SIBO- Overlooked Cause of GI Issues (Case Review)

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

A 47 year woman named Kristina was seen with the following symptoms:  Chronic bloating, gas and belching, abdominal distention, intermittent diarrhea/constipation and abdominal pain/discomfort.

Based on review of the patient’s symptoms and review of her medical records from her primary physician I was suspicious of a condition called SIBO (Small Intestine Bowel Overgrowth).

SIBO, small intestinal bacterial overgrowth, is defined as an increase in the number of bacteria, and/or changes in the types of bacteria present in the small bowel.

The normal small bowel, which connects the stomach to the large bowel, is approximately 20 feet long. Bacteria are normally present throughout the entire gastrointestinal tract, but in varied amounts. Relatively few bacteria normally live in the small bowel. In most patients, SIBO is not caused by a single type of bacteria, but is an overgrowth of the various types of bacteria that should normally be found in the large bowel.

The most accepted test to diagnosis SIBO is called the hydrogen/methane breath test. 

Here are results of Kristina’s SIBO breath test:

Antibiotics are often used to treat SIBO. However, studies show that despite treatment with antibiotics, recurrence develops in almost half of all patients within one year. The most commonly used antibiotic for SIBO is rifaximin. The treatment I decided to recommend included the following natural botanicals: Biotics FC Cidal with Biotics Dysbiocide at a dose of 2 caps 2 x day x 4 weeks, for each formula. I worked the patient up to this dose over a two week period to minimize die-off symptoms.

In addition to the botanicals I recommended a SIBO diet. The SIBO diet is a temporary elimination diet that incorporates low–FODMAP foods to decrease bacterial overgrowth. Click Here for a food guide for SIBO.

Kristina followed the above treatment protocol for six weeks with excellent results. Her follow-up breath test was negative. It has been 8 months and she is still doing quite well.

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