SIBO, or Small Intestinal Bacterial Overgrowth, is a topic that has been gaining strong popularity and interest among the medical community recently, especially since it has created lots of controversy and polarity. However, after countless studies and debates, specialists, in the search for the underlying causes of SIBO, could finally agree on something that took them by surprise: Apparently, this condition is much more common than it seemed, affecting 20% of the general population (1).
But, what’s SIBO then?
To understand what SIBO is, you first need to know how our gut works. We all have countless bacteria in our intestines, and that’s okay! In fact, we have both friendly and bad bacteria.
Good bacteria support the immune system, optimising your metabolism, and easing digestion. The problem begins when there’s an excess of bacteria. Small Intestinal Bacterial Overgrowth (SIBO) is a medical condition in which too much bacteria has accumulated in the gut.
SIBO can cause:
- Gas increment and bloating.
- Poor digestion.
- Abdominal pain and gastrointestinal discomfort.
- And much more.
Have you ever experienced any of these symptoms? Then, keep reading! In this article, we will discuss which are the not-so-obvious underlying causes of SIBO so you can better assess your gut health and change any behaviour that may be causing your SIBO.
Since we’re talking about a gastrointestinal condition, of course, one of the main underlying causes of SIBO has to do precisely with our diet. Whether “we are what we eat” or not, it’s a fact that when we eat, not only are we feeding ourselves to get more energy, but we’re also feeding our microbiota. Consequently, what we ingest has a direct impact on the growth of our natural bacteria.
Foods such as grains, sugar, dairy, or ultra-processed products, as well as over-consumption of healthy foods like raw vegetables and fruits that are rich in fibre or fructose, as well as fermented foods, can cause more fermentation in our intestines than needed. Therefore, for some people, high consumption of these foods in our daily diets could cause great damage to our intestinal flora or gut microbiome.
Continuing with what we consume in our day to day, it shouldn’t come as a surprise that the abuse of alcohol is on this list, too. Even though it’s well-known that alcohol is metabolised by the liver, it still affects the rest of the organs involved in the digestive system. And our intestines aren’t an exception!
In fact, alcohol not only stimulates intestinal inflammation and irritation (causing significant pain and discomfort) but can also increase gut permeability, preventing the absorption of nutrients (2). A high and regular intake of alcoholic beverages may alter the microbiota’s composition and, consequently, its function for life.
Due to our hectic routines, we tend to sacrifice hours of sleep to keep up with all we have to do. However, we must not forget how crucial it is to have a good night’s sleep every day. The duration and the quality of our sleep have a massive impact on our bodies’ processes, including hormonal cycles, tissue healing and regeneration, and even digestion.
When it comes to SIBO, good rest is key to preventing it! Lack of proper sleep can “interrupt” these cycles, delaying digestion and nutrient absorption as well as causing constant inflammation in the intestinal tract. In the worst-case scenario, the sum of sleep disturbances could lead to chronic digestive malfunctions.
Everyone seems to agree that the three main pillars to having a healthy lifestyle are:
- How we eat.
- How we sleep.
- How we move.
If we consider food to be our “source of energy”, then it’s necessary to use it properly. When exercising, not only does our body find an effective way to use this energy, but it also has a positive impact on our metabolism, digestion, nutrient absorption, and hormonal cycles.
In other words, exercise is the best regulator of our body’s processes! Lack of exercise may slow down our system and even help the development of chronic diseases because of all the “energy” that hasn’t been utilised (3).
Yes. Stress is, once again, one of the underlying causes of SIBO (4). Not surprising, right? We’re so used to it that we simply end up ignoring it. But, since “stress is in the air”, let’s not underestimate its power!
Human beings are both body and mind. The strong connection between what we think and feel and what we experience in the external world always affects our bodies. When we like someone, we feel “butterflies” in the stomach. When we’re sad, our throat “closes”. And when we’re nervous, our hands sweat.
Under stressful situations, our stress hormones raise as a natural body response. However, chronic stress also means chronic exposure to these hormonal raises, which is really damaging to the normal function of our intestines.
Our famous “gut-brain connection” (5) responds automatically to these hormones, causing inflammation, irritation, abdominal cramps, and even diarrhoea. Nowadays, it’s well known how strongly connected our digestive system, and our feelings are!
We know what you might be thinking: “Wait! How is that even possible?”
Believe it or not, those two are more connected than you’d think… But not in the way you may be expecting. The intestinal mucosa is home to a large population of bacteria, viruses, and fungi that form our microbiota (6). As our flora has a direct role in our immune system, any disease or illness that attacks this function will, consequently, affect our gut’s state.
