SIBO. SIMO. SIFO. What’s Happening In the Small Intestine?

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Is SIBO the new leaky gut? Until recently, digestive issues were often attributed to “leaky gut” but now everyone seems to be talking about “small intestine bacteria overgrowth” or SIBO.

SIBO is considered a bacteria issue. However, many people do not see lasting results from typical SIBO treatments. Now we are hearing new terms like SIMO (small intestine microorganism overgrowth) and SIFO (small intestine fungal overgrowth). What is really going on?

As we continue to see gastrointestinal (GI) problem occur in greater numbers, we need to step back and look at things differently. In reality, the GI tract starts at the lips and ends at the rectum. It is a continuous “tube” and problems can occur anywhere along the way: mouth, esophagus, stomach, small intestine, and large intestine. Issues can also occur in the organs that feed into the GI tract.

The fact is SIBO or small intestinal problems in general can occur because of a wide variety of issues. Antibiotic use is a common cause for imbalance. Other regular culprits include unresolved food poisoning, toxic exposures, stress and traumas, and even electromagnetic frequencies (EMFs). In fact, I believe our smart phones are a big contributing factor.

Continue reading and I will explain more about this and the many other possible causes and solutions for small intestine problems.

What is the Small Intestine?

First, lets look at the small intestine and its role in the body. The small intestine (SI), which is approximately 20 feet long, is designed to digest food and absorb its nutrients through the villi and microvilli that line the intestinal walls.

In a healthy SI, these villi work with the muscles to create what is called peristalsis or migration motor complex. The walls of the small intestine create a series of muscle contractions to sweep remaining debris and waste into the large intestine. Some people can feel or hear the sound it makes every 90 minutes between meals, indicating your intestines are being cleared out.

Digestion actually starts in the mouth, continues in the stomach, and moves into the small intestines where a majority of digestion and nutrient absorption occurs. The last 10% or so of the digestive process occurs in the large intestines where debris and waste products are created by the good bacteria and other microorganisms found there. Waste products also include unwanted microbes (or pathogens) like bad bacteria, viruses, parasites, and yeast/fungus.

Ultimately, this debris and waste product is expelled by the body through your bowel movements. At least it should be. If you don’t have daily bowel movements, the by-products can get backed up and end up residing in the small intestines, where they are not supposed to be, causing fermentation, toxicity, etc. This in turn damages the micro villi and creates a whole host of symptoms.

Signs of Small Intestinal Problems

SIBO and other small intestinal issues can affect all age ranges, including children. If you are new to SIBO and its related cousins, SIMO and SIFO, here are some of the common symptoms:

  • Gas, bloating, diarrhea and/or constipation
  • Abdominal pain or cramping
  • Issues with digesting food and absorbing nutrients
  • Other GI issues such as IBS or IBD and leaky gut
  • Food intolerances, particularly histamine and FODMAPs
  • Deficiencies in vitamins (such as A, B12, D and E) and minerals
  • Neurotransmitter imbalances
  • Chronic or extreme fatigue (often from lack of vitamin absorption)
  • Skin issues such as rosacea, eczema, psoriasis, urticaria (chronic hives), scleroderma, etc.
  • Thyroid problems including Hashimoto’s and hypothyroidism
  • Gall bladder issues
  • Chronic fungal or Candida issues
  • Cognitive issues
  • Autoimmune disease

Other possible symptoms include fatigue, due to not absorbing nutrients, and even brain fog, especially if fungal overgrowth like Candida is present. Food sensitivities can also occur, especially when you find that your food issues vary from day to day and you can’t figure out which food or foods are affecting you.

Identifying and Resolving Classic “SIBO”

True SIBO is typically thought to be a result of good bacteria, like lactobacillus and Bifidobacterium, ending up in the SI when it normally should reside in the large intestines. In truth, small intestine issues can be a result of many things. It is difficult to identify. As you can see from the symptoms listed above, it affects so many other parts of the body: stomach, large intestine, gall bladder, skin, thyroid, brain, etc.

The classic medical test to check for SIBO is the breath test. A person is given a sugar (lactulose, glucose and sometimes fructose) and then checked to see if it produces hydrogen gas or methane gas. A “GI map test” can also be used to check for commensal bacteria.

