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Guillermou's avatar

As Dr. Mercola advises, individualized dietary therapy is critical. Each patient may respond differently to a diet, tolerating foods they theoretically shouldn't or not tolerating foods they should. Furthermore, when designing a specific diet, each patient's habits, preferences, aversions, and socioeconomic status should be considered. The primary goal should always be to keep the diet as minimally restrictive as possible, reduce the risk of nutritional deficiencies, and, when possible, utilize nutrition education tools to promote healthier eating.

SIBO is a common digestive disorder that can cause a range of digestive symptoms. Two common bacteria can induce SIBO: hydrogen-producing bacteria and hydrogen sulfide (H2S)-producing bacteria. A different organism called archaea can create a third type of gas, methane (CH4), which causes a condition called intestinal inflammatory overgrowth (IMO).

Research has found that people have higher amounts of Desulfovibrio spp., a bacteria that can produce H2S, if they have ulcerative colitis, a form of inflammatory bowel disease. Anyone can have this bacteria, and in fact, having small amounts of these bacteria is beneficial. At low levels, these bacteria can create ATP, a form of energy. At higher levels, around 5 parts per million (ppm), bacterial overgrowth can develop. And at extremely high levels, colorectal cancer can develop. Even a type of yeast called S. cerevisiae, also known as brewer's yeast, can produce highly toxic H2S gas. That said, H2S SIBO is incredibly rare: less than 5% of all SIBO cases.

Some SIBO organisms create hydrogen sulfide (H2S) gas as a byproduct. We now know that Fusobacterium varium and Desulfovibrio piger are the two main producers of H2S gas in most SIBO cases. This H2S gas causes damage to the body's cells. Anyone who has been near an erupting volcano will know the smell of H2S. This sulfur-like odor is very irritating to the nose, but also to the rest of the body.

https://brodynd.com/sibo-hs-hydrogen-sulfide-h2s/ ----

https://drruscio.com/hydrogen-sulfide-sibo/ ----

https://www.ibs-solutions.co.uk/phdi/p1.nsf/supppages/ibs?opendocument&part=4

A temporary low-FODMAP diet is commonly recommended for the treatment of irritable bowel syndrome (IBS). However, its use is increasingly common for the management of SIBO, with studies evaluating its potential to improve symptoms. This is because the diet is based on the elimination of rapidly fermenting, osmotically active, and poorly absorbed foods from the small intestine. Reducing their consumption consequently decreases both osmotic activity and gas production, which, according to some studies, improves symptoms in patients with IBS and SIBO. The group of fermentable carbohydrates in the FODMAP group includes oligosaccharides (fructans and galactans), disaccharides (lactose), monosaccharides (fructose), and polyols (sorbitol, mannitol, maltitol, xylitol, and isomalt) [

Several factors have been associated with the development of SIBO and could explain the higher prevalence in patients with these characteristics. The intestine has mechanisms that, if functioning properly, prevent the excessive proliferation of bacteria in the small intestine. These mechanisms include gastric acid, bile, and pancreatic enzymes, which have bacteriostatic and bactericidal properties, as well as peristaltic movements that propel food and bacteria toward the end of the digestive tract and the ileocecal valve, which prevents colonic bacteria from migrating back to the small intestine.

However, if these mechanisms fail, the likelihood of developing SIBO increases. Several factors can reduce the effectiveness of these mechanisms. First, SIBO has been shown to be more common in women and older adults. Furthermore, it commonly occurs alongside other digestive disorders such as dyspepsia, intestinal motility dysfunction, and systemic sclerosis. Regarding other possible etiologies, SIBO has been associated with various conditions such as hypothyroidism, diabetes, pancreatitis, rosacea, Parkinson's disease, and coronary artery disease, as well as with patients undergoing abdominal surgery.