For instance, studies have shown that in the case of HIV (Human immunodeficiency virus) patients, alterations in the microbiota are really common because their immune system is unable to fight and eliminate bad bacteria. The weaker the immune system, the easier and faster bad bacteria will reproduce in the small intestine. In other words: unprotected sexual behaviours open the door to tons of diseases that can attack, and even destroy, your natural defences.
It’s common knowledge that high exposure to radiation, from excessive x-rays to, for example, some cancer treatments (7), has negative consequences on our bodies. Unfortunately, our intestines are some of the organs that might be affected, especially when it comes to permeability issues.
Not only does repetitive radiation alter the mucosal fluids and the microbiome’s composition, but it also increases intestinal permeability. If our gut becomes fully or even partially permeable, there’s a high risk of malnutrition since it would be impossible for the intestine to absorb nutrients from our food.
We all have hormones, both men and women. However, having more complex cycles makes women more likely to suffer from hormonal disorders. Menstruation, pregnancies, post-partum, and menopause are just some of the many cycles most women deal with throughout their lives.
Believe it or not, these hormonal changes have a strong impact on women’s digestive systems. Have you ever noticed that women tend to suffer more from gastrointestinal issues than men? Have you ever wondered why?
Even though it’s a topic that still needs to be studied in-depth, specialists have discovered that there’s a direct connection between the levels of progesterone and estrogen (which vary throughout each cycle) and the digestive system.
These hormones have a strong impact on:
- Digestion and how fast food passes through the intestines.
- Inflammation (caused by gas).
- Pain threshold.
Another group of people who are highly affected by SIBO are the elderly. Yes, advanced age is a risk factor and an underlying cause of Small Intestinal Bacteria Overgrowth (8). In general, seniors are more exposed to certain conditions because their defences are vulnerable. On top of that, a weaker immune system is also common among these age groups.
Still, that’s not the only reason why the elderly are more likely to suffer from this condition. The regular ingestion of numerous strong medications that seniors usually take can also reduce the production of gastric acid. Moreover, too much medication may slow down the small intestine’s motility, causing a greater digestive function imbalance.
Although the development of SIBO depends on multiple factors, such as diet, lifestyle and genetics, studies have shown that between 14.5% and 15.6% of healthy older patients suffer from this condition (9). So, we can assume that in seniors with previous gastrointestinal conditions, the number of SIBO patients might be even higher.
There are plenty of gastrointestinal, inflammatory, and autoimmune chronic diseases and conditions that may affect, or even cause, SIBO. Some of these include Crohn’s disease, celiac disease, liver cirrhosis, and food intolerances, allergies, or sensitivities.
The very first underlying cause of SIBO we discussed at the beginning of this article was “having an unhealthy diet”. However, when planning our diet, it is also important to take into consideration which foods personally give us discomfort or even pain.
Some of the most common intolerances and diagnoses that can promote or affect SIBO are the following:
People who are lactose intolerant shouldn’t ingest any dairy products, since they don’t have enough lactase enzymes, which are responsible for dissolving lactose (10). If they consume any dairy, as they can’t digest lactose in the small intestine, it goes into the colon, where bacteria will decompose it by producing extra hydrogen.
This disease is an autoimmune disorder in which the immune system totally rejects the gluten protein found in wheat, rye, and barley products, producing irritation and inflammation in the whole body (11).
Something curious about celiac disease is that many people who don’t have this disease and yet, present some kind of gluten rejection or allergy. In fact, nowadays, more people are jumping into “the gluten-free trend”, the autoimmune diet, or simply adopting different gluten replacements to prevent discomfort and inflammation.
Unlike the other two conditions, IBS is diagnosed based on symptoms, such as regular abdominal pain and bloating, and not on allergies or intolerances (12). Much like Crohn’s disease, people who suffer from IBS (10% of the global population) have high sensitivity to fermentable and fermented foods, leading to altered bowel habits. Since this condition varies too much, while some people suffer from chronic diarrhoea, others deal with constipation, and others constantly fluctuate from one extreme to another.
Cirrhotic patients are in the final stage of chronic hepatitis, which is a severe dysfunction of the liver (13). The production of gases such as, hydrogen and methane stimulates bacterial overgrowth, raising the presence of SIBO in cirrhotic patients up to 47.1%.
Some of the symptoms all these diseases generally have in common include bloating, flatulence, abdominal cramps, nausea, heartburn, and diarrhoea. If none of these conditions are treated, the patient will most likely develop SIBO.
Your intestine is a world only YOU can discover! We believe that self-awareness and self-care are the key to understanding what your body is going through and what it needs. And while SIBO can be pretty painful and difficult to manage, accepting and loving your body may be the first step to improving your health and quality of life.Now that you finally know the 14 underlying causes of SIBO, it’s time to make the first move and take action. The good news is you don’t have to do this all by yourself! If you feel lost or simply don’t know where to start, click here to take our FREE Personalised Health Assessment and get started on your healing journey!