These tests can be informative and may determine that you have an imbalance in your gut bacteria, but they are not necessarily getting to the core issue(s). They can also give you false negatives. As you will learn in the next section, there are many possible reasons for small intestine problems. A clear diagnosis can be difficult to determine.

That also means that the classic 3-step SIBO protocol may not be enough. The typical steps include:

  1. Starve the bacteria overgrowth by removing all sugars that feed it. This includes removing alcohol, grains, and legumes from the diet and minimizing starchy veggies and fruit.
  2. Reduce the bad bacteria with the use of medications and/or natural herbs. Natural methods typically include using a special blend of herbs as well as fatty acids and binders.
  3. Restore the balance by adding back the correct friendly bacteria that maintain a healthy gut as you wean off other supplements.

This strategy seems to work for some people, but if the main issue is not bacteria-related you may not see long-term results. Even those that initially see results often find themselves with SIBO-like symptoms again a few months later.

Step three can also be tricky. There are so many different strains of bacteria. If the wrong bacteria are re-introduced to “re-inoculate” your gut, you may recreate the problem or start a new one.

In fact, I believe that some people may have created their SIBO issue as a result of taking the same probiotics for an extended length of time. Probiotic supplements only contain a limited number of strains (typically 8 to 12 strains), yet your gut contains hundreds of strains. If you take the same product too long, you can create mono-cultures in the gut and ultimately create a different kind of imbalance over time. (This is why I believe muscle testing and/or bio-energetic screenings are such helpful tools.)

Many Possible Underlying Causes (or Risk Factors)

In reality, there are many factors that need to be considered when trying to resolve small intestinal issues, whether it is SIBO, SIMO, SIFO or something else. With so many possible contributing factors, you have to go back to the fundamentals, looking at your health history, nutrient deficiencies, traumatic experiences, lifestyle factors, etc.

Any number of the following can be a contributing factor. A combination of factors is not unusual. In fact, many aspects outside the small intestine can affect the small intestine, disrupting its motility and causing food to stay trapped. This includes EMFs and wireless radiation, which will be explained in more detail in the next section.

Poor food choices. Too much sugar, alcohol, processed foods, etc. will compromise digestion over time and feed the wrong bacteria or microbes. For some this will include grains (especially gluten), dairy (casein), and legumes (lectins). Oxalates is another common culprit. Continuously eating pesticide-laden and genetically modified (GMO) foods additionally depletes your minerals and kills off your good gut bacteria. However, a culprit food can also be unique to you, especially if you have been eating a particular food in large quantities for an extended period of time.

Eating gluten and dairy. Gluten and dairy are the two most common food culprits because they are known to flatten the villi that line the small intestine over time, which affects the nutrient uptake that occurs there. These foods can also affect the tight gap junctions in the intestinal lining, allowing foreign substances (like gluten and casein proteins) into the blood stream where they don’t belong, which creates inflammation.

Low stomach acid. The stomach needs hydrochloric acid (HCl) to digest the foods you eat. Many people are deficient due to age, toxic exposures, GMO foods, etc. Contrary to popular belief, GERD and acid reflux are also related to too little stomach acid. When your food is not properly digested in the stomach it puts extra work on the small intestine, creating an imbalance.

Gall bladder and bile deficiencies. Stomach acid is additionally needed to allow bile to be released from the gall bladder. This bile acid further helps you digest your food, especially fatty foods. Your gall bladder and the many bile ducts connected to the gall bladder can get backed up and/or clogged with toxins, parasites, etc. If your bile is not flowing optimally, further imbalances in the small intestine can occur.

Low digestive enzymes and the pancreas. Digestive enzymes from the pancreas are also needed for proper digestion of foods in the stomach. They are needed to breakdown your foods into absorbable nutrients. For example, proteins need to be broken down into amino acids, the building blocks for your neurotransmitters that help control your emotions. However, digestive enzymes often reduce with age and stressors. The pancreas’s sphincter, which is needed to properly release the enzyme excretions into the SI, may also become compromised by toxins, microbes, etc.

Previous food poisoning. Common microbes that cause food poisoning include Salmonella, E. coli, Shigella, Campylobactor, etc. There is also a list of parasites to consider. You might be exposed when traveling in a foreign country or when eating locally. You may have an immediate reaction such as a high fever, vomiting, and/or diarrhea and then feel better after a day or two. However, these microbes can sometimes remain in the body and cause bigger intestinal issues later on. Other food poisoning can go unnoticed and cause a low-grade infection that goes undetected, especially if you do not have enough good gut microbes to counterbalance the problem.

