11. SMALL INTESTINE. SIBO. Causes, Symptoms, Diagnosis, Treatment BIG picture plan, NO antibiotics!!!!
Small intestinal bacterial overgrowth (SIBO).


A typical person harbors more than 500 distinct species of bacteria in small intestine. bacterial density in the small intestine is also important. Duodenum: 10 x1 to 10x3 CFU (Colony Forming Units) /mL: gram-positive cocci and rods
Jejunum: 10x4-10x7 CFU/mL: Enterococcus faecalis, lactobacilli, diphtheroids, and the yeast Candida.
Ileum: 10x4-10x7 CFU/mL and has a microbe community similar to that of the colon: anaerobic, gram-positive and gram-negative rods and cocci.


Causes of sibo:
Decreased production of HCL in stomach (Hypochlorhydria)
Problem with liver/gallbladder/bile
Pancreatic insufficiency
Bacterial/viral infections of GI
Drugs/antibiotics
Chemicals/High-Fructose Corn Syrup
Foods (dairy)
Constipation
Immune system health.


Testing for SIBO:
Breath testing.
Noninvasive, measures the amount of hydrogen or methane that you breathe out after drinking a mixture of glucose and water. A rapid rise in exhaled hydrogen or methane indicate bacterial overgrowth.
Small intestine aspirate and fluid culture.
The gold standard test for bacterial overgrowth. Fluid sample obtained during endoscopy. keep in mind that not all bugs will grow in a petri dish. we know that they are there just because we can see their genetic info.
Treatment of sibo big picture: fix the cause! do not take antibiotic.
Deal with decreased production of HCL in stomach (Hypochlorhydria)
solve the problem with liver/gallbladder/bile
treat pancreatic insufficiency
treat acute Bacterial/viral infections of GI
Stop drugs: antibiotics, NSAI
do not eat chemicals/High-Fructose Corn Syrup
Eliminate dairy
treat Constipation
deal with Immune system health.


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Stay healthy
Dr. Veronica

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