How fasting for SIBO can ease the symptoms

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In recent years, fasting has gained significant attention as a powerful tool for improving various aspects of health. Fasting for SIBO isn't just a dietary choice for many; it's a lifestyle adjustment that may offer profound benefits, especially for those wanting to manage gut symptoms like bloating, gassiness, heartburn, and more.

If you are one of the many individuals struggling with chronic gut symptoms, particularly IBS (Irritable Bowel Syndrome) or SIBO (Small Intestinal Bacterial Overgrowth), this post will provide valuable insights into how fasting could be a part of your journey to better (gut) health.

But the main question is: is it right for everyone? Let's find out.

What is fasting?

Fasting is the voluntary abstention from all or some kinds of food or drink for a specific period. It is a practice that has been a part of human culture for centuries, often for religious or health reasons.

There are several common types of fasting, each with its unique approach and benefits:

  • Intermittent fasting (IF): This involves cycling between periods of eating and fasting. Popular methods include the 16/8 method (fasting for 16 hours and eating within an 8-hour window) and the 5:2 method (eating normally for five days and restricting calories on two non-consecutive days).
  • Extended fasting: This involves fasting for more than 24 hours, often ranging from 48 hours to several days.
  • Time-restricted eating: Similar to intermittent fasting, this method restricts eating to certain hours of the day, such as an 8-hour or 10-hour window.
  • Alternate-day fasting: This involves alternating between days of normal eating and days of fasting or very low-calorie intake. This type of fasting is also known as 4:3 fasting, meaning that a person may follow normal calorie intake for 4 days and restrict food intake or even completely fast for 3 days.
How fasting for SIBO can ease the symptoms

The benefits of fasting: beyond weight management

Fasting offers a myriad of health benefits that extend beyond weight management.

It has been associated with:

  • improved blood sugar control, enhanced insulin sensitivity,
  • improved blood pressure,
  • increased resistance to stress,
  • better brain function,
  • improved metabolic health (aid weight loss),
  • improved gut permeability (aka "leaky gut") - fasting gives the digestive system a break, allowing for repair and reducing the burden on the gut,
  • improved gut microbiome diversity,
  • reduced inflammation,
  • initiation of autophagy, a process that removes damaged cells and regenerates new ones, promoting overall cellular health,
  • delayed aging, and more.

Understanding SIBO

Small Intestinal Bacterial Overgrowth (SIBO) occurs when there is an abnormal increase in the number of bacteria in the small intestine, particularly types of bacteria that are typically found in the colon. Besides bacteria, an ancient organism called archaea can also overgrow in the intestines, slowing down gut movement.

This overgrowth can interfere with the digestion and absorption of nutrients, leading to various symptoms such as bloating, abdominal pain, diarrhea, and malnutrition. Read more about SIBO here.

Fasting for SIBO

Most of the time, SIBO is a consequence of a deeper issue. SIBO is often associated with impaired gut motility - the ability of your digestive system to move contents through the gut (namely, a type of gut motility called the migrating motor complex or, shortly MMC).

MMC is a cyclic motility pattern that helps clear the gut of residual food and bacteria to prevent them from overgrowing in the small intestines, and it occurs every 90-120 minutes but only gets activated between meals. So, if you eat or you constantly snack throughout the day, this process gets interrupted.

Simple fasting, which is also known as meal spacing, has been shown to support the migrating motor complex (MMC) and alleviate SIBO symptoms. Simple fasting could mean spacing your meals 3 – 5 hours apart and avoiding eating and drinking any caloric beverages.

Fasting for SIBO can reduce the food supply (carbohydrates) for bacteria in the small intestine, potentially decreasing bacterial overgrowth.

This break provided to the digestive system during fasting can allow for repair and healing of the gut lining, which is often compromised in individuals with SIBO. This is when an overnight 12-hour fast can help because most of the repair happens during your sleep.

However, fasting isn't a one-size-fits-all solution.

Special considerations in case of fasting for SIBO

While fasting for SIBO can be beneficial, it is important to consider that it might not be suitable for everyone.