The body has numerous innate mechanisms to protect itself from SIBO. This includes gastrointestinal barriers such as gastric enzymes, bile, and intestinal secretions. Exponential bacterial proliferation may be due to the dysfunction of these natural defenses.

-----Immunodeficiency syndromes: diseases that compromise the immune system's response.

-----Low stomach acid: The absence or insufficiency of hydrochloric acid in the gastric secretions of the stomach and other digestive organs allows bacterial growth.

-----Pancreatic insufficiency: Occurs when the pancreas does not produce enough enzymes for the digestion and assimilation of nutrients.

-----Small intestinal bacterial overgrowth, or SIBO, also occurs when bacteria from the large intestine can spread to the small intestine.

Advances in metagenomics have facilitated a better understanding of SIBO, highlighting its role in the broader context of gut microbiology. This has led to new management strategies, such as the use of probiotics and nutritional therapy. However, SIBO relapses are common, occurring in up to 43% of patients within 9 months of antibiotic treatment. Therefore, addressing the underlying causes and improving lifestyle are crucial. Nutrition can play a key role in this regard. Prescribing a disease-specific diet can be beneficial for patients in terms of symptom control and relapse prevention. This review will argue that dietitians can play a relevant role in disease management by determining the most appropriate dietary therapy for SIBO. To do so, they should be familiar with the latest and most relevant information on SIBO dietary management. This familiarity will allow them to provide adequate and sufficient nutrition, avoid potential nutritional deficiencies, and prevent the disease from worsening due to inadequate diets.

In the case of SIBO, its usefulness has been studied, with some research supporting its use due to its effects on the gut microbiota. These studies are based on the fact that when food is rapidly absorbed in the early sections of the small intestine, it deprives the bacteria located further downstream of nutrients, thereby reducing their abundance. Although a 14-day regimen in 124 patients showed a positive effect in 80% of cases, with concomitant improvement in clinical symptoms, 11% dropped out of the trial due to an inability to tolerate the diet. However, a prospective, open-label trial evaluated the effect, tolerability, and safety of a two-week, exclusive course of a novel palatable elemental diet (PED) in adult subjects with SIBO and/or IMO. All subjects completed the trial, and the PED significantly impacted the gut microbiome, including reductions in Prevotella_9, Fusobacterium, and Methanobrevibacter smithii.

In the case of SIBO, its usefulness has been studied, and some research supports its use due to its effects on the gut microbiota. These studies are based on the fact that when food is rapidly absorbed in the early sections of the small intestine, it deprives bacteria located further downstream of nutrients, thereby reducing their abundance. Although a 14-day regimen in 124 patients showed a positive effect in 80% of cases, with concomitant improvement in clinical symptoms, 11% dropped out of the trial due to an inability to tolerate the diet. However, a prospective, open-label trial evaluated the effect, tolerability, and safety of a two-week exclusive treatment with a novel palatable elemental diet (PAD) in adults with SIBO and/or IMO. All subjects completed the trial, and the PAD had a significant impact on the gut microbiome, including reductions in Prevotella_9, Fusobacterium, and Methanobrevibacter smithii.

NUTRITIONAL APPROACH TO SMALL INTESTINAL BACTERIAL OVERGROWTH: A NARRATIVE REVIEW----

https://www.mdpi.com/2072-6643/17/9/1410 (03/2025)------

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Just steve's avatar

Being One Size Does Not Fit All, an individualized dietary therapy is critical. For those of us who have been doing the best we can for decades, and through those decades no matter how hard we try, more offenders are thrown at us, year to follow year. This shows even though much of what many of us had been doing was in the right territories - But May Have Been the Wrong Timing. With our Gut being such a large part of our Mental, Emotional, Physical and Immune Systems it is sensible if the Gut isn't healed, given it's needs first, as the Foundation all the others are built on, those can't function properly until the Gut is proper.

