What in the world are SIBO and SIFO (pronounced "see-bo") ????
B: Bacteria or F: Fungus (candida or yeast)
Up until last week, I had personally only heard of a Candida (or yeast) overgrowth. The terms SIBO and SIFO were foreign to me. But I was lucky enough to stumble across a 5-day online class all about these words, and boy did I learn a ton! So this seems like the appropriate place to say "Hey, I'm so glad you're reading this post so I can tell you the basic, beginner stuff I've learned recently, but please know that you should always talk to your doctor (and find one that will listen) who can run the appropriate tests to confirm these conditions before you attempt to self-diagnose and treat yourself." I am just now finding out about this stuff and only know a tiny bit!
A quick background ------->
I have been experiencing symptoms of bloating, fatigue, weight gain, cold hands and feet, and stomach pains for a couple of years now, and these symptoms have EXPONENTIALLY increased in the past 6 months. We're talking the kind of fatigue where I cry at the end of the day because I don't have the energy to drive my car the 2 miles home. The kind of tired where I don't get excited about upcoming events, I say "no" to quite a lot, and I am not the best version of a wife or friend that I want to be because I just don't want to be bothered. I just want to sleep. I don't have the energy to laugh and smile. We're talking the kind of bloating where it hurts to have even elastic touching my stomach. And the kind of weight gain that is happening so fast that even my cleanest of clean diets and daily exercise cannot manage. My thyroid is functioning at 0.0%, I no longer get a period, and my gut biome is 84% "bad bacteria".
So whoa, wait a second. For those of you that have followed me or know me personally, this might be shocking to hear. Because people will often tell me "you're the healthiest person I know!" Which is kinda true. I do eat crazy healthy. I'm a pescetarian who rarely eats grains with the exception of some quinoa, oats, and rice here and there. I pressure cook all my beans and lentils - on my carbohydrate days. Meaning I cycle my carbohydrates so that I'm eating super healthy fats and lean proteins from eggs, fish, shellfish, and fermented soy every day of the week with carbohydrates like sweet potatoes on two of those days. I eat vegetables with every meal. Fermented foods are my staple. I rarely eat dairy or fruit. I don't touch refined sugar or processed foods of any kind. And I portion out my "treats" of stevia-sweetened chocolate and local, raw honey homemade nut milk lattes..... On top of that, I sleep 7+ hours per night and I exercise every day. I write in a journal and work on deep breathing every night. I even foam roll during commercials while we watch our evening TV.
Picture of health, right? Not so fast. I haven't mentioned the wine. I only drink on Fridays and Saturdays, but when I do, I can have anywhere from 3-6 glasses at a time. Then there are my portions. I am in love with food. Maybe even addicted. Because I can't seem to get quite enough in. And I like to eat right before I go to bed at night. It's like I have to. That exercise I do 7 days a week? High-intensity, hour-long running, jumping, and big weights workouts every day. Not to mention drinking an adrenal-killing pre-workout every morning before I start. And finally, in my past, I struggled with bulimia, years of crazy weight-loss pills, and a diet completely based off processed boxed and frozen "fat-free and low-fat" foods including more than a 2-liter of diet soda every day. Those years were going to catch up to me and apparently my mid-30's was the perfect time.
Okay, okay.... now that you have a bit of a picture of me, let's get back to SIBO/SIFO and how this all relates. Since I have hit my rock-bottom with feeling like absolute poo, I've been searching for reasons why. My regular doctor lets me know she supports and believes me, but conventional testing is not showing her what is wrong. I I have to do some digging on my own. I have long suspected Adrenal Fatigue and Leaky Gut to play main roles in my struggle with health, and had also started to learn about Candida (yeast) overgrowth. While searching more about all of these topics, I ran into SIBO.
WHAT EXACTLY IS SIBO?
When we eat food, digestion first begins in the mouth. (So chew your food 20, 30, even 50 times!) Then it passes down the throat into the stomach where it is further digested by stomach acid. From there, it goes into the SMALL INTESTINE, then the large, and then the colon - until it's pushed out 24-72 hours later. Along the way, trillions of bacteria are feeding off this food. There should be thousands of different species of this bacteria, and in a healthy person, the majority of those are the "good guys". But for a lot of us, something went wrong along the way and we have too many bad bacteria. And those bad bacteria can sit in one or all of the digestive passages mentioned above.
