Massage & Bodywork

MAY | JUNE 2019

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36 m a s s a g e & b o d y w o r k m a y / j u n e 2 0 1 9 education PATHOLOGY PERSPECTIVES Small Intestinal Bacterial Overgrowth By Ruth Werner SIBO: WHAT IS IT? Small intestinal bacterial overgrowth (SIBO), sometimes called bacterial overgrowth syndrome, is the condition of having either too many bacteria in the upper small intestine, having the wrong types of bacteria there, or a combination of both. While this condition has been recognized for a long time, it is difficult to know how many people may be affected. This is because SIBO occurs in conjunction with several other similar-looking conditions, and diagnostic techniques are not very precise. While many of us may have non-optimal or non-average levels of bacteria in our proximal small intestine, SIBO only becomes a problem when these bacteria interfere with nutrient absorption, leaving us vulnerable to vitamin and mineral deficiencies and a host of other complications. HOW DOES SIBO START? SIBO occurs when the intestinal microbiome is disrupted and bacteria at the proximal end of the GI tract proliferate. (More on the wonders of the intestinal microbiome is covered in the video that accompanies the digital edition of this article.) Depending on how they are described, the contributing factors to SIBO fall in four main categories. Problems with Motility Any situation that interferes with healthy, strong peristalsis can raise the risk of SIBO by interfering with the appropriate clearance of bacteria in the gut. Gut motility can be limited by Parkinson's disease, diabetic neuropathy that affects the vagus nerve, scleroderma, hypothyroidism, and other conditions. In addition, treatment for cancer and narcotics use can slow peristalsis. Structural Problems in the Intestines Any structural congenital problem with the intestines can contribute to SIBO, but more common structural issues are associated with gut surgeries, including gastric bypass, or the strictures and scarring that can accrue with Crohn's disease or intestinal diverticulitis. A dysfunctional ileocecal valve that allows backflow from the colon into the small intestine is another structural anomaly seen with some people who have SIBO. Here's a scenario: your client is a 67-year-old woman who struggles with her health. She has a history of diabetes and hypothyroidism, both of which she has treated with inconsistent success. Now she tells you she may not be able to stay through a whole session, because she may have to use the bathroom: gas, bloating, and diarrhea are her constant companions. She has lost a lot of weight in the last several months, her skin is dry, and her hair is thinning and brittle. What may be happening?

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