhibitors (PPIs) and antacids are commonly prescribed or purchased medications that lead to low stomach acid production. (8)

Low stomach acid, also known as hypochlorhydria, can cause a wide range of digestive symptoms (9):

  • Heartburn, nausea, acid reflux symptoms, GERD
  • Trouble digesting meat
  • Gas and bloating after eating, early fullness
  • Food allergies and intolerances
  • Nutritional deficiencies (iron, vitamin B12, Magnesium)
  • Hair loss, thinning hair, or brittle fingernails
  • Undigested food particles in the stool
  • Constipation or diarrhea
  • Skin problems, such as acne or eczema
  • Overgrowth of bacteria and yeast (Candida albicans)

Liver

The liver makes a digestive juice called bile that helps digest fats and some vitamins. Bile ducts carry bile from the liver to the gallbladder for storage between meals or to the small intestine for use when food is present.
But bile has other roles besides food digestion. It serves to maintain the intestinal environment clean with its antimicrobial properties. Bile keeps the bacteria in check and prevents them from colonizing the small intestine.
Bile also plays a vital role in removing toxins from the body. Toxins from liver detoxification processes are secreted into bile and eliminated through feces (bowel function). (10)

Stagnant or sluggish bile flow, also known as cholestasis, can be caused by various factors. Some of the causes of stagnant or sluggish bile flow can be drugs, sex hormones, bile duct obstruction (like gallstones), low-fat diet, etc. (11)

Here are some signs of poor bile flow:

  • Greasy, foul-smelling, and light-colored stools
  • Nausea
  • Bloating
  • Diarrhea or constipation
  • Vitamin deficiencies (fat-soluble)
  • Fatigue
  • Migraines
  • Skin problems such as acne or eczema
  • Jaundice
  • Mood swings
  • Liver inflammation

Pancreas

The pancreas makes digestive juice with enzymes that break down carbohydrates, fats, and proteins. The pancreas delivers the digestive juice to the small intestine for proper digestion. The main types of pancreatic enzymes include:

  • Lipase: breaks down fats into fatty acids
  • Protease: breaks down proteins into amino acids
  • Amylase: breaks down carbohydrates (starch) into sugars

Food may not be broken down properly without enough pancreatic enzymes, leading to pancreatic insufficiency or exocrine pancreatic insufficiency (EPI), producing digestive issues such as gas and bloating, feelings of fullness, abdominal pain and cramps, and diarrhea. Sometimes, insufficient pancreatic enzymes can lead to malabsorption and malnutrition. (12)

Small intestine

The small intestine makes digestive juice, which mixes with bile and pancreatic juice to complete the breakdown of proteins, carbohydrates, and fats. Bacteria in the small intestine produce some of the enzymes needed to digest carbohydrates.

If the small intestine cannot absorb the nutrients and fluids, we may talk about malabsorption syndrome. This issue may involve symptoms such as chronic diarrhea (undigested food passes through the digestive system too fast), weight loss (not being able to absorb the nutrients needed for the body), abdominal pain and bloating; pale, bulky, and smelly stools; fatigue, etc. (13)

SIBO (Small Intestinal Bacterial Overgrowth)

Another reason for chronic bloating can be Small Intestinal Bacterial Overgrowth (SIBO). SIBO is a condition when an unusually high number of bacteria grow in the small intestine, where the bacterial population should be relatively low compared to the large intestine. These bacteria in the wrong place ferment carbohydrates and produce gases, leading to bloating, flatulence, discomfort, constipation and/or diarrhea, abdominal pain, nausea, and fatigue. Still, it can also impact your skin, hormones, joints, etc. (14) You can read more about the various types of SIBO here.

But even if you are diagnosed with SIBO, it is still important to dig deeper and discover why you have SIBO. There could be a few reasons behind SIBO bloating, such as low stomach acid, gut motility issues (that hinder the movement of the gut (MMC) to sweep out remaining food particles and waste toward the colon), medications, and adhesions. Learn more about how to tackle the most common causes of SIBO.  

Imbalance in the gut microbiome community

Trillions of microbes like bacteria, viruses, and fungi live in your colon, known as the gut microbiome. The microbiome consists of microbes that are beneficial for us and those that are potentially harmful. The gut microbiome plays a crucial role in digesting food, absorbing and synthesizing nutrients, affecting the immune system, controlling brain health, influencing metabolism, and many other functions. (15)

However, certain factors can disrupt the balance between the microbes, causing digestive symptoms like bloating and gassiness, constipation and/or diarrhea, and other symptoms.

