Small Intestine Bowel Overgrowth

By Dr. Michaela Falkner, ND

Small Intestine Bowel Overgrowth is a common and often overlooked cause to chronic digestive health concerns.

Small Intestine Bowel Overgrowth (referred to as SIBO) is an accumulation of normally occurring bacteria in the small intestine, not necessarily in high numbers, but in a region that they don’t belong. Often mistaken for Irritable Bowel Syndrome (IBS), SIBO is the cause of 60% of incorrectly diagnosed cases of IBS. It is generally less responsive to changes in stress and mood than traditional IBS, so while many patients report pretty good results from stress reduction techniques, they still have persistent symptoms.

The research on SIBO is still new, but we know that SIBO tends to result from a few different factors including stagnant bowels and lack of proper movement, lack of sufficient stomach acid, and a few more structural issues. SIBO can also be an indicator or accompany many underlying conditions such as autoimmune diseases, adhesions from surgery, post infections, and many others.

The small intestine is supposed to have relatively few bacteria in it, but due to the above causes, bacteria will set up shop and start digesting our food for us in the small intestine as opposed to the large intestine. This causes an abundance of gas that becomes trappped temporarily in the small intestine until it can move onto the large intestine. This is where many of the symptoms of SIBO originate.

So what does SIBO look like? Common symptoms are bloating (especially after eating healthy foods that are high in fiber and prebiotics), reflux, gas, fatigue, diarrhea, constipation, or combination diarrhea-constipation. This bloating is further exacerbated by carbohydrates and sugar. A keynote symptom I often see in patients is that the “healthier” they eat (salads, veggies, etc), the worse the gas and bloating.

Does this sound like you? Have you tried pro-biotics and your gut issues worsened? Have you attempted to eat a better diet only to feel much worse? Do you commonly go to bed looking a few months pregnant, but wake up with a flat stomach in the morning and feel great fasted? SIBO even interferes with your absorption of vitamins and minerals, leading to hair loss, fatigue, depression, and low iron stores.

The best way we can diagnose SIBO is through a breath test. A special diet and fast is followed, then a patient blows into a little bag to establish a baseline. The patient then drinks a lactulose solution and breaths into the bag multiple times over 2-3 hours. The samples are then sent in and analyzed for methane and hydrogen gas. By looking at how much those gases increase over the 2-3 hour timespan can help your doctor determine if you likely have SIBO or not.

If you have been diagnosed with SIBO, there are various things we at Hill Park Medical Center can do to support you. We can provide nutrient IVs to boost energy and immune function to support you while you are undergoing treatment. SIBO often causes difficulty in absorbing key nutrients like B12, iron, and magnesium, which can leave us feeling depleted, so a quick IV can help add those nutrients back into your body.

We have developed our own Hill Park Medical Center SIBO herbal compound that has been shown to be effective to eradicate the bacteria residing in your gut while supporting healthy movement of the bowels. Some of the herbs we commonly use are garlic, oregano, goldenseal, and caprylic acid. We then accompany these herbs with different factors that help “reteach” the bowels to move appropriately such as B6, 5HTP, ginger, and our bitters formula. There are also various diets to explore, including FODMAP, SCD, and elemental diets. This overall approach serves to correct the root cause of the concern and decrease chances of recurrence.

Our doctors have extensive firsthand experience with SIBO and know that there is no one way to correct it. Let us help you to find your solution to the discomforting symptoms, including embarrassing gas and bloating that you might be experiencing! Make an appointment to get started!

Eliminating Allergies Without Injections

Eliminating Allergies Without Injections

How is this allergy season going for you so far?

Does your nose get so congested and stuffy that it’s hard to breathe?

Do your eyes feel like they’re itching or watering all the time?

Is daytime drowsiness or fatigue slowing you down?

Does your asthma act up simply from going outside?

Are your allergies poorly controlled with your current medications and inhalers?

Does the thought of doing allergy injections sound painful or like a hassle?

We have a solution for you…

Allergies and asthma are the 5th leading cause of chronic disease in America. Nearly four million work and school days are missed each year due to seasonal ragweed allergies alone! Allergy concerns are on the rise in Sonoma County, with many people having their first allergic event within 3 years of living here. Northern California is a uniquely difficult allergy region because of our temperatures, microclimates, highway design, and air quality issues. The temperatures bring us our amazing landscapes, but also contribute to an unusually high pollen count and poor air quality.

A significant concern with allergies is preventing the progression to asthma or developing multiple additional allergies. There is an “atopic march” in which 16-40% patients with an allergic runny nose are likely to develop asthma later on in life. People with airborne allergies such as pollen, dust mites, or pet dander, are the most at risk to develop additional allergies as they get older.

An “allergen” is a typically benign protein that the body recognizes as a threat and then mounts an immune response to ‘wash away’ the allergen, resulting in our symptom experience of a runny nose, watery eyes, etc. Sublingual Immunotherapy (also referred to as SLIT) is a very effective treatment that “desensitizes” and eliminates the body’s response to an allergen. This form of immunotherapy is administered by placing drops underneath the tongue. The region under the tongue is especially responsive to this therapy as it allows the immune system to have exposure to the immunotherapy concentration of allergens without undesired effects. The treatment is non-invasive, does not involve needles, and eliminates the need for weekly travel to an allergy clinic receive injections. In 2009, the World Health Organization stated that SLIT represents a good alternative to more standard immunotherapy delivered by injections, commonly referred to as “allergy shots”. SLIT is widely used in Europe – as of 2011 about 40% of European allergists were using SLIT as a treatment.

Before starting SLIT, blood tests are performed to assess how allergic a person is to their suspected allergens: pollen, molds, grasses, pets, foods, etc.. The concentration of the body’s allergic responsivity determines the treatment dose of the allergen. The goal is to expose the body to the concentration of an allergen that is just below the concentration in which the immune system mounts an allergic response, thereby normalizing the presence of the allergen and desensitizing the body’s response to the allergen altogether. As treatment progresses, the concentration and dosage of the solution is adjusted over time as the immune system responds favorably. Improvement is usually seen within 2 to 4 months for pollens and 6 months to a year for dust mite allergy. The treatment can be started at any time of the year and “pre-season” treatments are extremely helpful for seasonal allergens such as grasses, weeds, and trees. The allergy response can be completely resolved and eliminated within 1-3 years.

There is strong evidence that supports an excellent safety profile of sublingual immunotherapy for people of all ages. This is a much more pleasant allergy treatment alternative for kids, their parents, and grownups alike. SLIT is very well tolerated, with the most common side effects being oral itching, swelling, nausea, vomiting, and stomach ache. These side effects, which are not common, are either mild and go away by themselves or are easily managed by a temporary reduction in dose of therapy.

In addition to using immunotherapy, it is important to decrease exposure to allergic triggers as much as possible. It is hard to avoid pollen when outdoors, especially when the weather is nice. Daily rinses using a neti pot to clear the nasal passages can also help quite a bit. One factor often overlooked when treating allergies is the benefit of avoiding foods that a person is allergic to. For example, if a person is allergic to mold, they should avoid foods that are moldy (e.g., some cheeses, mushrooms, vinegar, sour cream, dried fruit), which are more common than you might expect. Would you believe that even chocolate and fruit juices are moldy? Yeast in the gut also contributes to the level of mold in the body, so treating an overgrowth can be of great benefit.

To learn more about options for treating allergies using SLIT, allergen testing, yeast overgrowth, and taking a holistic look at your health, we welcome you to schedule an appointment with Richard Chen, MD. He is currently offering patients a 15 minute introductory visit or phone call at no charge.

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