Is it SIBO Syndrome or Lyme Disease?

If you have muscle pain, suffer from recurrent joint discomfort, feeling fatigued, having anxiety and insomnia, you haven't had a normal bowel movement and you've had (or suspect you've had) Lyme disease and believe you've developed a chronic form of it or one of its co-infections, antibiotics make you feel better (but you don't want to be on them all the time), you're convinced you've damaged your gut, and almost everything you eat makes you feel worse, you feel better after eliminating gluten and dairy from your diet, but excellent health remains elusive, in that case, SIBO (Small Intestinal Bacterial Overgrowth Syndrome) could be a contributing factor. SIBO can be easily detected via a breath test that you can perform in the comfort of your own home. It is a common diagnosis that is frequently misdiagnosed.

SIBO is a disorder in which bacteria that ordinarily reside in the large intestine migrate to the small intestine. SIBO's metabolic byproducts alter bowel motions, causing diarrhoea and/or constipation. SIBO can induce discomfort in the intestines as well as in the muscles and joints of the body. I've also seen it cause lower back pains, inguinal pains, migraines, and as a big contributor to menstruation disorders, typically resulting in poor hormone conjugation in the liver, resulting in PMS, PCOS, and fibroids. SIBO is a fundamental cause of intestinal dysbiosis that allows chronic Candidiasis to develop and become resistant to treatment. Patients who require long-term antibiotics are more likely to develop Clostridium difficile infections if they already have SIBO. Recurrent Helicobacter pylori infections (stomach ulcers), halitosis (poor breath), gall stones/sludge, and recurrent yeast infections are all caused by SIBO (Candidiasis).

SIBO sufferers typically suspect that their diets are to blame for a lot of their problems, but defining all of the sensitivities is difficult, and the situation seems to fluctuate without warning or is inconsistent. Gluten and dairy are particularly effective at feeding SIBO bacteria, so many people who aren't allergic to them feel better avoiding them. This is most likely the cause for the rise in the number of people opting for gluten-free diets and those who benefit from dairy and grain-free diets (e.g. Paleo, Atkins, GAPS, bone-broth diets, etc.).

SIBO is a term that refers to a collection of big intestinal bacteria, including E. coli and Klebsiella. These gut bacteria are rarely exposed to the carbs and sugars found in the small intestine. Sugars and carbs act as fertilisers, causing SIBO to become extremely active. They not only continue to proliferate, but they also obliterate your regular flora in the small intestine. SIBO also produces chemicals and gases that aren't ordinarily found in the small intestine, such as hydrogen gas, methane gas, and ammonia. Unlike the big intestine, the small intestine has a limited amount of bacteria, and if they get overgrown, these organisms will consume nutrients that would otherwise be taken into the body. A person with SIBO may become malnourished as a result, and a brief course of Myers nutritional IVs and daily use of a good multivitamin will help.

Dietary adjustments, particular antibiotics, botanicals, and the Elemental Diet are all common treatments for SIBO. After a lactulose challenge, the findings of a hydrogen/methane breath test are used to determine the optimal treatment or combination of therapies. Your doctor must also seek for the causes of SIBO and manage them in order to prevent the condition from returning.

If you think you have Lyme disease or another tick-borne infection, have taken antibiotics, have diarrhoea and/or constipation, are bloated, gassy, have unexplained skin rashes, hormone abnormalities, or various food sensitivities, you should examine your SIBO status and pay attention to gut instinct.

What are the signs and symptoms of Small Intestinal Bacterial Overgrowth Syndrome (SIBO)?

SIBO symptoms are similar to those of a range of other gastrointestinal disorders, and SIBO is frequently caused by another ailment. Depending on the severity of your disease, you may suffer some or all of the following:

• Pain in the abdomen
• Distension in the abdomen
• Nausea
• Bloating
• Indigestion
• Gas
• Diarrhea
• Constipation
• Weight loss that occurs unintentionally
• Fatigue or exhaustion
• Feeling discomfort or full after eating
• Malnutrition

Symptoms of Small Intestinal Bacterial Overgrowth Syndrome (SIBO), Lyme Disease and antibiotic usage that overlap

When Should you See a Doctor?

Many intestinal issues cause bloating, nausea, and diarrhoea as indications and symptoms. If you have any of the following symptoms, see your doctor for a comprehensive assessment:

• Diarrhea that persists
• Weight reduction that occurs quickly and unintentionally
• Abdominal pain that lasts for several days

If you have severe abdominal pain, seek immediate medical care.

What are Other Possible Causes Small Intestinal Bacterial Overgrowth Syndrome (SIBO)?

SIBO is a bacterial overgrowth in the small intestine that can be caused by a variety of factors.

• Abdominal/ Gastric Surgery

Gastric bypass for obesity and gastrectomy for peptic ulcers and stomach cancer are two examples of abdominal surgery complications.

• Adhesions

Scar tissue (intestinal adhesions) that wraps around the outside of the small bowel and bulging pouches of tissue that protrude through the small intestine wall are examples of structural issues in and around the small intestine (intestinal diverticulosis)

• Medical Conditions

Crohn's disease, radiation enteritis, scleroderma, celiac disease, diabetes, and other medical diseases that cause food and waste items to flow slowly through the small intestine (motility).

Why does Small Intestinal Bacterial Overgrowth Syndrome (SIBO) occur?

SIBO (small intestinal bacterial overgrowth) is a bacterial overgrowth that occurs in the small intestine.

The small intestine, which is nearly 20 feet long, is the longest segment of your digestive tract (6.1 meters). Food combines with digestive juices in the small intestine, where nutrients are absorbed into the bloodstream.

