A relapse in SIBO is incredibly common. In fact, some studies show that more than 45% of people with SIBO are reinfected or experience SIBO relapse within just a few months of treatment and that percentage increases in older people and people with multiple health problems.

I would say that percentage is probably even higher based on all the people I talk to everyday that tell me about their relapse. Here’s my question for you, Have you or even your doctor ever considered the role your livers involvement in SIBO.

You see….. if your doctor is only prescribing antimicrobials or Rifaximin/Xifaxin and recommending a low FODMAP diet, your are guaranteed to fail and have another relapse. Heres an article on the 4 Mistakes People Make on Low FODMAP diet

If you find yourself feeling defeated in your journey for better gut health and you have one SIBO relapse after another, I hope today’s video on ways to support your liver when you have SIBO or IBS will help you realize that there is so much that can be done to regain your health when we think about this from a functional medicine perspective.

If you are just joining me for the first time, I’m Dr Hagmeyer, I’m the clinic director here at Dr Hagmeyer.com where we help provide answers and solutions for people who struggle with chronic GI problems using functional and lifestyle medicine.

If you are still struggling with SIBO, be sure to watch todays video all the way to the end. Because in today’s video I want to help you not understand the crucial and overlooked role the liver plays in SIBO, but I also want to share with you a number of ways you can support your liver when you have SIBO so you can prevent a relapse.

You see, supporting your liver when you have SIBO and GI problems is essential and here’s why…

It’s bad enough our liver is constantly being taxed and burdened by pollution, medications, processed foods, pesticides, but when you have SIBO, there is another toxin your liver and gall bladder are being subjected to and burdened by and these are endotoxins.

Endotoxins are produced by gram negative bacteria and they cause a number of problems when you have SIBO and they are a major cause for a SIBO relapse.

These endotoxins, irritate the mucosal lining of the gastrointestinal tract causing irritating of the gut lining, they cause leaky gut (1) allowing toxins to slip into the bloodstream triggering inflammation(2). This inflammation can impair liver and gallbladder function leading to reduced bile flow contributing to kidney and gallbladder stones.

Remember your liver filters your blood, it makes Bile, it’s involved in over 200 different reactions in your body, but when these endotoxins overwhelm your liver you’re going to suffer with poor detoxification, inflammation, impaired bile flow, your going to experience oxidative stress at the cellular levels, you’re going to have depleted glutathione and levels and all of this ultimately is going to end up in a relapse of your SIBO. I have seen this hundreds and hundreds of times.

Here’s the other thing…. No matter how well you follow and adhere to a low fodmap diet you need to remember that there are many causes to SIBO and successful long term success requires a multipronged approach that includes liver and gallbladder support.

Prevent a SIBO Relapse By Supporting Your Liver

Increase Bile production and Bile Flow

Like I have been mentioning, One thing we need to do when we have SIBO is make sure we have sufficient bile production and sufficient bile flow.

Here’s the thing…..

People who have SIBO often have reduced bile acids production that leads to a congested liver and a congested gallbladder and when your liver and gallbladder is congested you’re going to experience problems with bile production leading to symptoms of bladder stones, kidney stones, diarrhea, gas, bloating, stomach cramps, erratic bowel movements, weight loss, and as the disease progresses pale clay colored stools.

But here is why bile and healthy bile flow are so important. Bile contains bile acids, which are critical for digestion and absorption of fats and fat-soluble vitamins in the small intestine. Many of these fat soluble vitamins like A,D,E,K are very important to gut health. 2^nd bile is an antimicrobial and it helps keep bacteria levels low in the small intestines. Poor bile flow leads to more bacterial growth in the small intestines. 3rd, bile stimulates motility. Poor bile flow slows down motility leaving more time for food and fibers to sit in the gut to be fermented by SIBO bugs. I see many of my clients have improvement in symptoms from just increasing bile flow!

There are few natural ways to improve bile flow that I want you to be aware of and I recommend that you talk with your functional medicine doctor about which of these ways are best to implement. Usually, a combination of these are needed for optimal bile production and bile flow.

So here are four ways to increase bile production and bile flow.

Bitter herbs can increase bile flow. Milk thistle, dandelion greens or dandelion tea, goldenrod, juicing beets and beet greens, gentian these are all great ways to improve bile flow.