When we get an overgrowth of bad bacteria in the small intestine, they feed on the food coming from the stomach and produce one of two (or both) forms of gas. This causes the bloating and the pain in the belly. This is why you might be okay in the morning but then look 6 months pregnant by afternoon. You've eaten, and so have they. The same goes for yeast. At some point, naturally occurring yeast got the upper hand in your body and reproduced at will. Often times because there is a lack of good bacteria to keep yeast in check. And now there is a fungal overgrowth.
WHAT CAUSES THIS TO HAPPEN?
From what I learned, it looks like doctors think this often starts with a food poisoning incident or ingesting a parasite at some point. This could have been a food poisoning incident you don't even remember. Maybe it didn't really even affect you all that badly. A parasite can come from a piece of sushi, undercooked meat, barefoot walking, or drinking from a stream. There are tons of ways. Also, if you are having issues with too low acid in your stomach, bad bacteria get to pass through into the small intestine without a fight, where they can colonize and take over. So this is also a potential cause. In any case, given how little SIBO is known and talked about, it may have been building in your system for years, and finding the exact cause will be difficult. In my personal opinion, because this bacterial infection has probably been going on for quite some time, and the good bacteria aren't present to combat yeast, I believe it's likely for SIFO to be present as well.
WHAT ARE THE SYMPTOMS?
SIBO and SIFO symptoms are similar, and they are also pretty dang general. A trained professional can help test for the exact diagnosis.
- brain fog
- constipation and/or diarrhea
- memory problems
- tingling and/or cold hands and feet
- anemia that will not resolve, primarily low ferritin
- clumsiness and loss of balance
- weight gain
- thyroid issues
WHAT CAN YOU DO?
The first thing you need to do is find a functional medicine doctor or naturopath that can help you test for and then treat these conditions. There are a zillion variables with each, and to treat correctly, you need to invest in a trained professional. Oftentimes, conventional doctors have learned very little about SIBO and SIFO, even Gastro-Intestinal specialists. Search for someone who has experience with these and ask for references if need be.
After finding the right doc, and he/she hears your history and symptoms, there are a few tests that can be done to confirm for SIBO and SIFO. For SIBO, a lactulose breath test is given. You drink a concoction of stuff and then breathe into a bag over the course of 3 hours. That breath is then analyzed for gasses that those bad bacteria give off. I would recommend getting the full kit - the one that tests for gasses from glucose (sugar), fructose (fruit), and lactose (dairy). It's important to know what foods are giving you the most reactions. For SIFO, an organic acids test may be an option as taking a sample out of the small intestines to test for yeast is more provocative and difficult. A stool sample will not work for either of these because a stool sample is testing the bacteria at the end of the digestive cycle - the colon.
If SIBO or SIFO is confirmed, there are three approaches to treatment.
- A course of antibiotics, usually lasting 2 weeks.
- A course of herbal supplements with diet changes lasting 30-90 days.
- The Elemental Diet lasting 14-21 days.
From the training I listened to, most docs like to start with the antibiotics and then move on to the herbals and diet. The Elemental Diet is a difficult program and seems to be saved for the more resistant cases.
Changes in eating include a low-carbohydrate diet ----- taking out the sugars, fruit, and dairy that the bacteria are eating to therefore starve them off. Docs can also recommend a low FODMAP diet. FODMAPs are foods that produce a gas when digested and therefore only add to the current problems. Examples of FODMAPs are cruciferous vegetables like broccoli and cauliflower as well as beans and legumes like lentils. And sorry wine, alcohol is a big no-no.
Herbal supplements include
- Allicin (a component of garlic)
- Caprylic Acid
- Oregano Oil
- Pau D'Arco Tea
Leaky Gut typically goes hand in hand with SIBO so rebuilding the health of the digestive tract lining is also important. Some supplements that assist with this are:
- Marshmallow Root
- Alpha Lipoic Acid
- Digestive Enzymes
- Fermented foods
- Restore 4 Life
- Slippery Elm
- Digestive Bitters
- Black Walnut
- Grapefruit Seed Extract
- Clove oil
- Olive Leaf
A word of caution here. Probiotics, digestive enzymes, fermented foods, and some of the other herbs used to treat Leaky Gut can actually exacerbate SIBO and are not safe to use until the SIBO is resolved. Another reason it is super important to work with a doctor who can coach you along on when to add in different items.
Were SIBO and SIFO new terms for you before you read this post? Was it written in a way that shed some light on the topic that you feel you can investigate a little further if you're having some of the symptoms? I encourage you to search a little more on your own and see what you find!