IBS and SIBO natural treatment is much easier to treat than you may think with functional medicine
I like the idea of learning functional medicine the same way you would learn to play a musical instrument, especially when it comes to IBS and SIBO natural treatment. Even though you spend time learning theory and basics, you mainly learn to play the instrument by learning individual songs.
Of course, you may find some seminars and courses frustrating because the instructor is trying to teach you to play La Campanella, and you haven’t quite mastered Mary Had a Little Lamb. Many conditions, even some that frustrate traditional medicine, are actually very simple to “play.” Medicine, under the influence of the pharmaceutical industry, ignores many concepts out of hand. The idea of looking at the bowel flora as an ecosystem is ignored as “unproven.”
The ‘unproven’ and treating disease
In the 19th century, Ignaz Semmelweis was ignored when he suggested surgeons wash their hands between patients. Semmelweis believed the doctors were spreading disease between patients. Of course, his ideas were ignored because they were “unproven.” The same sorts of people who ignored Semmelweis are in charge of our health care today (which is part of the reason we spend more than $3.7 trillion per year).
I liken treating insulin insensitivity to playing “Chopsticks.” This may be a bit more like “Heart and Soul.” To ensure good results, consider the following:
- You are not treating disease: You are fixing the body’s infrastructure. The nature of the “disease” is telling you where the shortcomings in that infrastructure lie.
- Treatment is cumulative and should work: Some practitioners are in the habit of giving a supplement or a piece of advice that should help, but they do so without intent. They may give a probiotic to the IBS patient, for example, but fail to do anything else. It is better to “go after” the condition and hit it with everything you can think of. Vince Lombardi said the Packers never lost a game; they just ran out of time. Similarly, in natural health care, you never fail; you just didn’t hit it hard enough.
- Treat from north to south: Problems with the small and large intestine are often due to incomplete digestion higher up the GI tract (“north”). Food is not completely digested, and it literally rots further down the line.
IBS and SIBO natural treatment: start with diet
Diet has been used to get SIBO (small intestinal bacterial overgrowth) and IBS (irritable bowel syndrome) under control. The FODMAP diet (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) is most commonly used by the medical profession. The FODMAP diet is difficult to follow. It is complicated, and not everyone with SIBO or IBS responds to it.
The idea is to starve the bacteria. Since you don’t know which bacteria are present, it is hit and miss. It is easier and more effective to simply limit carbohydrates. Sugar and undigested complex carbohydrates feed bacteria and yeast. Also, many SIBO patients also have insulin insensitivity. If the patient is overweight, he or she should be limited to 40 grams of carbohydrates per day. If weight is not an issue, 80 grams of carbohydrates is allowed.
To give perspective, there are seven grams of carbohydrates in a cup of green beans and 27 grams of carbohydrates in a banana. If the patient eats vegetables and not a lot of fruit, it is easy to keep to this discipline. Remember, it is only for eight weeks. Starchy foods, like a potato, contain 37 grams of carbohydrates, and are to be avoided. There are other problems with complex carbohydrates, like potatoes. If they are not properly digested (and they often are not in people with digestive problems), they feed bacteria.
The Specific Carbohydrate Diet was developed by Sidney Haas, MD, to treat celiac disease and inflammatory bowel disease. Elaine Gottschall, in her book “Ending the Vicious Cycle,” wrote about it. It presents a reasonable mechanism for at least some cases of Crohn’s disease and ulcerative colitis. Many practitioners have found this approach helps with other digestive issues, like SIBO natural treatment, IBS, GERD, etc. The mechanism that leads to digestive problems that Gottschall suggests is as follows:
Incomplete digestion -> Growth of improper GI flora -> Irritation of the SI mucosa -> Decreased production of enzymes from the SI (disaccharidases) -> Incomplete digestion -> More improper flora, etc.
The patient is to have no complex carbohydrates or disaccharides. That means no grains (wheat, rice, corn), disaccharides (table sugar, lactose from dairy), or any starches like potatoes or beans. This diet has been used to treat Crohn’s disease and ulcerative colitis, as well as IBS and SIBO.
SIBO natural treatment and the microbiome
It is appropriate to discuss SIBO natural treatment and IBS natural treatment at the same time. For one thing, SIBO is likely to be responsible for most cases of IBS.1,2 Even if that is not the case, bacteria and the makeup of the microbiome is strongly linked to irritable bowel syndrome.3,4,5,6,7,8,9,10,11,12
Fecal transplant has been used to successfully treat IBS.9 That, combined with the fact that many cases of IBS begin as a gastrointestinal infection,10 indicate involvement of the microbiome with IBS.
Treating the microbiome can include:
Killing microbes: Since the growth of inappropriate flora is the cause of SIBO and the likely cause of IBS, killing undesirable bacteria is a good strategy. Natural substances, unlike antibiotic drugs, tend to not further disrupt the microbiome.