Mycotoxins and mold. Mycotoxins are the toxins produced by mold. This mold can be in your home or environment or in your body. Mycotoxins can affect the migrating motor complex, which is a common problem with SIBO and other small intestine issues. Mycotoxins can also attack the bile acids, causing sluggish bile and making clearing and digesting more difficult.

Undetected infection and biofilm. Often a chronic infection goes undetected either because it is hiding in a particular organ or because it is hiding in biofilm. Biofilm is a thick sticky or slime-like substance that protects a group of microbes and toxins so they can live symbiotically without being detected by your immune system, basically creating place for them to hide and making them difficult to detect. Parasites, Candida, and heavy metals, for example, are known to “hide out together” in biofilm. Biofilm can be found inside the GI tract; common areas are the teeth/mouth and intestinal lining.

Nerve damage. Unresolved exposure to microbes like Lyme-related organisms and parasites (including Borrelia which tends to hide out in the gut lining) over time can cause SIBO-like symptoms because of the toll it takes on your nervous system. Your nervous system is interconnected so that damage in one area can affect the gut and disrupt gut motility.

Physical trauma. Other forms of nerve and muscle damage can result from physical traumas to the body. Examples include direct trauma to the gut (like a sports injury or car accident), previous surgery (like a C-section or laparoscopy procedure), or certain conditions such as diabetes, scleroderma, diverticulosis, and Crohn’s disease. Even things unrelated to the gut, like a head injury or giving birth, can shock the digestive system. Neurological disorders, such as MS, ALS, and Parkinson’s, can affect the nervous system as well.

Other stressors. Chronic stress can disrupt your microbiome and suppress your immune system and includes things like not enough sleep, too much exercise, constantly eating the wrong foods, etc. Chronic emotional and mental stress are also triggers: work or school problems, marriage issues, death of a loved one, etc. We all have stressors in our life, but it is how you deal with the stress that determines how it affects you physically. Some of this is conditioned in childhood. Constant stress keeps your autonomic nervous system on high alert.

Medication use. There are certain medications known to create a gut imbalance, including antibiotics, birth control pills, and NSAIDS (including over-the-counter options like Ibuprofen/Motrin and Aspirin). These disrupt your microbiome and contribute to leaky gut even after one dose. However, there are many medications that can possibly disrupt the gut, including the small intestine. According to Dr. Mark Pimentel, opiate use is known to cause SIBO. Proton pump inhibiting drugs and statins can cause similar issues. Another common culprit is tetracycline, which is often taken for acne.

Estrogen dominance. Toxins known as endocrine disruptors can accumulate in the body and cause elevated estrogen. This often occurs due to long term exposures to chemicals found in everyday products like plastic (water bottles/containers and polyester clothes), antibacterial items, laundry detergents, body products, processed foods, new furniture or building materials, etc. Chemicals include things like fire retardants, food additives, Teflon, chlorine, fluoride, BPA/BPS, pesticides, etc. The unnaturally high estrogen levels that result can contribute to poor gall bladder function and actually change the physiology of the bile, inhibit bile and pancreatic excretions which in turn affect the small intestine.

Extreme fatigue. Fatigue alone can be an indication of small intestine issues. When there is an imbalance of bacteria, it can interfere with absorption of nutrients, especially vitamin B12. B12 is needed for DNA synthesis and red blood cell production, which when lacking can cause fatigue and weakness. It is a form of anemia. Vitamin B12 is also needed for proper methylation and detoxification. A toxic small intestine can create fatigue as well.

Your birth experience. If you were born by C-section, you did not receive lactobacillus or other beneficial flora from the birth canal. Or, if you were not breast fed, you did not get bifidobacterial from the mother. Optimally, your body needs these early on for proper development of your gut flora.

Low thyroid function. Cellular hypothyroidism can cause small intestine issues. You need enough thyroid hormones in the cells of the digestive tract for the thyroid to work optimally. For example, some of your thyroid’s T4 hormone is converted to T3 by your gut flora. Some experts believe that at least half of the people with hypothyroidism also have SIBO.

Ileocecal valve issues. Your ileocecal valve is located between the small intestine and large intestine. This valve opens and closes as food moves through your digestive tract. Parasites, candida, and other infections (or biofilm) can cause this valve to become faulty or even stuck in the open position, which causes further digestive problems.

