What is the best treatment of SIBO? Part 2

The treatment for Small Intestinal Bacteria Overgrowth (SIBO) can be categorized into two groups: Reduce the overgrowth and Repair the damage done.  For this part of the series on SIBO treatment, I will focus on the strategies of repairing the integrity of the brush border, the cells that line our gastrointestinal (GI) tract, and supporting the motility of the small intestine.  

Repair the Brush Border

In the small intestine, we have these villi and microvilli that line the small intestine.  They are called the brush border because the appearance of them do resemble a brush.  The purpose of the brush border is to maximize the body’s ability to absorb nutrients by increasing surface area and to facilitate the last step of digestion.  In SIBO, the brush border becomes a battlefield against the irritants produced by the bacteria.  Many villi are often destroyed.  The border is inflamed, porous, and covered by a layer of mucus.  

To help the brush border, we can support the following:

  • Utilize digestive enzymes and brush border enzymes to reduce foods left for bacteria to ferment and to reduce undigested foods fallen into the bloodstream to cause inflammation in the whole body.
  • Utilize herbs to reduce inflammation.
  • Utilize binders to help bind and eliminate those irritants.
  • Utilize amino acids to help repair and restore the villi.

Support Motility

One main problem with SIBO is the dysfunctional motility in the small intestine.  You can find more information about this in my blog: How do you get SIBO?

The tools we use to support the motility of the GI tract are called the prokinetic agents.  These agents can be used to reduce symptoms and prevent a recurrence.  There are both pharmaceutical and herbal options.  There is an important concept that often confuses my patients, that the prokinetic agents are different from laxatives.  Laxatives only work at the colon.  A prokinetic agent can work at the entire GI tract or just the upper GI and leaving the colon alone, so one doesn’t have to worry about the side effect of diarrhea.  

When it comes to treating SIBO, it is important to consult a professional in this field.  You need to be careful about drug and herb interaction.  Products need to be selected based on the individual’s unique situation and needs; otherwise, they can worsen your symptoms rather than helping.  


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