Saccharomyces Boulardii: This has been used to treat inflammatory bowel disease and other intestinal Infections.13,14 It is a microbe that will crowd out all other microbes in the GI tract and disappear when supplementation is discontinued.
Olive Leaf: This not only kills bacteria, but supports the immune system.15,16
Berberine: This will not only kill undesirable bacteria, but will also support normal bowel bacteria and reduce intestinal inflammation. It has also been used to treat colitis.17,18,19,45
Emulsified Organic Oregano Oil is one of the most powerful natural substances that kill undesirable bacteria20,21,22,23.
Potassium iodide: Iodine is commonly used as an antiseptic and is very well-researched as an antimicrobial.24,25,26,27
A treatment protocol
Bacteria proliferate on carbohydrates; therefore, carbohydrate intake must be limited with the complete removal of grains, fermented foods, alcohol, starchy vegetables, dairy, legumes and sweeteners other than honey.
If the patient is obese, daily carbohydrate intake should be limited to not more than 40 grams a day. If not obese, up to 80 grams of carbohydrates a day can be ingested.
Supplement for two weeks, then one week off, and repeat the pattern until the eight weeks are up:
Emulsified organic oregano oil blend – 3-5 drops in 6-8 ounces of pure water 3x daily
Berberine HCL – 1 capsule 3x daily
Olive leaf – 2 capsules 3x daily
Potassium iodide – 1 capsule daily (12.5 mg iodine)
During the week off, away from the other supplements, take:
Saccharomyces boulardii – 1 capsule 2x daily
The above protocol was recommended by Harry Eidenier, PhD. I have never seen it not work. He also recommends treating insulin insensitivity with a multiple vitamin designed for insulin insensitivity. Many companies make them. Patients with insulin insensitivity have a tendency to develop SIBO and IBS. He says the protocol is effective 80% of the time and other issues may need to be addressed to further improve results.
He adds, “Although the above protocol has been effective at the 80% plus confidence, if hypochlorhydria, pancreatic or biliary dysfunction, hepatic disease, Type II diabetes and/or ICV dysfunction are still present, they must be resolved or there is a high probability of the SIBO returning.”
In general, the medical profession focuses on increasing pH (suppressing acid production) for people with digestive issues. If you do a literature search, you will find very little written about the stomach pH not being low enough (aka hypochlorhydra).
One old study found a susceptibility to cholera linked to hypochlorhydra.28 If you have adequate stomach acid, it will kill vibrio cholerae when you ingest it, protecting from cholera. Suppressing HCl production can be harmful. Research has shown a relationship between SIBO and PPI (proton pump inhibitor) medication.29
Another study performed on mice by researchers from the University of Michigan Medical School at the Howard Hughes Medical Institute shows that acid-suppressing medications (PPIs, like Prilosec and Prevacid) may aggravate the conditions they are designed to treat. Interfering with acid production by using omeprazole (PPI inhibitor) interferes with the body’s defense against bacteria, further causing irritation and inflammation of the mucosa.
In a study that looked at the effect HCl production had on the microbiome, researchers concluded, “On one hand, the high acidity of the human stomach prevents pathogen exposure, but it also decreases the likelihood of recolonization by beneficial microbes if and when they go missing. However, in those cases where acidity is reduced, the gut is more likely to be colonized by pathogens.”30
You need bile to digest fat. Poor digestion of fat can also cause problems with the microbiome. Biliary stasis can also be the cause of GERD. The liver and gallbladder play a role in digestion.
The liver produces bile, and the gallbladder stores it. Bile enables you to digest and absorb fats. The liver should produce 1 to 1-1/2 quarts of bile per day. Sometimes there is not enough bile produced or the bile becomes thick and sluggish. This situation is known as “biliary stasis.” If biliary stasis is present, bile can back up and cause further damage to the liver. There are products that are designed to thin the bile and improve the digestion of fats. Several companies make them; the best ones have an artichoke base.
PAUL VARNAS, DC, DACBN, is a graduate of the National College of Chiropractic and has had a functional medicine practice for 34 years. He is the author of several books and has taught nutrition at the National University of Health Sciences. For a free PDF of “Instantly Have a Functional Medicine Practice,” email him at firstname.lastname@example.org or visit drvarnas.com.