Chronic inflammation. Inflammation can be a good thing. It is your body’s way of attacking a problem so that you can heal. However, chronic inflammation occurs when your immune system cannot resolve the issue, such as in the case of a low-grade infection or constant mold exposure. It increases your cytokine load and taxes your immune system, much of which is housed in the gut.

Histamine intolerance. According to Dr. Amy Myers, histamine intolerance is closely connected with SIBO. Both SIBO and histamine issues can result from (1) a buildup of food and histamine-producing bacteria, (2) a lack of sufficient DAO, an enzyme responsible for breaking down histamine in the gut which causes an increase in circulating histamines, and (3) increase in food sensitivities caused by leaky gut and disrupted motility.

It can be a “catch-22” situation. A compromised small intestine can create nutrient deficiencies, histamine problems, methylation/MTHFR and sulfation issues (both needed for proper detoxification), blood sugar problems (including insulin resistance and diabetes), cholesterol issues, low thyroid function, etc. Yet, all of these health problems affect your digestive system and can potentially cause SIBO-like problems.

Even autoimmune disease can be a factor. In fact, some consider SIBO an autoimmune condition. Any long-term imbalance in the GI track can produce toxic compounds which in turn damage the villi and microvilli that line your gut. This causes the tight junctions in the gut lining to open and cause leaky gut (similar to the effects of eating gluten or casein), letting things like toxins, microbes, proteins, and other food particles get through and into the blood steam where they don’t belong. This in turn causes your immune system to go into overdrive, tagging these things as invaders to attack, signaling inflammation, and resulting in more small intestine symptoms.

The Electrosmog (EMF) Connection

The more I research electromagnetic frequencies (EMFs) and electrosmog in general, I am convinced our continual and constantly increasing exposure is affecting our digestive system, especially the radiation caused by wireless devices. Think about it for a minute. Once data became available on our cell phones and other wireless devices, we started holding them close to our stomachs and small intestines on a regular basis, not to mention carrying them on our body.

There has been an explosion of SIBO and many other gastrointestinal problems over the last decade or two. Electrosmog, especially cellphone and cell tower use, has dramatically increased over this time.

EMFs and wireless radiation (Wi-Fi) affect the gut. It is known that microwave radiation from wireless devices, such as our cellphone, penetrates our physical body. It affects our organs at the cellular level as well as the delicate balance of our gut’s microbiome.

When exposed to the gut area, wireless radiation can potentially:

  • Disrupt the balance of good and bad (like E. coli) bacteria in the gut – good bacteria like Lactobacillus reduce in number and bad bacteria like E.Coli proliferate
  • Excite mold in the body to create more mycotoxins which can end up in the gut
  • Cause naturally occurring fungus/yeast in our gut, like Candida albicans, to proliferate and become more virulent
  • Make parasites in the gut more active

Each of these alone can cause small intestine issues. However, when combined with other physiological disruptions caused by EMFs in general, it is a recipe for small intestine problems.

Examples include hardening of the cellular wall so that toxins cannot be released and nutrients cannot be absorbed at a cellular level, disrupting the energetic signals of our nerves which also happen to line our intestinal walls, affecting the pineal gland which causes inadequate sleep and in turn stresses the digestive system, etc.

How to Resolve Small Intestinal Issues

As you can see from the extensive lists above, many things can cause small intestinal issues or GI problems in general. You can call it SIBO, SIFO, IBS or leaky gut, but unless you address and resolve the underlying issues you will not have lasting success.

The biggest take-a-way? No two people will be the same. Find an open-minded health practitioner who addresses the whole body and looks at your entire health history.

In the meantime, below are some things to consider. Use this information to help you start making changes as you find someone to work with.

Food. One of the key things is to clean up is your diet. This includes no sugar, no alcohol and no smoking. You should be eating very clean food as close to nature as possible: limited processed foods, no genetically modified foods (GMOs), no gluten or dairy, and organic whenever possible. Very simply, it should consist of many fresh vegetables and fruits, clean protein, and good quality fats. Certain veggies, such as onion, garlic, white potato and sweet potato, typically need to be eliminated, at least temporarily. (The diet recommended most often is a low-FODMAP diet, however, even that may need to be modified.)

