We know that one of the causes of SIBO is low stomach acid (Hypochlorhydria).
This is very common in thyroid disease, especially if a patient, in addition, takes beta-blockers or experiences great stress.
Stomach acid can be improved with betaine with pepsin supplementation or lemon juice.
Same goes for stress response, different adaptogens (herbs) can be used to support your adrenal system and stress response.
But what about the liver? Why the liver is so important when it comes to SIBO and what can You do about it?
Well, let us explain!
In some cases, low stomach acid is caused by sluggish liver!
Normally, our liver metabolises fats, proteins, and carbohydrates. It also detoxifies chemicals, secretes bile that ends up back in the intestines.
The liver makes proteins important for blood clotting and other functions. It is a very important organ!
When it becomes sluggish, bile production decreases. This is when the liver has to "ask for help" to our stomach to create more hydrochloric acid. This is to make sure that the macronutrients and especially fat are metabolised.
Stomach increases hydrochloric acid, which works for a while until it becomes exhausted and the stomach acid production decreases.
Undigested fats and proteins finish in the small intestine, making it food for different pathogenes.
This is when Candida overgrowth happens. It happens in order to protect us from the pathogens like Strep.
Ultimately, when bile level and hydrochloric acid drop so much that Candida can't protect us any more from pathogens.
Here is when SIBO appears, which is the overgrowth of Strep and other bacteria like Escherichia coli, Streptococcus, Lactobacillus, Bacteroides, and Enterococcus species.
Thus, as You can see, in many cases it all starts in the liver!
So what can You do about it, how can You treat it?
Well, the first and most important thing is to establish what caused Your SIBO in the first place. Is it the sluggish liver? Is it just low stomach acid? Is it because You've taken too many medications or multiple courses of antibiotics? This is step 1!
Step 1 - Right Diagnosis!
Step 2 - Protocol tailored to You, which targets the underlying cause of SIBO.
Step 2 (For example):
Let's say that the cause is the sluggish liver like we've talked in this article.
In this case, You have to start a diet, which supports your liver and eradicates SIBO. This is usually done with a low FODMAP diet.
One of the most common questions we're getting is: What if I'm on AIP diet to heal my Graves’ Disease or Hashimoto’s?
Should I continue AIP or change to the low FODMAP diet or combine both?
The answer is: You should prioritise the trigger of Your thyroid disease. Thus, in this case, we want to treat SIBO at first with a low FODMAP diet and then once it's treated, change the dietary protocol.
In addition to diet, You have to use prescription antibiotics or natural herbs and supplements.
Prescription antibiotics, which are usually used is Rifaximin, while natural herbs and supplements include for example berberine, oregano oil, Conker tree, garlic extract, Quebracho.
When it comes to antibiotics, we're not a huge fan of them...However, Rifaximin is not that bad as an antibiotic. The reason for this is that it stays in the small intestine and does not affect bacteria in the large intestine. This is definitely an advantage when it comes to conventional treatment.
Nevertheless, we definitely prefer herbal antimicrobials and supplements when it comes to treating SIBO.
How long should You be using these herbs?
For 6 weeks.
For how long do You have to use a low FODMAP diet?
Can You transition to GAPS diet after these 6 weeks?
How long should GAPS diet last?
Can I go back to my normal diet or AIP diet after GAPS diet?
What can You do to help sluggish liver?
Take liver support supplements like Quercetin, Green Tea Extract leaf, L-Glutathione, Milk Thistle Extract seed.
How can You improve low stomach acid?
Add lemon juice to your water before each meal.
Should You use Prokinetics to prevent relapse of SIBO?
Prokinetics help to stimulate the MMC (migrating motor complex ). Most cases of SIBO occur with a dysfunctional MMC.
Taking prokinetics can be necessary to prevent a relapse after getting treatment for SIBO.
Low Dose Naltrexone and Low-dose Erythromycin are the most popular.
You can also use ginger, which is a more natural option.