SIBO – Small Intestinal Bacterial Overgrowth
How is SIBO treated?
To treat SIBO a gastroenterologist will first understand if there are any underlying anatomical issues or associated conditions and will tackle or repair these first. Conditions that may cause SIBO include motility disorders such as gastroparesis, structural issues like diverticulosis or even complications following gastric surgery.
Once the underlying issue is solved, SIBO is usually treated the antibiotic therapy and a closer examination of nutritional deficiencies to reverse the overgrowth of bacteria (under the guidance of an experienced gastroenterologist). While it can take several months to get SIBO under control, Dr Rehan Haidry has seen complete symptom resolution in almost all his SIBO patients.
Questions and Appointments
For any enquiries about conditions, tests or treatments, please feel free to call Dr Rehan Haidry’s medical secretary Debra Hyams.
Treatments Available
Antibiotics
The most effective way of treating bacterial growth is antibiotics. A short course of antibiotics is usually effective in reducing the abnormal bacteria in the intestine. However, if the underlying problem is not treated then the bacteria can quickly return and for some patients, long-term antibiotics are prescribed.
Nutritional Support
Nutritional deficiencies may play a key role in treating and manging SIBO. People suffering from malnutrition due to SIBO will need nutritional support and help to reduce intestinal distress as well as boosting their vitamin intake. Treatments include:
- Nutritional supplementation: patients with SIBO can be offered intramuscular B-12 injections as well as iron and calcium supplements.
- Lactose-free nutrition: damage within the small intestine can make it hard or impossible for the body to digest lactose (milk sugar) so avoiding lactose-based products is recommended for better gut health.
Elemental Diet
An elemental diet is a nutritionally complete, liquid-based formula that contains pre-digested nutrients, including amino acids, simple carbohydrates, and essential vitamins and minerals. It is commonly used in treating Small Intestinal Bacterial Overgrowth (SIBO) due to its ability to reduce bacterial overgrowth while providing essential nutrition.
How the elemental diet works for SIBO
- Starves Bacteria: Since the nutrients are already broken down, they are absorbed quickly in the upper small intestine, preventing undigested food from reaching the bacteria that contribute to SIBO.
- Reduces Inflammation: The diet can help reduce intestinal inflammation and promote gut healing.
- Alters the Gut Microbiome: Studies suggest that an elemental diet can shift the bacterial composition in the gut, reducing overgrowth and restoring balance.
- Supports Motility: SIBO is often linked to impaired gut motility; the elemental diet may aid in resetting the migrating motor complex (MMC), which helps clear bacteria from the small intestine.
An Elemental Diet is typically followed for 2-3 weeks (under medical supervision) and the patients consumes only the elemental formula (no other solid food). Patients should consider that elemental formulas can be expensive, they may find the formula taste unpleasant and some people experience temporary ‘detox’ symptoms, like bloating and/or headache. Die to the liquid only intake, most people lose weight.
After the diet, a slow re-introduction of foods is necessary; following a low-FODMAP diet (reducing fermentable carbs), alongside herbal/natural antimicrobials (e.g. oregano oil) and medications or supplements that enhance gut motility (prokinetics).
A 2004 study (Digestive Diseases and Sciences) found that 80-85% of SIBO patients experienced bacterial eradication after 2-3 weeks on an elemental diet. Research studies have demonstrated that an elemental diet was as effective as antibiotics (like rifaximin) at reducing SIBO symptoms.
The elemental diet is a powerful tool for treating SIBO, often used as a first-line therapy for those who do not respond well to antibiotics or prefer a dietary approach. However, it should be done under medical supervision to ensure proper nutrient intake and minimise side effects.
Do you have a question about SIBO or would like to make an appointment?
How can I best treat SIBO?
Dr Rehan Haidry treats many patients with SIBO and related gastrointestinal infections and disease. If you are experiencing any of the symptoms above you can book an appointment directly at one of Dr Haidry’s clinics or seek a referral from your GP.
Get In Touch
For any enquiries about conditions, tests or treatments, please feel free to call Dr Rehan Haidry’s medical secretary Debra Hyams on:
Tel: 0203 423 7609 | Email: rhaidrymedsec@ccf.org