Intermittent fasting. Intermittent fasting can also be helpful, because it allows time for the digestive system to repair itself. It could be as simple as not eating anything after 7pm, eliminated any snacking and drinks other than water, and not eating again until 8 or 9am. This is a good way to start if you are new to intermittent fasting. Personally, I like to skip breakfast two or three days a week for an extended fast. Take it slow and see what works for you.

Supplements. Certain supplements will be beneficial, but it will depend on the person and the underlying cause(s). Examples include:

  • Digestive Assistance – When your digestion is compromised it may need assistance, such as digestive enzymes and/or hydrochloric acid (HCl), especially as you work to heal.
  • Bile Flow – Proper bile flow is also critical for digestion, especially when eating fatty foods. Certain herbs and nutrients can be used to thin the bile and help with production and balancing the gall bladder. (If you do not have a gall bladder you may need additional support.)
  • Biofilm Busters – There are products that can be used to help break up biofilm so that you can more specifically go after the bacteria, fungus, etc. with anti-microbial supplements and remove toxins.
  • Re-establishing Peristalsis – Prokinetics medicines and supplements are available to help re-establish the small intestine’s migrating motor complex. These might be required for a while as your body relearns how to do it on its own. (Certain exercises may also be helpful with this.)
  • Binders – A good binder may be necessary to help absorb specific toxins in the gut so they can safely exit the body. However, binders are notorious for containing toxins themselves, so selecting the right brand is important. The type of binder will depend on the issue and the person.
  • Gut Repair – Certain gut repairing supplements may also be helpful. Even foods like bone broth (if you are not sensitive to glutamines) or vegetable broth can be helpful.
  • Nutritional Support – Specific nutrient are also typically necessary, especially if you have had small intestine problems for a while. Things like glandular support (for adrenals and/or thyroid), neurotransmitter support (especially helpful with moods), and histamine support as well as certain vitamins (like Vitamin D and B12), minerals, and other nutrients.

Notice that I did not include probiotic and prebiotic supplements in the list above. Prebiotics and probiotics as well as fermented foods are extremely individual. Timing is important, since adding too much good bacteria too soon can create additional problems. However, others may benefit from the right type of good bacteria earlier in the healing process. Each person will have unique requirements so it is best to work with a healthcare practitioner.

Life Style Choices. The more you can do to clean up your life in general, the more it supports your digestive system. The basics include getting enough quality sleep, reducing your stress, incorporating movement, and being well hydrated, some of which are explained here. You also want to clean up the number of toxins you are exposed to on a daily basis. This includes cleaning up your body products, replacing toxic cleaning products, improving up your drinking water, etc. Find the biggest culprits in your life and change those first.

Reduce EMFs. The number one thing you can do to support your digestive system right away is to reduce your exposure to EMFs and wireless radiation, especially keeping wireless devices away from your belly and body in general. This will become even more important as technologies get more advanced and higher frequencies are used. You should also turn off as many wireless signals on your phone as possible, like Bluetooth, GPS, etc. as explained in this video here. You can also obtain products that help block some of the signals while using the devices as discussed here. (A good intro EMF article with an extensive list of action items can be found here.)

Additional Therapies. Your healthcare practitioner may recommend additional therapies along your path to healing. Some can be done at home and others may require a specialist to help bring your body and your digestive system into better balance. Vagus nerve stimulation is an important one. Other example therapies include visceral manipulation, myofascial massage, cranial sacral therapy, chiropractic manipulation, Shiatsu, etc.

Again, each person will be different. I am partial to using muscle testing and/or bioenergetic screenings to help figure out difficult to determine health issues and create a game plan for healing. These modalities allow you to look at the body differently than using standard medical testing alone.

Most importantly, you need an alternative health practitioner that looks at the whole body and listens to your personal story. Someone who can check your overall health history, review the many possible risk factors mentioned above, and help you incorporate better lifestyle habits as part of the healing process.

If you have been struggling with SIBO-like symptoms, there is hope! Please contact me for more information.

This article was written by Sharon K. Harmon, PhD, founder of Life Design for Health. As a “Health Designer” and an advocate for EMF safety she has a passion for helping people find their way back to optimum health by looking at the body from a unique perspective. Please contact her if you would like to know more. There is a great deal of health-related information in her blog articles and on her website, including a healing foods and pantry list and recipes that are gluten-free, dairy-free and GMO-free.

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