Today on Episode 1 of the Restorative Nourishment Podcast we are discussing SIBO with Angela Pifer, FMN, LCN, CN, SIBO Guru. What is SIBO? How to test for it, the different diets that can be used in conjunction with other treatments, and the myriad of root causes that can set someone up for developing SIBO.
In this episode, Angela discusses how to navigate SIBO. There is an evolving approach to looking at SIBO, from both a dietary and a medication standpoint. The standard approach for years has been to starve out organisms, but is this the best route? How can we look at SIBO with a functional medicine lens? Angela shares her wisdom and tips for navigating SIBO based on her 20 years of clinical experience working with IBS and SIBO patients in this podcast.
What is SIBO?
SIBO is a small intestinal bacterial or archaea overgrowth, although other organisms such as fungi can also be overgrowing (SIFO). The small intestines normally don't contain large amounts of organisms. Therefore, in SIBO, organisms overgrowing in the small intestines can produce painful and chronic digestive symptoms such as excessive gas, nausea, bloating, abdominal distention, and pain. In a flare, these symptoms may feel debilitating. These organisms produce gasses such as hydrogen, hydrogen sulfide, and methane and can be tested for on a breath test. We all produce varying levels of these gasses, but in SIBO, one or more of these gasses will be produced at much higher levels than what is considered normal.
What are the Root Causes of SIBO?
There are many contributing factors involved in the development of SIBO, including food poisoning and the development of anti-vinculin antibodies (when the immune system gets confused and starts to attack self). Vinculin is involved in the regulation of the migrating motor complex (MMC)—part of the digestive process that creates peristalsis through a system of electrical waves (the smooth muscle waves that sweep undigested food and bacteria through the intestines). When an autoimmune reaction to vinculin occurs, the migrating motor complex cannot operate correctly, therefore, allowing undigested food and bacteria to ferment in the small intestines. The vagus nerve signals the MMC during a fasting state (in between meals and at night during sleep), therefore, anything that can disrupt the vagal nerve can also create a slow down in the intestines. Think about stress, childhood trauma, ongoing relational trauma, chronic inflammation, and underlying infections. These can all impair vagal nerve activity. Deep breathing, yoga, massage, singing, gargling, and meditation can help restore proper vagal nerve functioning.
Other contributors to SIBO include low thyroid hormone. Hypothyroidism is associated with a slow metabolism, slow gastric motility and delayed gastric emptying. Liver congestion and lack of bile flow can be an underlying contributor to SIBO as well. Bile acts as a detergent and clears out bacteria and food particles from the small intestines. Other contributors to the development of SIBO include antibiotic use, alcohol consumption, and chlorinated water.
What Diets are Beneficial for Managing SIBO?
In this podcast we discuss the Low-FODMAP Diet, the Specific Carbohydrate Diet (SCD), and the SIBO Specific Diet. These diets are best used in conjunction with other treatments, depending on your specific needs and underlying root causes. The SIBO Specific Diet is a very restrictive diet that combines the low-FODMAP diet and SCD. It is best to start with less-restrictive diets first before trying something very restrictive (remember that stress impedes vagal nerve functioning)! The SIBO Bi-Phasic Diet is another option to help manage symptoms. This is the SIBO Specific Diet that has been separated out into phases or stages.
One of the best meals for restoring nourishment without exacerbating symptoms is a simple carrot, ginger, and chicken soup. Another option we mention in the podcast is a celeriac and chicken soup. Both of these recipes are excellent to use during your healing process in order to help keep symptoms calm and take in easily digestible nutrients. When cooking meat, use an Instant Pot or Slow Cooker to break down meat fibers, allowing for easier digestion of essential amino acids. This Instant Pot Shredded Beef is easy to make and easy to digest. Try making up a batch of Instant Pot Shredded Chicken and freezing portions for later use. You may also want to consider an Amino Acid Supplement (stirred into water or blended into smoothies).
We mention trying to incorporate legumes in very small amounts once you are at a stage where symptoms have calmed down enough. It is important to soak dry beans for 24 hours on your counter and then drain off the soaking water, and cook them in an Instant Pot for best digestibility. Try lima beans or lentils first in tablespoon portions.
Meal Plans for SIBO:
We have a variety of meal plans for these diets in our membership portal. Members have access to meal plans and over 1400 recipes. To begin, try saving these meal plans to your account, or plug in the food restrictions given to you by your doctor into this site (when logged in) and create your own meal plans. Remember, it is best to restrict the least amount of foods to help manage SIBO symptoms.
- Easy SCD Breakfasts
- SCD Family Dinners
- Low-FODMAP + Grain-Free Dinners
- 3-Day Low-FODMAP Meal Plan
- SIBO Specific Breakfasts
- SIBO Specific Dinners