These factors may include the following:

  • Medications like antibiotics can kill both harmful and beneficial bacteria in the gut. (16) While these medications could be life-saving in several cases, they are prescribed way too often, creating a huge imbalance that may take years to restore.
  • Western diet is typically high in processed foods, sugar, and inflammatory seed oils that may feed pathogens in the gut. (17)
  • Particular lifestyle and environmental factors can also negatively impact the gut microbiome, such as chronic stress, trauma, smoking, lack of quality sleep, sedentary lifestyle, environmental toxins, etc. (18)

The consequence of an imbalanced gut microbiome community (dysbiosis) commonly results in symptoms like bloating.

6 things that harm your gut microbiome

How to test for the causes of bloating?

Identifying the root causes of bloating is vital to managing it effectively. The good news is that various diagnostic tests can help pinpoint the causes. I want to clarify two of the most popular tests that could be useful in your bloating healing journey.

SIBO Breath test

Since chronic bloating is one of the leading symptoms of SIBO, a breath test seems like a logical choice among testing options. A breath test for SIBO is a non-invasive test that measures the amount of gases produced by bacteria in the small intestine. The test can be performed at home, and it involves consuming a sugar solution (usually lactulose or glucose) and then measuring the levels of hydrogen and methane (or hydrogen sulfide) in the breath samples at specific intervals. If bacteria are abundant in the small intestine, they ferment the sugar solution by creating gases that the breath test can capture. The breath test aims to determine what type of SIBO and how much overgrowth you have because each type requires a different, tailored treatment plan. (19)

Comprehensive stool test

A comprehensive stool test is a non-invasive diagnostic assessment that can help identify imbalances in the large intestine by assessing the balance of bacteria, yeast/fungus, and other organisms present. The test measures key markers of digestion, absorption, inflammation, immune response, and intestinal function. The test can give us an excellent overview of your intestinal health and help pinpoint the causes of digestive symptoms like bloating.

Managing bloating in the short-term

While long-term solutions are essential, managing immediate bloating symptoms can significantly improve comfort.

Here are a few things you can do:

  • Try dietary changes if you have chronic bloating due to SIBO: Limiting temporarily high FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), foods can help manage symptoms related to SIBO and other digestive disorders. These foods include wheat, onions, garlic, many of cruciferous veggies, dairy products, legumes, etc.(20) Read more about the SIBO and low-FODMAP diet here. Remember that diet alone will not resolve the causes of your SIBO, and it should only be used short term.
  • For those who fight bloating regularly, opting for cooked food instead of raw foods could be a better option for digestion.
  • Practice mindful eating habits by making sure you take the time to sit at the table to eat and chew your food properly. Allowing time to consume your meal in a relaxed manner can help reduce bloating. Not to mention, slow eating can prevent overeating as well. (21)
  • Consider natural remedies like peppermint oil (avoid if you have reflux symptoms or GERD), ginger, and chamomile tea are known for their anti-bloating properties. Other herbs such as cumin, dill, parsley, and basil may be beneficial to reduce flatulence. (21)
  • A gentle exercise routine can help stimulate intestinal contractions, expel gas, and reduce bloating. Walking, yoga, Pilates, and tai chi are all great options. (22)
  • If you experience massive bloating after eating, that is also painful; activated charcoal can help bind excess gas in the intestines and reduce bloating as a quick fix. An important note with activated charcoal is to take it at least 1 hour (but rather 2 hours) away from food, medications, and supplements as it binds to not just toxins but everything else. (23)

Remember, these are temporary measures. It's essential to seek professional help if you experience chronic bloating. Unraveling the root causes of your discomfort is the key to creating a long-term, effective strategy for bloating relief.

Bloating isn't just an inconvenience; it's a signal from your body that something isn't quite right. By understanding the underlying issues, you can address bloating at its root and reclaim your comfort, health, and well-being.

 

This post is only for informational purposes and is not meant to diagnose, treat or cure any disease. I recommend always consulting your healthcare practitioner before trying any treatment or dietary changes.

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