What is a SIBO?

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General information about SIBO Small intestinal overgrowth syndrome

Small intestinal bacterial overgrowth syndrome is also called SIBO, overgrowth syndrome or small intestinal overgrowth. This is an overgrowth of the small intestine with bacteria or germs from the large intestine. In the large intestine, these bacteria are important and desired. The physiological flora of the small intestine consists of lactobacilli and enterococci, which in overgrowth syndrome are pushed back by colon germs and other pathogenic (disease-causing) germs. These are for example Klebsiellen, E. coli, Bifidobacterien, Bacteroidetes and Clostridien Thus it can come to a false settlement of the small intestine.

This is referred to as small intestinal colonization.

In the case of a small intestine miscolonization, the large intestine bacteria have a significantly higher nutrient supply in the small intestine than would happen in the large intestine. This allows the bacteria to proliferate. Toxic metabolic products are formed, which can inflame the intestinal mucosa. This can then also lead to increased permeability of the intestinal wall, a so-called leaky gut syndrome. When colon germs are located in the small intestine, they also produce significantly more gases, such as hydrogen, methane or hydrogen sulfide. This increased gas production can cause very unpleasant symptoms such as belching, a bloated abdomen and abdominal pain.

Causes of SIBO

The causes of SIBO syndrome can be divided into four groups:

  • Digestive disorders, such as gastric acid deficiency due to malfunction of the autonomic nervous system or drug intake, chronic gastritis type A, exocrine pancreatic insufficiency (pancreas weakness), lactose intolerance and fructose intolerance.
  • Problems with the further transport of the intestinal contents; possible causes are autoimmune disorders after gastrointestinal infections, adhesions in the abdominal cavity after operations, inflammations or injuries, medication such as opiates, hypothyroidism, damage to the intestinal nerves due to diabetes and infections.
  • Impairment of the immune system due to stress, medication, variable immunodeficiency syndrome (CVID), and chronic immune disorders
  • Defects in the transition from the small intestine to the large intestine (ileocaecal valve, Bauhin’s valve), surgical removal of the valve, food allergies, genetic disease such as Ehler-Danlos syndrome. This is because the digestive process causes bacteria to be specifically transported away toward the colon.

Other causes can be damage to the intestinal flora due to environmental stress, for example, antibiotic intake, food allergies, heavy metal exposure, mast cell activation syndrome (MCAS) or hygiene errors during sexual activity.

Miscolonization of the small intestine with unicellular parasites such as Giardia lambia may also be a cause. Small intestinal bacterial overgrowth (SIBO) may also occur more frequently after certain surgical procedures on the intestine, such as “blind-ended intestinal loops.”

Symptoms of SIBO

What can be SIBO symptoms?

A wide variety of symptoms can indicate a small intestinal malabsorption. Here is a small, incomplete list of possible symptoms:

  • unclear complaints in the gastrointestinal tract
  • Bloated belly
  • Belching
  • Intolerance of whole grain products and raw vegetables
  • Allergies
  • Flatulence
  • Bad breath
  • Skin rashes
  • Food intolerances
  • Heartburn
  • tongue burning
  • Dizziness
  • bad breath
  • Nausea
  • Diarrhea

Despite severe symptoms, this clinical picture is often not properly recognized and diagnosed. In many cases, irritable bowel syndrome (IBS) is caused by a malabsorption of the small intestine.

For patients, the symptoms of SIBO are not only unpleasant, but sometimes also shameful, when flatulence makes normal everyday life difficult.

In a special form of SIBO, however, constipation also occurs. In this case, methane-forming archaea are usually involved in the faulty colonization. This is then called an IMO syndrome (Intestinal Methanogen Overgrowth).

Here you can learn more about SIBO

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