- Scand J Gastroenterol. 2015;50(9):1076-87 Molecular assessment of differences in the duodenal microbiome in subjects with irritable bowel
- J Gastroenterol Hepatol. 2011 Apr;26 Suppl 3:135-8 Small intestinal bacterial overgrowth (SIBO) in irritable bowel syndrome: frequency and predictors
- Dig Dis Sci. 2009 Jan;54(1):132-5 Incidence of predominant methanogenic flora in irritable bowel syndrome patients and apparently healthy controls from North India
- J Ethnopharmacol. 2019 Jun 12;237:182-191 Effect of water extract from Berberis heteropoda Schrenk roots on diarrhea-predominant irritable bowel syndrome by adjusting intestinal flora
- Dig Liver Dis. 2017 Apr;49(4):331-337 Altered molecular signature of intestinal microbiota in irritable bowel syndrome patients compared with healthy controls: A systematic review and meta-analysis
- Zhong Xi Yi Jie He Xue Bao. 2004 Sep;2(5):340-2 [Observation on intestinal flora in patients of irritable bowel syndrome after treatment of Chinese integrative medicine]
- Zhongguo Zhong Xi Yi Jie He Za Zhi. 2006 Mar;26(3):218-20 [Preliminary study on intestinal flora in diarrhea type irritable bowel syndrome with pi-wei dampness-heat syndrome]
- World J Gastroenterol. 2014 Mar 14;20(10):2449-55 Overgrowth of the indigenous gut microbiome and irritable bowel syndrome
- Expert Rev Gastroenterol Hepatol. 2018 May;12(5):439-445. Fecal microbiota transplantation for managing irritable bowel syndrome
- J Clin Gastroenterol. 2017 Nov/Dec;51(10):869-877 Postinfection Irritable Bowel Syndrome: The Links Between Gastroenteritis, Inflammation, the Microbiome, and Functional Disease
- Curr Opin Endocrinol Diabetes Obes. 2014 Feb;21(1):15-21 Irritable bowel syndrome, inflammatory bowel disease and the microbiome
- Chin Med J (Engl). 2019 Apr 20;132(8):889-904 Characteristic dysbiosis of gut microbiota of Chinese patients with diarrhea-predominant irritable bowel syndrome by an insight into the pan-microbiome
- Immunopharmacol Immunotoxicol. 2018 Dec;40(6):465-475 Review of Saccharomyces boulardii as a treatment option in IBD
- World J Gastroenterol. 2019 May 14;25(18):2188-2203 Diversity of Saccharomyces boulardii CNCM I-745 mechanisms of action against intestinal infections
- Antioxidants (Basel). 2017 May 17;6(2):34 A Study of the Protective Properties of Iraqi Olive Leaves against Oxidation and Pathogenic Bacteria in Food Applications
- Endocr Metab Immune Disord Drug Targets 2018;18(1):85-93 Olive Leaf Extracts Act as Modulators of the Human Immune Response
- Biomed Pharmacother. 2019 Oct;118:109131 Effects of berberine and metformin on intestinal inflammation and gut microbiome composition in db/db mice
- Appl Microbiol Biotechnol. 2020 Feb;104(4):1737-1749 Berberine ameliorates colonic damage accompanied with the modulation of dysfunctional bacteria and functions in ulcerative colitis rats
- Acta Pharmacol Toxicol (Copenh) 1952;8(1):71-8 Toxicity of alkaloids to certain bacteria. II. Berberine, physostigmine, and sanguinarine
- Pak J Pharm Sci. 2009 Oct;22(4):421-4 Antibacterial activity of oregano (Origanum vulgare Linn.) against gram positive bacteria
- Food Microbiol. 2015 May;47:69-73 Application of an oregano oil nanoemulsion to the control of foodborne bacteria on fresh lettuce
- Curr Pharm Des. 2019;25(16):1809-1816 Essential Oil and Ethanol Extract of Oregano (Origanum vulgare L.) from Armenian Flora as a Natural Source of Terpenes, Flavonoids and other Phytochemicals with Antiradical, Antioxidant, Metal Chelating, Tyrosinase Inhibitory and Antibacterial Activity
- Pak J Pharm Sci. 2009 Oct;22(4):421-4 Antibacterial activity of oregano (Origanum vulgare Linn.) against gram positive bacteria
- J Oral Sci. 2017 Dec 27;59(4):597-601 The effects of essential oil, povidone-iodine, and chlorhexidine mouthwash on salivary nitrate/nitrite and nitrate-reducing bacteria
- Zhonghua Yan Ke Za Zhi. 2008 Dec;44(12):1098-102 [Comparative study of gentamycin and povidone-iodine on eliminating the conjunctival bacteria]
- Phys Chem Chem Phys. 2010 Oct 21;12(39):12653-7 The aluminium and iodine pentoxide reaction for the destruction of spore forming bacteria
- J Cataract Refract Surg. 2012 Jan;38(1):92-6. Effect of povidone-iodine concentration and exposure time on bacteria isolated from endophthalmitis cases
- (Lancet 1978 Oct 21;2(8095):856-9)
- Eksp Klin Gastroenterol and SIBO natural treatment (2014;(12):30-6.)
- (PLOS ONE | DOI:10.1371/journal.pone.0134116 July 29, 2015)