7 June 2022
Tackling SIBO: Should I do a bespoke or an off the shelf programmes – Which is best?
As a Registered Nutritional Therapist (NT) and Functional Medicine practitioner (IFMCP), who specialises in SIBO and complex digestive issues, I often get asked which is better – a general off the shelf plan package or following a specific bespoke SIBO protocol.
Many SIBO programmes have similar elements. Essentially, you first want to test that SIBO (small intestinal bacterial overgrowth), is present. This is typically done via a specialised breath test, taking samples at regular intervals over a number of hours.
There are various types of SIBO – Hydrogen, Methane and Hydrogen Sulphide which can occur and present in multiple combinations.
And there are also different approaches to each, varying from kill, starve and push-out approaches, using a combination of antibiotics, antimicrobials and targeted supplements. And because SIBO is often the consequence of some other dysfunction or imbalance within
the body, – or driver – if this is not resolved as part of your plan, it can increase your risk of relapse and the need for further SIBO treatment.
As SIBO is chronic in two thirds of people, the driver really needs addressing. Key triggers and drivers of SIBO include low stomach acid (including using Proton Pump Inhibitors such as omeprazole), poor bile flow/liver health, abdominal surgery (e.g. gall bladder removal and hysterectomy), radiotherapy, lack of pancreatic enzymes, diabetes, diverticulosis, coeliac disease, stress, ileocaecal valve dysfunction (the doorway between the small intestine and colon), food poisoning, regular alcohol and a dysfunctional Migrating Motor Complex (MMC).
Layer over the top of these challenges the huge variety of symptoms seen amongst SIBO sufferers, which means that intervention needs to be tailored specifically to the individual, and you start to understand why a single herbal product is often not going to work for the vast majority of people.
Certain specialised supplements are also well-researched for treating and successful outcomes in SIBO programmes, including certain types of fibre, such as guar gum, prokinetics and NAC, for breaking down biofilms (the protective coating around the bacteria). These need to be used at the appropriate time in the programme to ensure the best outcome and not al are suitable for all types of SIBO. For example someone with an intestinal methane problem may be give allicin however if hydrogen sulphide bacteria are also present – this may cause a worsening not improvement of symptoms.
Working with a bespoke SIBO practitioner will allow you to explain your full health history in detail and, if your practitioner believes you need additional detoxification support, for example, that will be put in place before your protocol, so the ‘die-off’ phase is much better tolerated. Or as there are many co morbidities that can occur alongside SIBO including diabetes, pancreatic insufficiency and autoimmune viruses such as hypothyroid, it is important to check that there is not another condition contributing to your symptoms. By working with a specialist practitioner they can support you in further testing such as a comprehensive stool test to check immune, inflammatory and other relevant markers.
Ultimately, we are all unique in terms of our genetics, environment, past exposure to toxins/ infections, stress, diet and lifestyle. We are also unique in the cause of our SIBO and also the type of SIBO we may have, coupled with the unique diversity of our gut microbiome, it is hard to see how a ‘one size fits all’ approach to complex condition such as SIBO, with multiple drivers and triggers can be as effective as a bespoke plan.
if you are interested in getting a specialist bespoke plan from one of our practitioners where we have over 25 years of clinical experience please visit www.IBSandsiboclinics.co.uk or to get a SIBO test visit www.smartsibotest.com
IBSANDSIBOCLINICS.CO.UK
IBS and SIBO Clinics – Treatment for IBS and SIBO Symptoms