Patients with a history of severe motility issues or other specific gastrointestinal conditions like gastroparesis – delayed stomach emptying – should approach fasting cautiously and always under medical guidance. They may find that smaller meals work better than fasting for prolonged periods.

It is also not recommended for children or those who have a history of eating disorders or hypoglycemia (low blood sugar levels). People with an irregular heartbeat, low blood pressure, or extreme fatigue should also avoid fasting.

Women, in particular, need to be mindful when considering fasting regimes.

Hormonal balances are delicate, and fasting can influence these, sometimes negatively.

For women who are pregnant, breastfeeding, or those with a history of hormonal imbalances (thyroid problems), fasting might pose more risks than benefits.

Fasting can affect the menstrual cycle and reproductive hormones. Women may need to adjust their fasting schedule according to their cycle to avoid potential disruptions.

The other factor is that women may have a more pronounced stress response to fasting, which can affect cortisol levels.

In general, it is best to discuss the possible benefits versus risks with your healthcare provider before trying fasting, especially if you have any health conditions.

How to start with fasting for SIBO safely

Implementing fasting safely, especially when dealing with a condition like SIBO, requires careful planning and consideration.

  1. Begin with shorter fasting periods – like doing meal spacing (so leaving a 3 or 5-hour gap between meals) or an overnight 12 or 14-hour fast and gradually increase the duration as your body adapts.
  2. Initially, hunger and cravings are common but often subside as the body adapts. Drinking filtered water and herbal teas can help manage these feelings. Fasting can also lead to electrolyte imbalances. Consuming mineral-rich broths or using electrolyte supplements during your eating windows can help maintain balance.
  3. Pay attention to how your body reacts. If you experience extreme fatigue, dizziness, anxiety, headaches, or other adverse effects, reassess if it is better to change your eating schedule.
  4. Don't force your body into fasting if it is not ready for it! It can cause more stress and digestive distress, which creates the opposite effect.
  5. Ensure that when you do eat, your diet is rich in nutrients to support your body's needs. Focus on whole foods, lean proteins, healthy fats, and plenty of vegetables based on your tolerance.
  6. Combining fasting with mindful eating habits can enhance the benefits. Mindful eating involves paying full attention to the experience of eating, including chewing your food thoroughly, which can help improve digestion and satisfaction.
  7. Try to limit high-intensity exercises while fasting. Switch to more gentle body movements such as yoga, walking, pilates, or others.
  8. If you begin your journey, it may be helpful to find a supportive community or an accountability partner who could help make the fasting journey more enjoyable and manageable.

How to follow intermittent fasting for SIBO

If you're considering intermittent fasting (IF), a method that involves cycling between periods of eating and fasting, then there are a few things you need to know.

The most popular approach is the 16/8 method, where you fast for 16 hours and eat within an 8-hour window. This can be a gentle start to experiencing the benefits of fasting without overwhelming your system.

An example could be:

12:00 PM: Begin your eating window with lunch as the first meal of the day.

3:00 PM: Have a healthy snack, depending on your energy needs and personal preferences.

6:00 PM to 7:00 PM: Enjoy a well-balanced dinner.

8:00 PM: Close your eating window. Ideally, you should finish eating by 8:00 PM, which allows your body to begin fasting until noon the next day.

Some people like to have breakfast and skip dinner. This could mean starting with breakfast at 9:00 AM and finishing your last meal at 5:00 PM, for example.

I often find that people may do better starting the day with a protein-rich breakfast and closing the day with an early dinner. This way, they give the digestive system a break at night when digestion gets slower.

In conclusion

Fasting offers an array of potential health benefits and could be particularly beneficial for managing SIBO by improving gut motility. However, it requires careful consideration and should be tailored to individual health needs, especially for women and those with underlying health conditions.

For many, intermittent fasting may not be feasible, so in that case, it could be helpful to start with a 3-5-hour gap between meals and focus on a 12-hour overnight fast to support the MMC. It's important to remember that what works for one person may not work for you, so it's essential to listen to your body, seek guidance, and be patient with the process.

Disclaimer:

The information provided on this site is for educational purposes only, is not intended as medical advice, and does not claim to diagnose, heal, treat, or cure any conditions. Always consult with a healthcare professional before starting any fasting regimen, especially if you have underlying health conditions or are taking medication. Seeking Gut Health is not responsible for any adverse effects or consequences resulting from the use of the information provided on this site.