Because of the quick flow of contents and the presence of bile, your small intestine has less microorganisms than your big intestine (colon). In SIBO, however, stationary food in the small intestine serves as a great breeding environment for bacteria. Toxins may be produced by the bacteria, and they may also obstruct nutrient absorption. Food breakdown products caused by bacterial digestion can also cause diarrhoea.

The following factors increase the risk of SIBO:

• Abdominal/ gastric surgery
• Certain medical conditions especially gastrointestinal diseases
• Obesity or ulcers which may necessitate gastric surgery.
• A small intestine structural defect or a damage to the small intestine
• A fistula is an irregular channel connecting two intestinal segments.
• The small intestine is affected by Crohn's disease, intestinal lymphoma, or scleroderma.
• Radiation therapy to the abdomen in the past
• Diverticulosis of the small intestine Diabetes
• Previous abdominal surgery-related adhesions

What are the Complications of Small Intestinal Bacterial Overgrowth Syndrome (SIBO)?

SIBO (small intestine bacterial overgrowth) can lead to a slew of issues, including:

• Malabsorption: Fats, carbs, and proteins are poorly absorbed. Excess bacteria in the small intestine break down bile salts, which are normally needed to digest fats, resulting in inadequate fat digestion and diarrhoea. Bacterial compounds can also affect the mucous lining (mucosa) of the small intestine, causing carbohydrate and protein absorption to be reduced.

• Bacteria can compete for food that is available. In addition, chemicals created by bacteria breaking down stationary food might cause diarrhoea. Diarrhea, malnutrition, and weight loss are all symptoms of bacterial overgrowth when combined.

• Deficiencies:  Your body can't properly absorb fat-soluble vitamins A, D, E, and K as a result of insufficient fat absorption. Vitamin B-12 is synthesised and used by bacteria in the small intestine, and it is necessary for the correct functioning of your nervous system, as well as the formation of blood cells and DNA.

• Vitamin B-12 Deficiency: Bacterial overgrowth can cause B-12 deficiency, which can cause weakness, weariness, tingling, and numbness in your hands and feet, as well as mental confusion in severe cases. B-12 deficiency can cause irreparable damage to your central nervous system.

• Osteoporosis: Bones that have weakened can easily fracture (osteoporosis). Damage to your intestine caused by aberrant bacterial growth leads to inadequate calcium absorption over time, which can lead to bone problems including osteoporosis.

• Renal Stones: Stones in the kidneys. Kidney stones can develop as a result of poor calcium absorption.

How is Small Intestinal Bacterial Overgrowth Syndrome (SIBO) Diagnosed?

You may have to undergo tests to look for bacterial overgrowth in your small intestine, poor fat absorption, or other abnormalities that may be causing or contributing to your symptoms in order to identify small intestinal bacterial overgrowth (SIBO). The following are examples of common tests:

• Breath analysis: This sort of noninvasive test determines how much hydrogen or methane you exhale after consuming a glucose and water mixture. Exhaled hydrogen or methane levels that rise quickly could suggest bacterial overgrowth in your small intestine. Breath testing is less specific than other types of tests for identifying bacterial overgrowth, despite its widespread availability.

• Fluid culture and aspiration of the small intestine: This is the gold standard test for bacterial overgrowth at the moment. A long, flexible tube (endoscope) is sent down your neck and across your upper digestive tract to your small intestine to retrieve the fluid sample. A sample of intestinal fluid is taken and analysed in a laboratory for bacterial growth.

• In addition to these tests, your doctor may suggest blood tests to check for vitamin deficiencies or a stool test to check for fat malabsorption. To examine for structural abnormalities of the intestine, your doctor may recommend imaging tests such as X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI).

How is Small Intestinal Bacterial Overgrowth Syndrome (SIBO) Treated?

Doctors treat SIBO by addressing the underlying issue if possible, such as surgically correcting a postoperative loop, stricture, or fistula. However, reversing a loop is not always possible. In that instance, the focus of treatment is on addressing nutritional deficits and bacterial overgrowth.

Antibiotic treatment

Antibiotics are usually the first line of defence against bacterial overgrowth in most people. Even if test findings are ambiguous or no testing is done, doctors may begin this treatment if your symptoms and medical history strongly suggest this is the cause. If antibiotic treatment is ineffective, testing may be done.

Antibiotics can typically drastically lower the amount of aberrant microorganisms in a short period of time. However, bacteria can resurface if the antibiotic is stopped, thus treatment may be required for a long time. Some persons with a loop in their small intestine may not require antibiotics for a long time, while others may require them on a regular basis.

To assist minimise bacterial resistance, doctors may alternate between medicines. Antibiotics kill most bacteria in the intestine, both normal and pathological. As a result, antibiotics might exacerbate some of the conditions they're supposed to treat, such as diarrhoea. This problem can be avoided by switching between various medicines.

Nutritional assistance

Correcting nutritional inadequacies is an important element of managing SIBO, especially in patients who have lost a lot of weight. Malnutrition is treatable, but the harm it causes is not always reversible.

These medications may help with weight gain, nutritional shortages, and digestive distress:

Supplements for nutrition: Vitamin B-12 intramuscular injections, as well as oral vitamins, calcium, and iron supplements, may be required for those with SIBO.

Diet that is lactose-free. You may lose the capacity to digest milk sugar if your small intestine is damaged (lactose). In that scenario, most lactose-containing food should be avoided, or lactase preparations that aid in the digestion of milk sugar should be used.

Because the bacteria employed in the culturing process naturally break down lactose, some persons with the condition may be able to stomach yoghurt.

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