Although, probiotics can be an effective therapy for dysbiosis, probiotics given to individuals with SIBO may exacerbate the fermentation-based symptoms. SIBO patients eating the healthiest of diets can still be susceptible to gas, bloating, and an intolerance to certain foods, likes foods high in FODMAPS (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), as well as experience problems with fermented foods and probiotic supplementation. Increased microbial activity from the overgrowth of bacteria undeniably leads to excess fermentation in the small intestine, which is at the core of SIBO-like symptoms. The release of cytoskeletal proteins (e.g., ?-actinin, talin and vinculin) transcellularly results in IgG, IgM, and IgA antibody production against bacterial cytotoxins along with cytoskeletal proteins and may even lead to an increased risk for autoimmunity due to molecular mimicry. This is a novel discovery because leaky gut syndrome was often thought to be associated with just the degradation of tight junction proteins.

2 Cytolethal distending toxin B subtype can damage cytoskeletal proteins within the intestinal epithelial cells without disrupting the tight junction, 3 and eventually may lead to increased intestinal permeability and. The Link to Cytolethal Distending ToxinsĬytolethal distending toxins (CDTs) are compounds secreted by gram-negative bacteria (e.g., Escherichia coli, Salmonella, Shigella and Campylobacter jejuni), that are also the same type of bacteria often associated with infections of the stomach and small intestine. When left unchecked in the environment of the small intestine, they can overgrow and cause devastating chronic symptoms for your patients. 1Įssentially, food poisoning can introduce pathogenic bacteria into the small intestine. Mark Pimentel has suggested that prior food poisoning can lead to irritable bowel syndrome and SIBO. Traditionally, this overgrowth was thought to be the result of motility issues, either from inadequate firing of the migrating motor complex due to archaea’s methane production or vagal nerve malfunction. Sometimes these levels can even approach the levels that we normally find in the colon. SIBO is an increasingly common condition, where simply put, there’s too high of a concentration of bacteria in the small intestine, which could be due to an overgrowth of naturally occurring flora in the small bowel or translocation of bacteria from the large intestine, where they are found in higher concentration. If this is the case, you may want to consider small intestinal bacterial overgrowth (SIBO). But what happens when the patient doesn’t show improvement, and even small diet changes still present with gas, bloating, diarrhea and food intolerances? Patients like these are frustrating, especially if you have tried numerous approaches, like an elimination diet, with unsuccessful results, and you cannot pinpoint the cause of their symptoms. These are common complaints that present across most GI cases. For the functional medicine practitioner, it is not a rare occurrence when a patient presents to your office with uncomfortable gastrointestinal symptoms such as bloating, abdominal pain, diarrhea and/or constipation.

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