OVERGROWTHS (SIBO/IMO/SIFO/CANDIDA)

SIBO Made Simple | EP 06 | Prebiotic and Probiotic Protocols: a SIBO Management Misnomer with Dr. Jason Hawrelak

The article from Feed Me Phoebe features an interview with Dr. Jason Hawrelak, a researcher and clinician specializing in gut health, discussing the roles of prebiotics and probiotics in treating Small Intestinal Bacterial Overgrowth (SIBO) and Irritable Bowel Syndrome (IBS). Dr. Hawrelak explains that certain prebiotic fibers can aid in improving gut motility and reducing the risk of SIBO relapse, while specific probiotics may help alleviate IBS symptoms. He also addresses common misconceptions about the low FODMAP diet, emphasizing its potential to disrupt the gut microbiome if followed long-term. The discussion provides insights into how dietary choices and supplements can support gut health and manage SIBO and IBS symptoms.

The First Advanced Network Analysis of the Small Bowel Microbiome in Small Intestinal Bacterial Overgrowth (SIBO)

This study analysed the small bowel microbiome in people with Small Intestinal Bacterial Overgrowth (SIBO) using advanced network methods. It found that SIBO causes significant disruption to the normal balance and connections between gut bacteria, mainly due to higher levels of Escherichia and Klebsiella bacteria. These changes reduce the overall health and stability of the microbial community.

Root causes of SIBO: Motality Issues

The article explains that SIBO (small intestinal bacterial overgrowth) often results not from bacteria themselves but from slowed gut motility, which creates the perfect environment for bacterial overgrowth. Key factors disrupting motility include chronic inflammation triggered by endotoxins, abolition of the migrating motor complex (MMC), methane gas production that directly slows intestinal movement, and long‑term stress or vagus nerve dysfunction disrupting the gut’s rest‑digest rhythm.

Personality, Anxiety, and Stress in Patients with Small Intestine Bacterial Overgrowth Syndrome. The Polish Preliminary Study

The article explores the psychological factors associated with Small Intestine Bacterial Overgrowth (SIBO). It reveals that individuals with SIBO often exhibit higher levels of anxiety and stress, along with certain personality traits, compared to the general population. The study suggests that these psychological factors may influence the severity and progression of SIBO, highlighting the importance of considering mental health in the management of this condition.

The Stress & SIBO Connection

The article by Dr. Amy Myers discusses how chronic stress can contribute to Small Intestinal Bacterial Overgrowth (SIBO), a condition where excessive bacteria inhabit the small intestine. Stress impairs digestive functions by reducing stomach acid production and disrupting the migrating motor complex, which is responsible for clearing bacteria from the small intestine. Additionally, stress weakens the gut's mucosal immunity, making it more susceptible to infections.

SIBO: Small Intestinal Bacteria Overgrowth - Root Cause

To prevent relapse of Small Intestinal Bacterial Overgrowth (SIBO), it's essential to address underlying causes and support gut health. Key strategies include stimulating the migrating motor complex (MMC) with prokinetic agents, following a SIBO-specific diet, and supporting stomach acid production if deficient. Additionally, removing proton pump inhibitors and antacids, undergoing visceral manipulation to improve motility, and correcting anatomical issues like ileocecal valve dysfunction can be beneficial. Managing stress and treating concurrent conditions that contribute to SIBO are also important. Implementing these measures can help maintain remission and prevent recurrence of SIBO symptoms.

Small Intestinal Bacterial Overgrowth: Comprehensive Review of Diagnosis, Prevention, and Treatment Methods

This review explores Small Intestinal Bacterial Overgrowth (SIBO), a common gastrointestinal disorder where excessive bacteria accumulate in the small intestine, leading to symptoms such as bloating, gas, abdominal pain, and malabsorption of nutrients like vitamin B12 and folate. Diagnosis is often delayed because testing can be invasive. The paper reviews current diagnostic approaches, including breath tests, and discusses prevention and treatment strategies—such as antibiotics and dietary changes—to restore healthy gut microbial balance and improve symptoms among affected individuals.