References
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SIBO:

  1. Sorathia SJ, Chippa V, Rivas JM. Small Intestinal Bacterial Overgrowth. [Updated 2022 Oct 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546634/
  2. Deloose, E., Janssen, P., Depoortere, I. et al. The migrating motor complex: control mechanisms and its role in health and disease. Nat Rev Gastroenterol Hepatol 9, 271–285 (2012). https://doi.org/10.1038/nrgastro.2012.57

Fasting:

  1. Patterson R, et al. Intermittent fasting and human metabolic health. J Acad Nutr Diet. 2015;115(8):1203–1212. doi:10.1016/j.jand.2015.02.018.
  2. Mattson M, Longo V, Harvie M. Impact of intermittent fasting on health and disease processes. Ageing Res Rev. 2017;39:46–58.doi:10.1016/j.arr.2016.10.005.
  3. de Cabo R, Mattson MP. Effects of intermittent fasting on health, aging, and disease. N Engl J Med. 2019;381(26):2541–2551.doi:10.1056/NEJMra1905136.
  4. Trepanowski J, Kroeger C, Barnosky A, et al. Effect of alternate-day fasting on weight loss, weight maintenance, and cardioprotection among metabolically healthy obese adults: a randomized clinical trial. JAMA Intern Med. 2017;177(7):930–938. doi:10.1001/jamainternmed.2017.0936.
  5. Yang F, Liu C, Liu X, et al. Effect of epidemic intermittent fasting on cardiometabolic risk factors: a systematic review and metaanalysis of randomized controlled trials. Front Nutr. 2021;8:669325. Published 2021 Oct 18. doi:10.3389/fnut.2021.669325.
  6. Bitsanis D, Giannakou K, Hadjimbei E, Chrysostomou S. The effect of early time-restricted feeding on glycemic profile in adults: a systematic review of interventional studies. Rev Diabet Stud. 2022;18(1):10-19. doi:10.1900/RDS.2022.18.10.
  7. Sutton EF, Beyl R, Early KS, Cefalu WT, Ravussin E, Peterson CM. Early time-restricted feeding improves insulin sensitivity, blood pressure, and oxidative stress even without weight loss in men with prediabetes. Cell Metab. 2018;27(6):1212-1221.e3.doi:10.1016/j.cmet.2018.04.010.
  8. Martins C, Roekenes J, Hunter GR, Gower BA. Association between ketosis and metabolic adaptation at the level of resting metabolic rate. Clin Nutr. 2021;40(8):4824-4829. doi:10.1016/j.clnu.2021.06.029
  9. Ott, B., Skurk, T., Hastreiter, L., Lagkouvardos, I., Fischer, S., Büttner, J., Kellerer, T., Clavel, T., Rychlik, M., Haller, D., & Hauner, H. (2017). Effect of caloric restriction on gut permeability, inflammation markers, and fecal microbiota in obese women. Scientific reports, 7(1), 11955. https://doi.org/10.1038/s41598-017-12109-9
  10. Singh, R., Manchanda, S., Kaur, T., Kumar, S., Lakhanpal, D., Lakhman, S. S., & Kaur, G. (2015). Middle age onset short-term intermittent fasting dietary restriction prevents brain function impairments in male Wistar rats. Biogerontology, 16(6), 775–788. https://doi.org/10.1007/s10522-015-9603-y
  11. Beli, E., Yan, Y., Moldovan, L., Vieira, C. P., Gao, R., Duan, Y., Prasad, R., Bhatwadekar, A., White, F. A., Townsend, S. D., Chan, L., Ryan, C. N., Morton, D., Moldovan, E. G., Chu, F. I., Oudit, G. Y., Derendorf, H., Adorini, L., Wang, X. X., Evans-Molina, C., … Grant, M. B. (2018). Restructuring of the Gut Microbiome by Intermittent Fasting Prevents Retinopathy and Prolongs Survival in db/dbDiabetes, 67(9), 1867–1879. https://doi.org/10.2337/db18-0158

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