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Treatment-resistant abdominal pain and SIBO

… if your (colon) microbiome is in the wrong place?

Since our level of knowledge about the microbiome has increased significantly in recent years, research is now increasingly focusing on SIBO (small intestinal bacterial overgrowth).

Incorrect colonization and overgrowth of bacteria in the small intestine is becoming more and more common as a clinical picture. But what exactly happens here? Is this an answer to therapy-resistant, unexplained abdominal pain? Come and explore this topic together with us!

It should be mentioned at the outset that SIBO usually also manifests itself through non-specific complaints . This can make it difficult to distinguish from irritable bowel syndrome .

Pathophysiology (study of the disease processes and functional disorders) in SIBO. (1)

More specifically, it is an “excess” of bad bacteria in the small intestine , leading to symptoms such as bloating, abdominal pain, nausea, fatigue, and changes in bowel movements.

It can even go so far that fats, proteins and micronutrients are no longer properly absorbed by the body ( malabsorption ). In addition , surgeries that affect the movements of the small intestine increase the potential for SIBO .

In fact, the stomach and the beginning of the small intestine contain very few bacteria . The amount of these is largely kept in check by stomach acid , bile , enzymes (enable chemical reactions in the body) and immunoglobulins (protein molecules that fight pathogens), and intestinal movements (peristalsis).

As shown in the picture, you can clearly see the increase in bacteria as you get closer to the colon. (2)

The closer you get to the large intestine via the "conduction" of the small intestine via the ileocecal valve (separating the two structures) , the more bacteria can be found that are actually at home in the large intestine.

Normal, forwarding intestinal movements and a functioning ileocecal valve are prerequisites for preventing bacteria from "migrating backwards" from the large intestine to the small intestine.

So now SIBO can arise either from anatomical , immunological , as well as enzymatic problems, or if the two most important regulatory mechanisms, intestinal movements and gastric acid production , are altered to control the number of bacteria in the small intestine.

Intestinal contraction aims to further transport the food pulp, as well as microorganisms . If this movement is restricted, for example by certain medications or diabetes mellitus, this can impair the ability of the small intestine to clean itself .

The exact definition of SIBO is therefore: Bacterial overgrowth defined by an abnormally high level of bacteria and at the same time the presence of “wrong” (colon) bacteria in the small intestine, which can ferment carbohydrates into gas.

Furthermore, this can damage the mucous membrane of the small intestine, which can lead to essential building blocks (carbohydrates, proteins, fats, iron, vitamin B12) no longer being able to be absorbed from food.

These building blocks in turn serve as food for the microorganisms, which subsequently (through fermentation processes) leads to bloating/flatulence , acidic stools , or deficits in the supply of nutrients .

Therapy for SIBO is therefore as follows:

1. Correction of underlying diseases or anatomical peculiarities - if this is possible

2. Antibiotic therapy or use of vegetable substrates

3. Diet adjustment

4.Reducing fermentable carbohydrates is an effective dietary adaptation to control symptoms.

In summary, it should be emphasized again how important it is for us to take good care of our microbiome, drink enough , exercise enough and eat healthily .

All of this supports digestive processes and movements so that they can take place properly and your bacteria do not stray from the large intestine to the small intestine.

Do you know how your microbiome is made up?

With the myBioma microbiome analysis, you can find out from the comfort of your own home how your intestinal bacteria are doing and whether they help to keep you healthy.


Request more information. First free consultation!

Gabriela De Pasquale

Nutritional Consultation Estepona, Spain

+34 604398948


(1) dr medical Martin Wilhelmia; Diana Studerus, EBSD with MDPD with SV (02/28/2018). ” The Answer to Intractable Abdominal Discomfort?; SIBO: "small intestinal bacterial overgrowth". from





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