Source and identification of histamine-producing bacteria from fresh and temperature-abused albacore

Researchers analysed bacteria in fresh and improperly stored albacore tuna and found that certain species—especially Hafnia alvei—were major producers of histamine, a compound that can cause food poisoning. Most isolates produced low levels (< 300 ppm) of histamine, but those that did produce higher levels posed a risk. This highlights the importance of proper storage to prevent histamine accumulation in seafood and reduce the risk of foodborne illness.

The duodenal microbiome is altered in small intestinal bacterial overgrowth

The study looked at people with small intestinal bacterial overgrowth (SIBO) and compared them to those without, using fluid samples from the duodenum (a part of the small intestine). They found that people with SIBO had much higher bacterial counts, especially of Proteobacteria, and less of Firmicutes. The high levels of Proteobacteria were linked to lower overall diversity of bacteria and worse symptoms like bloating. This suggests that changes in the duodenal microbiome are related to SIBO and its symptoms.

Clinical trial: the combination of rifaximin with partially hydrolysed guar gum is more effective than rifaximin alone in eradicating small intestinal bacterial overgrowth

The study tested whether adding partially hydrolysed guar gum (a type of fibre) to the antibiotic rifaximin works better than rifaximin by itself for treating small intestinal bacterial overgrowth (SIBO). Patients with confirmed SIBO were randomly assigned to get either rifaximin alone, or rifaximin plus the gum, for 10 days. One month after finishing treatment, about 62% of patients taking just rifaximin had no SIBO anymore, while ~85-87% of those who took rifaximin plus the guar gum were cleared of SIBO. Symptoms improved a lot in patients in both groups. The conclusion is that combining the fibre with the antibiotic may be more effective for eradicating SIBO than the antibiotic alone.

Small-Intestinal Bacterial Overgrowth is Associated With Concurrent Intestinal Inflammation But Not With Systemic Inflammation in Crohn's Disease Patients

This study investigated the relationship between small-intestinal bacterial overgrowth (SIBO) and inflammation in patients with Crohn's disease. The researchers found that SIBO was linked to increased inflammation within the intestines but did not correlate with higher levels of systemic inflammation in the body. These findings suggest that while SIBO may contribute to local gut inflammation in Crohn's disease, it does not appear to affect overall systemic inflammation.

Small intestinal bacterial overgrowth and celiac disease: A systematic review with pooled-data analysis

This article investigates the relationship between small intestinal bacterial overgrowth (SIBO) and celiac disease. The authors conducted a systematic review and pooled-data analysis to assess the prevalence of SIBO in individuals with celiac disease. Their findings suggest a higher prevalence of SIBO in patients with celiac disease compared to the general population. The study highlights the importance of considering SIBO in the management of celiac disease, as it may contribute to gastrointestinal symptoms and complicate disease management.

Reduced B12 uptake and increased gastrointestinal formate are associated with archaeome-mediated breath methane emission in humans

This study found that individuals who exhale higher amounts of methane (classified as high methane emitters) have a distinct gut microbiome characterized by a significant increase in the archaeon Methanobrevibacter smithii. These individuals also exhibited elevated levels of gastrointestinal formate and acetate. Interestingly, high methane emitters had reduced uptake of vitamin B12, suggesting that methanogenesis may interfere with B12 absorption. The research highlights the complex interplay between diet, microbiome composition, and metabolic processes in shaping gastrointestinal health.

Bismuth subsalicylate markedly decreases hydrogen sulfide release in the human colon

This study found that oral administration of bismuth subsalicylate significantly reduced H₂S release in the human colon. Since H₂S is a major contributor to the malodour of flatus and has been implicated in the pathogenesis of ulcerative colitis, these findings suggest that bismuth subsalicylate may be beneficial in reducing flatus odour and potentially in the treatment of ulcerative colitis.

Bismuth subsalicylate: history, chemistry, and safety

This review discusses the long-standing use of BSS (Bismouth Subsalicylate) in treating gastrointestinal discomforts such as nausea, heartburn, and diarrhea. It highlights the compound's dual action: the salicylate component offers anti-inflammatory effects, while the bismuth component provides antimicrobial properties. The article also addresses the safety considerations associated with BSS use, noting its generally favorable safety profile when used as directed.

