High Ryan,
I think your advice also is spot on.
Bacterial Overgrowth is always secondary to another problem, even motility (although having Bacterial Overgrowth can cause dysmotility through production of gasses which slow motility, setting up a negative spiral).
I have included 3 Report Abstracts including one from Boots which gives a general explanation. The last two reports are the most important and can be found in full online. The second states that Bacterial Overgrowth is more prominent than previously thought (Dr. Luke White also states that D-La is more prevalent than previously understood). The third Report gives a list of other health problems that are related or may cause Bacterial Overgrowth and states that Bac. O. is a poor prognosis of health and is likely to involve underlying health problems as you have pointed out.
Bacterial Overgrowth does not always cause Diarrhoea, it can also cause Constipation when more than one overgrowth are involved (Bacteria that live off Hydrogen producing Bacteria may produce Methane and Constipation so please do not exclude yourself if you do not suffer Diarrheoa).
Digestive health centre (Boots)
What is small intestinal bacterial overgrowth (SIBO)?
The small bowel, also known as the
small intestine, is part of the
digestive system that connects the
stomach with the large bowel (colon). The main purpose of the small intestine is to digest and absorb food into the body. The small bowel is divided into three parts: the duodenum (which food from the stomach empties into), the jejunum and the ileum (which empties undigested food into the
large intestine or colon).
The entire
gastrointestinal tract, including the small intestine, normally contains bacteria. The number of bacteria is greatest in the colon but much lower in the small intestine. Also, the types of bacteria within the small intestine are different to the types of bacteria within the colon.
Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria are present in the small intestine, while the types of bacteria found in the small intestine are more like the bacteria found in the colon.
Small intestinal bacterial overgrowth (SIBO) is also known as small bowel bacterial overgrowth syndrome (SBBOS).
What causes small intestinal bacterial overgrowth?
The gastrointestinal tract is a continuous muscular tube which digesting food travels along on its way to the colon. Normally, the coordinated action of the muscles of the stomach and small intestine propels the food from the stomach, through the small intestine and into the colon.
This muscular action also sweeps bacteria out of the small intestine and limits the numbers of bacteria in the small intestine. However, when a condition interferes with the normal activity in the small intestine, this can result in SIBO, by allowing bacteria to stay longer and multiply in the small intestine. The lack of normal muscular activity also may allow bacteria to spread backwards from the colon and into the small intestine.
Many conditions are associated with SIBO. A few are common:
- Neurological and muscular diseases can alter the normal activity of the intestinal muscles. Diabetes mellitus damages the nerves that control the intestinal muscles. Scleroderma damages the intestinal muscles directly. In both cases, abnormal muscular activity in the small intestine allows SIBO to develop.
- Partial or intermittent obstruction of the small intestine can interfere with the transport of food and bacteria through the small intestine and can result in SIBO. Causes of obstruction leading to SIBO include adhesions - or scarring - from previous surgery and Crohn's disease.
- Diverticuli (small pouches) of the small intestine which allow bacteria to multiply inside diverticuli.
What are small intestinal bacteria overgrowth symptoms?
The symptoms of SIBO include:
When the overgrowth is severe and prolonged, the bacteria may interfere with the digestion and the absorption of food, so that deficiencies of
vitamins and minerals may develop. Patients may also
lose weight. Patients with SIBO sometimes also report symptoms that are unrelated to the gastrointestinal tract, such as body aches or
fatigue. The symptoms of SIBO tend to be chronic (long-term). A typical patient with SIBO can experience symptoms that fluctuate in intensity over months, years or even decades, before a diagnosis is made.
Small Intestinal Bacterial Overgrowth
A Comprehensive Review
Andrew C. Dukowicz, MD,
Brian E. Lacy, PhD, MD,
and
Gary M. Levine, MD
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cited by other articles in PMC.
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Abstract
Small intestinal bacterial overgrowth (SIBO), defined as excessive bacteria in the small intestine, remains a poorly understood disease. Initially thought to occur in only a small number of patients, it is now apparent that this disorder is more prevalent than previously thought. Patients with SIBO vary in presentation, from being only mildly symptomatic to suffering from chronic diarrhea, weight loss, and malabsorption. A number of diagnostic tests are currently available, although the optimal treatment regimen remains elusive. Recently there has been renewed interest in SIBO and its putative association with irritable bowel syndrome. In this comprehensive review, we will discuss the epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment of SIBO.
Keywords: Bacterial overgrowth, small intestinal bacterial overgrowth, diarrhea, bloating, motility disorders, antibiotics
Small intestinal bacterial overgrowth (SIBO) is defined as the presence of excessive bacteria in the small intestine. SIBO is frequently implicated as the cause of chronic diarrhea and malabsorption. Patients with SIBO may also suffer from unintentional weight loss, nutritional deficiencies, and osteoporosis. A common misconception is that SIBO affects only a limited number of patients, such as those with an anatomic abnormality of the upper gastrointestinal (GI) tract or those with a motility disorder. However, SIBO may be more prevalent than previously thought. This apparent increase in prevalence may have occurred, in part, because readily available diagnostic tests have improved our ability to diagnose SIBO. This comprehensive review will discuss the epidemiology and pathophysiology of SIBO; review common clinical presentations, diagnostic tests, and their limitations; and discuss currently available treatment options.
Small intestinal bacterial overgrowth syndrome
Jan Bures,
Jiri Cyrany,
Darina Kohoutova,
Miroslav Förstl,
Stanislav Rejchrt,
Jaroslav Kvetina,
Viktor Vorisek, and
Marcela Kopacova
Author information ► Article notes ► Copyright and License information ►
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cited by other articles in PMC.
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Abstract
Human intestinal microbiota create a complex polymicrobial ecology. This is characterised by its high population density, wide diversity and complexity of interaction. Any dysbalance of this complex intestinal microbiome, both qualitative and quantitative, might have serious health consequence for a macro-organism, including small intestinal bacterial overgrowth syndrome (SIBO). SIBO is defined as an increase in the number and/or alteration in the type of bacteria in the upper gastrointestinal tract. There are several endogenous defence mechanisms for preventing bacterial overgrowth: gastric acid secretion, intestinal motility, intact ileo-caecal valve, immunoglobulins within intestinal secretion and bacteriostatic properties of pancreatic and biliary secretion. Aetiology of SIBO is usually complex, associated with disorders of protective antibacterial mechanisms (e.g. achlorhydria, pancreatic exocrine insufficiency, immunodeficiency syndromes), anatomical abnormalities (e.g. small intestinal obstruction, diverticula, fistulae, surgical blind loop, previous ileo-caecal resections) and/or motility disorders (e.g. scleroderma, autonomic neuropathy in diabetes mellitus, post-radiation enteropathy, small intestinal pseudo-obstruction). In some patients more than one factor may be involved. Symptoms related to SIBO are bloating, diarrhoea, malabsorption, weight loss and malnutrition. The gold standard for diagnosing SIBO is still microbial investigation of jejunal aspirates. Non-invasive hydrogen and methane breath tests are most commonly used for the diagnosis of SIBO using glucose or lactulose. Therapy for SIBO must be complex, addressing all causes, symptoms and complications, and fully individualised. It should include treatment of the underlying disease, nutritional support and cyclical gastro-intestinal selective antibiotics. Prognosis is usually serious, determined mostly by the underlying disease that led to SIBO.
Keywords: Bacterial overgrowth, Breath test, Hydrogen, Methane, Small intestine
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INTRODUCTION
Hope this is helpful to all trying to understand how Bacterial Overgrowth and D-La fit with CFS/ME symptoms (for those affected).
Paul.
