We recommend a comprehensive treatment plan that effectively identifies and addresses the root causes of SIBO. For this reason we recommend the following 6 Step treatment plan.
Step 1: Get Tested for SIBO
The results from your SIBO test tell so much more than just the positive or negative result and this is what helps me come up with an individualised treatment plan. As the breath test is conducted over a 3 hour period (see my previous article for more details on SIBO Testing) at intervals of 20 minutes, the results are fairly specific to where in the small intestines the SIBO is present.
The lactulose breath testing I recommend tests for both methane and hydrogen gases. Some people have raised methane, tending to be more constipation types and some have raised hydrogen and are more likely to suffer loose stools, urgency and diarrhoea. Occasionally both are raised. Different antimicrobial herbs work on the different gases and the dosages and duration vary on the results of the test.
Step 2: Clean Up Your Diet
The first step of SIBO Treatment is the diet. If I suspect someone has SIBO I'll refer them for the lactulose breath test and we'll start work cleaning up the diet before we get the results. I use various elimination diets, depending on the symptoms the client has, to identify their food triggers. This usually results in a reduction in symptoms before we even get the results.
If you get a positive SIBO test result there are specific dietary guidelines to follow to help starve the bacteria and reduce your symptoms. The diet I usually recommend is SIBO specific and changes with the stage of treatment and can always be individualised depending on the test results, the individual's symptoms and their current diet. This kind of restriction in the diet can be challenging to follow so I provide meal plans and recipes to help guid you through.
The diets found to be helpful in reducing typical SIBO symptoms are low in fermentable carbohydrates like:
- Low FODMAPs
- Specific Carbohydrate Diet
- GAPs Diet
- The Fast Tract Diet
Step 3: Implement SIBO Supplement Plan
Step two of SIBO treatment is to use the correct antimicrobial herbs to kill off the bacteria in the small intestine. There are several herbal supplements that have been found to successfully treat SIBO and we can be specific with which ones to use and for how long once we have your SIBO results.
Step 4: Address Leaky Gut and Reintroduction of Foods
Step three of SIBO treatment is to address leaky gut and reintroduce some of the foods that were eliminated to see if they can now be tolerated or if they still trigger symptoms. Either way you come away knowing what you can eat to be symptom free. Some people can go back to all foods at this stage and other have to stay away from certain foods to stay symptom free.
Step 5: Rebalancing Gut Microflora
Step four of SIBO treatment is rebalancing the gut's microflora. Keeping some of the processed and refined sugar from the diet and introducing some fermented foods (only once SIBO has been treated) can help create digestive balance and keep digestive symptoms away for the long term. It's also important to assess the quality of your digestion and address the need for digestive enzymes and the stimulation of stomach acid if relevant.
Step 6: Support the Migrating Motor Complex (MMC)
The final step in dealing with SIBO is to support the migrating motor complex (MMC). Sometimes treating the SIBO and rebalancing the microflora may be enough, but for others it's vital to make sure you have a healthy MMC using prokinetic supplements, allowing sufficient time between eating for the MMC to work properly and a combination of probiotics that help with motility.
Addressing Other Issues
For lots of SIBO sufferers SIBO isn't their only complication. Sometimes we have to look for potential issues in the large intestine as well and rebalance the good bugs and bad bugs through diet and supplements. Doing a CDSA (Complete Digestive Stool analysis) gives us this part of the equation. It isn't necessary for all SIBO clients but for those with long standing and more serious symptoms it helps identify what else may be going on. They may also have:
- Parasites: blastocystis hominis, giardia, cryptosporidium
- Chronic GI infections - clostridium difficile, h. pylori
- Fungal or yeast overgrowth - candida
It is important to address the diet, the herbal antibiotics, balancing the microflora and the healing of the leaky gut to help prevent recurrence. If you choose to treat SIBO with antibiotics it is recommended you still address dietary changes, healing a leaky gut and rebalancing the microflora or the rate or recurrence can be high. Most people see dramatic improvement within the first few weeks, however some do take longer and we need to keep digging for other contributing factors. The MTHFR gene variant can be relevant in more complex cases that don't respond as we'd expect to standard treatment, however we can test for this as well.
Where To From Here...
If you’d like to find out more about testing and treatment options for SIBO and IBS or digestive symptoms then please book in for a free nutrition strategy session so I can go over your options.
Or simply call me on my mobile - 0423 761 247 and I'll call you back as soon as I'm free.