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Guillermou's avatar

Just, a very apt reference. This review searched for studies on SIBO and related diseases in the PubMed, Science Direct, Web of Science, EMBASE, and Medline databases. These diseases were divided into 12 groups: (1) gastrointestinal disorders; (2) autoimmune diseases; (3) cardiovascular diseases; (4) metabolic diseases; (5) endocrine disorders; (6) nephrological disorders; (7) dermatological diseases; (8) neurological diseases; (9) developmental disorders; (10) mental disorders; (11) genetic diseases; and (12) gastrointestinal cancer.

Through a comprehensive review, it was demonstrated that a growing body of evidence highlights the association of SIBO with other disease groups, including autoimmune, cardiovascular, metabolic, endocrine, nephrological, dermatological, neurological, developmental, and mental disorders, as well as genetic diseases and gastrointestinal cancers. SIBO is a risk factor in many disease groups, complicating the course of these diseases and potentially playing a pathogenetic role in the development of their symptoms. In turn, metabolic diseases (e.g., diabetes) may be a predisposing factor for the development of SIBO. Knowledge about the associations between SIBO and various disease groups can help provide better diagnoses and allow for the timely initiation of effective treatments or co-treatments. Current knowledge about SIBO certainly provides information that can be used to address various clinical difficulties throughout the course of SIBO-related diseases. On the other hand, it should be noted that the body of knowledge about SIBO certainly requires continued expansion.

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https://www.mdpi.com/2227-9059/12/5/1030 (2025)

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Just steve's avatar

* "the researchers asked a better question: How do people actually feel after treatment? And that's where the answers start to get interesting. " * Huh, who knew? What a radical approach - according to the long dominant Medical Systems methods. Don't feel any different, feel worse, have more symptoms - problems...hush, We, the Experts have determined We Agree that We Agree the numbers are what matter the most. Healthy, smealthy, who needs health when we have a pill for that.

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Guillermou's avatar

Just, it's always interesting to read your reflections, which speak out against a flawed medical system. Also consider the relationship between non-alcoholic fatty liver disease and SIBO.

NAFLD, a more severe form, is estimated to affect between 1.5% and 6.5% of American adults. The prevalence of NAFLD is higher in people who are overweight (75%) and severely obese (90%). The prevalence of NAFLD is expected to increase significantly in the coming years, according to research projections from the American Liver Foundation.

Obese people, with or without NAFLD, have a higher incidence of small intestinal bacterial overgrowth (SIBO), and those with NAFLD have increased intestinal permeability, including a higher frequency of small intestinal bacterial overgrowth (SIBO). The health consequences of SIBO are primarily malabsorption disorders (vitamin B12, iron, choline, fats, carbohydrates, and proteins) and bile salt deconjugation. Undetected and untreated SIBO can lead to nutritional or energy malnutrition, which directly affects liver function (e.g., folic acid and choline deficiency). The gut-liver axis exists and plays a pivotal role in the homeostasis of human metabolic health. Various molecules, including gut-derived LPS and PAMPs, are subject to the first-pass effect in the liver, consequently impacting hepatic metabolism and predisposing it to NAFLD. Intestinal permeability is often observed in patients with NAFLD. In particular, the loss of gut barrier integrity promotes severe steatohepatitis in a diet high in saturated fat, fructose, and cholesterol. Dysbiosis of the gut microbiome and mycobiome can lead to hepatic steatosis, inflammation, and NAFLD progression. Selected types of probiotics and synbiotics appear to improve gut-liver function in patients with NAFLD, especially those containing Bifidobacterium breve and B. longum. Streptococcus salivarius subsp. thermophilus and Lactobacillus acidophilus, L. casei, and L. delbrueckii. SIBO is increasingly observed in patients with NAFLD. Untreated SIBO can lead to significant malnutrition (vitamin B12, choline, and protein deficiencies), which subsequently worsens hepatocyte function and increases intrahepatic lipid accumulation.

https://www.mdpi.com/2072-6643/15/6/1323 (2023).--

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