Let’s Rethink SIBO

Holistic Approach to SIBO and other Bowel disorders

I wanted to share some of the underlying things that I have found which need to be addressed before people can have improved digestive function. I have seen too many people suffering from this condition who have used the antimicrobial therapies alone, which in my experience allows for a 100% recurrence rate. The dysbiosis is not the problem, but a result of the underlying problem.

1) Digestion needs to be addressed from the top, down.

This means that the tone of the nervous system and any traumatic brain injuries or neurodegeneration processes need to be addressed (parasympathetic tone mediated by the vagus nerve is what allows for peristalsis, and most of the migrating motor complex to work), sinus congestion/subclinical infection needs to be addressed (so that the post-nasal drip of mucus doesn't mess with the stomach, neti pots work well!) saliva production optimized (esp in people who have had the mumps or MMR vaccine), stomach acid production needs to be improved (salt, B1, and Zinc, PPIs are counterproductive), Liver congestion needs to be handled, bile needs to be flowing (hydration, choline, beets), pancreatic enzymes need to be synthesized and released (protein, pancreatic glandular, not eating too often), all before we get to the small intestine.

2) Gastrointesinal Motility

There is a part of the nervous system called the Migrating Motor Complex, which kicks in ~1.5 hours after meals. This is designed to move any leftover food debris through the small into the large intestine. Antibodies that the immune system makes to neutralize cytolethal distending toxin (produced by a couple of the bacteria which cause food poisoning, including Salmonella) can cross-react with vinculin, a protein in the gut which allows the MMC to work. The lab test which looks for anti-vinculin antibodies and CDT B antibodies is actually quite a good test for confirming motility issues. This means that having a history of food poisoning can set people up for intestinal motility problems -> SIBO. In this way, a more appropriate name for SIBO could be Small Gut Dyskinesia Syndrome (SGDS). Other factors which affect GI motility are the autonomic nervous system (as mentioned above), elevated blood sugar levels seen in Diabetes (sugar affects the nerves which communicate with the gut), hypothyroidism, abdominal scar tissue, scleroderma, or radiation (cancer treatment). Fasting can be a great way to clean out the gut because the MMC is stimulated by ghrelin (the hunger hormone) and the MMC only works in between meals. Ginger, 5-HTP, B6 (P5P), and choline/acetylcholine can all helps to stimulate peristalsis.

3) Ileocecal valve

This is the valve between the small and the large intestine, and its function is to prevent the regurgitation or backflow of colon contents back into the small intestine. If this valve is stuck open (if it is inflamed or in spasm), bacteria from the colon can end up in the small intestine. This valve is under neurologic control, and many times stress (whether mental, temperature, physical/pain, or metabolic) can contribute to the dysfunction of it. Popcorn (because of the hull's sharp nature) and one of the chemicals in chocolate seem to be particularly detrimental to the function of the ICV, in addition to any foods that a person is sensitive to. Psychological stress or burnout can also cause the valve to be dysfunctional, and using an acupuncture technique called Neurological-emotional technique we can separate the stress response from its trigger.
Therapies that I have seen to be effective include visceral and spinal manipulation, low-level laser therapy (red for healing, violet for its antimicrobial effect) (esp. over the Ileocecal valve and vagus nerve), Neuro-Emotional technique to clear emotional stressors, therapies to reduce scar tissue (visceral manipulation, laser, castor oil, neural therapy with ozone gas), nutritional support for the patient's specific type of GI dysfunction, and antimicrobial herbs (ideally tested using some kind of biofeedback, in my opinion).
This post is not to be taken as medical advice, it is just FYI.
If you want to learn more, visit https://trueresilienceims.com/ulcerative-colitis-and-chrohns-disease/. I know the title of the page is related to IBD, but a truly holistic approach to any gastrointestinal issue needs to have the same above fundamentals addressed.
Dr. Evan

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