This process involves the migrating motor complex (MMC), which produces a cleansing wave to help remove waste from the small intestine, often referred to as the “housekeeper of the gut.” The MMC occurs about every 90 to 120 minutes during times of fasting.
Normally, the small intestine involves complex and coordinated movements to properly digest foods. In regard to SIBO and its impact on weight and nutritional status, Gerard Mullin, an associate professor of medicine and director of integrative GI nutrition services at Johns Hopkins Hospital, says, “Small intestinal bacterial overgrowth can cause malabsorption and wasting.”ĭiminished gastric acid secretion and disordered gastrointestinal motility of the small intestine are likely the most common contributors to SIBO. Low levels of B12 are common as anaerobic bacteria utilize this vitamin.5 Vitamin K deficiency is rare as bacterial microflora produce this vitamin.4 Elevated serum folate levels may present as the result of bacterial synthesis. Some bacteria produce toxins that damage the intestinal mucosa.2 Bacterial overgrowth has been associated with increased intestinal permeability and bacterial translocation.3 Chronic diarrhea due to fat maldigestion and malabsorption may contribute to vitamin A, D, and E deficiencies. Microbes that metabolize bile salts to insoluble compounds may lead to fat malabsorption and inflammation, while bacteria that prefer to metabolize carbohydrates produce marked bloating. The symptoms of SIBO vary depending on the type and amounts of microbes present in the small intestine.
Constipation may also be present but appears to be less common in this disorder. SIBO produces myriad gastrointestinal symptoms, including excess intestinal gas, bloating and abdominal distention, diarrhea, and pain. Dietitians should be well versed in this disorder and subsequent nutritional intervention. While gastrointestinal microflora confer many healthful benefits, including vitamin synthesis, enhanced digestion, and improved immune function, bacterial overgrowth is an increasingly recognized contributor to gastrointestinal symptoms, malabsorption, and malnutrition. Small intestinal bacterial overgrowth (SIBO) is a condition in which excessive amounts of bacteria (typically the colonic type) infiltrate the small intestine.1 Under normal conditions, the small intestine shelters far fewer and different types of bacteria compared with the colon. Small Intestinal Bacterial Overgrowth - What to Do When Unwelcome Microbes Invade