Hydrogen Sulfide in Physiology and Diseases of the Digestive Tract

This review discusses the physiological functions of H₂S in the digestive tract, including its role in regulating motility, inflammation, and epithelial integrity. The authors also explore how alterations in H₂S production or signalling may contribute to various gastrointestinal diseases, such as inflammatory bowel disease, colorectal cancer, and functional gastrointestinal disorders. The article emphasizes the potential of targeting H₂S pathways as a therapeutic strategy for these conditions.

Hydrogen sulfide signalling in the gastrointestinal tract

This review discusses the physiological functions of H₂S in the gastrointestinal tract, including its involvement in regulating motility, inflammation, and epithelial integrity. The author examines the mechanisms through which H₂S exerts its effects, such as modulation of ion channels and interaction with other signalling pathways. The article also explores the potential implications of H₂S signalling in various gastrointestinal disorders and its therapeutic potential.

A Pilot Study of the Effect of Green Kiwifruit on Human Intestinal Fermentation Measured by Hydrogen and Methane Breath Testing

This pilot study found that consuming green kiwifruit led to significant changes in breath hydrogen and methane levels, indicating alterations in intestinal fermentation. The results suggest that kiwifruit may influence gut microbial activity and fermentation processes. However, further research with larger sample sizes is needed to confirm these findings and understand the underlying mechanisms.

Elevated methane levels in small intestinal bacterial overgrowth suggests delayed small bowel and colonic transit

This study found that elevated methane levels in breath tests were associated with delayed transit times in both the small intestine and colon. The findings suggest that methane-producing bacteria in the gut may contribute to slower gastrointestinal motility, which is a common feature in SIBO. These results highlight the potential role of methane as a biomarker for assessing transit times and guiding treatment strategies in patients with SIBO.

Small intestinal fungal overgrowth

SIFO is characterized by an overgrowth of fungi, particularly Candida species, in the small intestine. This condition can lead to symptoms similar to small intestinal bacterial overgrowth (SIBO), such as bloating, diarrhea, and malabsorption. Diagnosis is challenging due to the lack of standardized testing methods. Treatment typically involves antifungal therapy, but further research is needed to establish effective management strategies.

Hyphal wall protein 1 gene: A potential marker for the identification of different Candida species and phylogenetic analysis

This study found that the HWP1 (Hyphal wall protein 1) gene is a reliable and specific marker for distinguishing between different Candida species. The researchers observed that variations in the HWP1 gene allowed for accurate identification and provided insights into the evolutionary relationships among Candida species. These findings suggest that the HWP1 gene can be a valuable tool in clinical diagnostics and epidemiological studies of Candida infections.

Immune defence against Candida fungal infections

This review discusses how the immune system recognizes and responds to Candida infections. It highlights the role of pattern recognition receptors in detecting the fungus and the subsequent activation of immune cells. The article also examines how the immune system differentiates between harmless colonization and harmful invasion, and how this affects the host's defense mechanisms. Additionally, the review explores the concept of immune memory in both innate and adaptive immunity following Candida exposure.

Metabolism impacts upon Candida immunogenicity and pathogenicity at multiple levels

This review discusses how Candida species adapt their metabolism to thrive in various host environments, affecting their virulence and immune recognition. The authors highlight the role of metabolic pathways in modulating cell wall composition, stress responses, and immune evasion mechanisms. Understanding these metabolic adaptations provides insights into potential therapeutic targets for treating Candida infections.

Levothyroxine therapy and impaired clearance are the strongest contributors to small intestinal bacterial overgrowth: Results of a retrospective cohort study

This study found that the use of levothyroxine therapy and impaired clearance mechanisms are the most significant contributors to the development of SIBO. These factors were identified as having the strongest association with SIBO in the cohort studied. The findings highlight the importance of considering thyroid medication and clearance functions when assessing the risk of SIBO in patients.