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Stages of SIBO

How Did I Develop SIBO

SIBO is an acronym for Small Intestinal Bacterial Overgrowth.  SIBO occurs when there is too much bacteria in the small intestines. Unlike the large intestine, the small intestine is supposed to have very low levels of bacteria. These bacteria can be bad bacteria but they can also be good bacteria. The key is that you have bacteria in an area where they don’t belong.

Too much of these bacteria in the small intestines will affect digestion and your ability to absorb nutrients but thats not all. When too much bacteria starts to overgrow in the small intestine, the function of the small intestine is hindered by the inflammation driven by these bacteria. This can lead to symptoms like constipation and diarrhea, fatigue, brain fog, Chronic systemic inflammation and many skin conditions ie Rosacea.

Stages of Small Intestinal Bacterial Overgrowth

SIBO- The Beginning Stages

It has been established through several studies that food poisoning or acute gastro-enteritis can be the cause of almost 60% of SIBO/ IBS cases. Bacteria that cause food poisoning include salmonella, campylobacter, shigella, e. coli, and Giardia. These bacteria and parasites secrete a toxin called cytolethal distending toxin (CdTB).

As one might imagine this toxin is not friendly to your cells and as part of the defense mechanism to this insult, your immune system begins producing antibodies against these CdTB toxins.

These antibodies attack a protein named Vinculin. But here is where it gets interesting. Vinculin is an important protein because it plays a role in something called the Migrating Motor Complex or the MMC. When the MMC stops working, food debris, waste, toxins, dead cells, stay in the small intestine instead of getting pushed along the GI tract. Some of these these bacteria take up residence in the small intestines and begin reproducing and robbing your body of nutrients. As they continue to feed on the food you eat, you start experiencing bloating, and gas.

Why is the MMC important?

The MMC is the “housekeeper of the digestive tract.” It sweeps food debris and opportunistic bacteria from the small intestine into the colon. This is a good thing. While it is OK for the large intestine to house 10 billion to 10 trillion microbes, the small intestine should only have 1,000 to 100 million. Learn more about the MMC and its role in SIBO here

Stages of Small Intestinal Bacterial Overgrowth

  1. Asymptomatic

The first stage of SIBO is the asymptomatic stage, or the time when you had the overgrowth, but were unaware due to the lack of signs and symptoms. You felt no ill effects other than slight bloating that you probably attributed to the foods that you ate. As you bacterial overgrowth continued, unknowing of the issues within your small intestine, you may have noticed more frequent bloating after eating. Again, you probably attributed this to the amount or type of foods you were ingesting.

  1. Moderate Symptoms

The next stage of SIBO yields a string of symptoms, including bloating combined with occasional constipation and/or diarrhea. Again, this may seem like an issue with the foods you’ve been eating, but the truth is that bacteria has now fully infiltrated your small intestine and has begun to ferment the carbohydrates in your diet, including sugar, grain, starch and fiber, they may also started creating biofilms. This fermentation of foods (Fruits, starches, certain vegetables),  leads to gas and bloating. Other strains of the bacteria cause fats to be broken down improperly, leading to diarrhea and light-colored stool. The bacteria will also begin to secrete toxins that affect the lining of the intestine breaking it down and causing localized intestinal inflammation at times. Nutrient deficiencies begin to show up including low levels of vitamin D and low iron. 

  1. Severe Symptoms

Unfortunately, the majority of my SIBO patients come to me at this stage. They’ve long surpassed what help they can find from traditional western medicine. They’ve tried alternative therapies. They’ve researched everything they can find on the Internet. Bloating is still an issue, but often due to the inflammation in the gut, things like brain fog, anxiety, depression and skin condition begin to show up. Sometimes, weight loss becomes the hallmark symptom as there is a serious underlying issues with absorption of vitamins and nutrients. Other issues begin to arise, including anemia, low albumin and decreased cholesterol. This leads to weight loss and constant bowel dysfunction, alternating between constipation and diarrhea.

Most patients finally realize there’s a problem in the third stage of SIBO and seek help for SIBO. If this sound familiar, contact our office today!

Contact us to schedule a free 15 minute consult to see if our SIBO program is a good place for you to start. 

In Summary:

In summary, SIBO often starts with a bout of food poisoning.  The immune system crates antibodies against Vinculin and CdTB. The immune system begin attacking vinculin and in the process shuts off the MMC. When the MMC stops working, food debris and bacteria stay in the small intestine instead of being pushed along the GI tract. These bacteria replicate, set up shop in the small intestines and then start robing you of nutrients. If you are ready fore expert help, Contact me- Dr. Hagmeyer. Let’s figure out the best way to approach your symptoms.

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