Eating Foods Rich in Choline. Not only is Choline a bile salt, but choline is needed for the production of acetylcholine which is an important neurotransmitter that plays a vital role to digestion and motility. Foods that contain choline include eggs, liver and beef. Choline can also be taken in supplement form. Another great way of increasing bile production is supplementation with Taurine. Your body uses taurine to make bile salts but if you don’t have a gall bladder, direct supplementation with bile salts like Oxbile and choline is another option. I recommend talking to your functional medicine doctor to see which is most appropriate for you Oxbile, choline or Taurine.

Bind up endotoxins from the gut

The next thing we want to think about when it comes to supporting the liver when we are trying to prevent a relapse of SIBO is binding up these microbes and the endotoxins that these bacteria producing.

When you bind up these toxins and then get them out of the body you are taking an important step at taking stress off your liver which in turn reduces inflammation, reducing endotoxin load.

Remember that bile not only helps absorb fats, bile removes toxins from the body. So, we need to have good bile flow and we need to trap these toxins and microbes. Now…

To bind up these toxins and bacteria, I often use things Immunoglobulins like the ones we see in SBI protect as well as a supplement like GI detox that contains charcoal, and clay.

Studies show that immunoglobulin G, can bind up the microbes in the GI tract and eliminate them prior to activating the immune system.

Reduce Oxidative Stress

The next thing we want to think about when it comes to supporting the liver and preventing SIBO relapse is oxidative stress.

Oxidative stress is defined as a disturbance in the balance between the production of reactive oxygen species (free radicals) and antioxidant defenses.

Oxidative stress is one of the main reasons for cellular damage and cell toxicity.

One of the best ways to reduce oxidative stress and cellular damage is to Increase your Glutathione Levels.

In fact the majority of my SIBO patients are put on supplemental liposomal glutathione to help increase glutathione levels and reduce oxidative stress and cell damage.

Glutathione is one of the most important things to help the liver detox toxins and this again is something that should be implemented in your SIBO program.

There are a number of ways that you can increase glutathione levels through your diet, but with all my patients, I recommend a combination of dietary strategies alongside specific supplementation to boost glutathione levels.

From a dietary standpoint be sure to increase your protein intake. I recommend eating anywhere between .5-1 gram per pound of body weight every day. If you are not dealing with any histamine issues collagen and gelatin from bone broth can be another great way to naturally supply your body with the raw materials to make glutathione but just be careful if you experience anxiety as the histamines found in bone broth can increase anxiety.

Additional Information on Glutathione

Whey protein can be another way to increase glutathione levels. Whey protein also has the ability to strengthen your immune system, reduce inflammation, maintain muscle mass and help with leaky gut.If your diet is really restricted and you are in a bad place with flare ups, it may be necessary to bring out the big guns and jump right into glutathione supplementation.

There are many different kinds of glutathione supplementation these days, but I recommend a liposomal glutathione.

Limit environmental toxin exposure

Reducing toxins from household cleaners, food, beauty products, hygiene products and more can help reduce backups in the liver. Here are some tips when it comes to reducing toxins:

Avoid using plastic containers (use glass water bottles and storage containers)
Buy organic food when possible
Filter your water and avoid storing in plastic.
Buy non-toxic household products and Cleaners
Buy non-toxic hygiene and beauty products like bleach free tampons, make-up, body wash, shampoo, conditioner, nail polish, hair products, sunscreen and skin care products
The Environmental Working group has a great website to help you choose better non-toxic options for you and your family.

Points To Remember When It Comes To Preventing Another SIBO Relapse

Just as a quick summary, there are many things that need to be considered that fall under this umbrella of supporting your liver. Today we talked about 4 ways to support your liver when you have SIBO. I talked about improving bile production and bile flow, I talked about reducing oxidative stress, I talked about the importance of binding up the endotoxins, I talked about eliminating toxins in your environment. I talked about some of the foods that can help with this and I talked about some of the supplements that do this as well. Its always best to implement a combination of dietary changes, and supplements in these cases.

All of these things thing when implemented into your SIBO treatment program can and will help prevent another relapse of your SIBO.

One thing I will tell you is that this is very easy to overlook the connection between the liver and SIBO, but If you are someone who has had multiple relapses, there are some missing pieces to your BIG picture.

The liver could be one of those pieces that needs attention. If you haven’t watched my SIBO video series, I encourage you to check the description box, and I will leave links to those videos. Also, If you feel like you hit a brick wall in your treatment program, or you feel that the doctor you are working with is missing some of the pieces of your health puzzle, the best way to get in touch with me is by going to my website and clicking on the start here button.

One last thing, If you struggled with SIBO and you found that supporting your liver with some of the things I talked about today made a big difference for you, drop me a comment below, tell me about your experience? What did you find helpful?