Contents
Let’s start by explaining what the intestinal microflora is. It is a group of microorganisms that live in our digestive tract, mainly bacteria. The intestinal bacteria have a number of beneficial functions for our body. We can mention the fermentation of dietary fiber, the absorption of nutrients, the production of K and B vitamins, the role in the immune system or the creation of a protective barrier against harmful substances.
If we are dealing with an excessive amount of bacteria in the small intestine, we are talking about the occurrence of small intestine bacterial overgrowth (SIBO). It is considered that the number of bacteria exceeds 105 in 1 γ or 1 ml of intestinal content. This condition most often leads to gastrointestinal complaints and their complications.
Causes of SIBO
The factors that cause excessive growth of the bacterial microflora include:
- inhibition of gastric acid secretion, often as a result of long-term therapy with proton pump inhibitors,
- disturbance of the secretion of pancreatic enzymes,
- anatomical abnormalities of the gastrointestinal tract, such as diverticula, tumors, and intestinal strictures
- immune disorders, immunoglobulin A deficiency.
SIBO is often seen in people with irritable bowel syndrome (IBS), Crohn’s disease, celiac disease, non-alcoholic fatty liver disease, cirrhosis, diabetic neuropathy, and cystic fibrosis.
What are the symptoms of bacterial overgrowth of the small intestine?
Symptoms include:
- fatty or osmotic diarrhea,
- excessive gas and gas,
- iron or vitamin B12 deficiency anemia,
- unintentional weight loss
- symptoms of mineral and vitamin deficiencies,
- swelling.
In some people, SIBO may not show any symptoms.
Diagnostics of the SIBO syndrome
Most often, in order to diagnose this syndrome, a breathing test with glucose is performed. After drinking the glucose solution in the patient’s exhaled air, the level of hydrogen excretion, which is produced by the bacteria in the intestine, is measured.
Small intestine content is also cultured to fully recognize small intestinal bacterial overgrowth.
Treatment and nutritional recommendations
Antibiotic therapy
First of all, it is necessary to determine the cause of the appearance of bacterial overgrowth. In most cases, antibiotic therapy is introduced that works on aerobic and anaerobic bacteria. In the event of recurrence of SIBO, repeated antibiotic therapy is introduced.
probiotics
During antibiotic therapy, probiotic therapy is often introduced, with the use of appropriate strains of bacteria. It aims to regenerate the beneficial intestinal microflora. The preparations from the Bifidobacterium family are the most commonly used.
Diet in the SIBO team
In the bacterial overgrowth of the small intestine, it is crucial to ensure an adequate supply of energy. This is to avoid unintentional weight loss and to lead to malnutrition. It is also important to pay attention to the adequate supply of vitamins and minerals in the diet, especially vitamins A, D, E, B12 and iron.
In the case of vitamin D, its supplementation is most often introduced. Vegetable oils should be included in the diet, especially linseed oil, rice oil, olive oil, rapeseed oil, also nuts, seeds and fatty sea fish. Vitamin B12 can be found in meat, eggs and dairy products. The rich sources of iron are meat (especially liver, beef and pork), legumes and eggs.
The LOW FODMAP diet may be helpful for the symptoms associated with SIBO. It is a diet in which carbohydrates that ferment easily in the intestine are limited, as increased bacterial fermentation can cause ailments such as flatulence, excessive gas, diarrhea.
The LOW FODMAP diet eliminates, inter alia, products such as: onions, garlic, legumes, cruciferous vegetables, dairy products, apples, pears, watermelon, plums, nectarines, rye, wheat, xylitol, fructose. In a next step, these products are reintroduced in moderate amounts. You can find more about the LOW FODMAP diet in Nina’s article: https://.pl/dieta-low-fodmap.
It is worth noting that the diet should be individually selected, because in the case of people with SIBO, the list of poorly tolerated products is often a very individual matter.
Bibliography:
https://www.termedia.pl/gastroenterologia/Zespol-przerostu-flory-bakteryjnej-jelita-cienkiego-a-zespol-jelita-nadwrazliwego,10972.html
https://www.mp.pl/pacjent/gastrologia/choroby/jelitocienkie/80685,zespol-rozrostu-bakteryjnego
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1440-1746.2009.06149.x