Five Factors that Contributed to My SIBO, and How You Can Avoid Them
SIBO, or Small Intestinal Bacterial Overgrowth, has been a close companion of mine for a few years. It has lead me to spend thousands of dollars on treatments and countless hours researching and learning about this crazy condition.
SIBO is a motility disorder of the small intestine, where the generally, mostly sterile small bowel is instead overgrown with bacteria that are supposed to belong only in the large intestine.
This condition can cause an enormous variety of symptoms, making it both extremely unpleasant to live with, and difficult to diagnose (even with a breath test - the current diagnostic gold standard).
My symptoms ranged from constipation and severe bloating, to insomnia and general fatigue, and seemed to develop almost overnight.
Looking back to right before my SIBO symptoms started to take over my life, I was living in a perfect SIBO-shaped storm, with so many of my lifestyle factors lining up to create a massive disruption in my gut function.
In this blog, you’ll learn about the five major factors that contributed to my SIBO and general gut dysfunction, and some tips about how to avoid them in your own life.
And I have to start out with a disclaimer saying that everyone is different, and just because these factors contributed to my SIBO, doesn’t mean they will or have contributed to yours. In general, these are some factors that can contribute to general gut dysfunction, and for gut-sensitive individuals (like me!) it might be beneficial to avoid or limit them.
Contributing Factor #1: Hormonal Birth Control
I had been married for two whole months before I started experiencing my SIBO symptoms, but I had started taking hormonal birth control about a year earlier in order to make sure my body was fully adjusted to the hormones before I was married.
I had tried a few different versions of the pill, and found that I could not handle the combined pill (containing both estrogen and progestin) because it would make me soooo nauseous.
So, I landed on using what is known as the mini-pill - a progestin only version.
I felt totally fine, symptoms wise using this form of birth control. But what I wasn’t aware of was the drastic effects this tiny pill was having on my gut.
Being on hormonal birth control, especially for an extended period of time, has been shown to alter the gut microbiome. One study looking at the relationship between hormonal contraceptive use and Inflammatory Bowel Diseases showed that women who took a birth control pill for longer than five years, and had a genetic susceptibility to Crohn’s Disease, were more likely than women who weren’t on the pill to actually develop the disease.
Specifically, in my case, taking the progestin-only pill likely inhibited the healthy function of my gut even more. An increase in progesterone (the body’s version of the synthetic progestin in the pill) has been shown to slow intestinal motility and inhibit gastric emptying, both huge factors in developing SIBO.
If your intestines aren’t able to sweep food, bacteria, and other matter through your system at a normal rate, things will start to back up. And in the case of SIBO, bacteria will start to make their home in the small intestine, giving you all of those symptoms of gas, bloating, and constipation/diarrhea.
As soon as I realized that my birth control method of choice might be contributing to my SIBO, I stopped taking the pill and got the ParaGard (copper, non-hormonal) IUD inserted.
If you are concerned at all about your birth control and its effect on your microbiome or gut function, I would recommend switching to a non-hormonal version of contraception.
There are so many great, non-hormonal options including condoms, the copper IUD, and the fertility awareness method/cycle tracking.
If you want to start tracking your cycle I would highly recommend reading the book, Taking Charge of Your Fertility by Toni Weschler. She provides so much great information about how to not only track your cycle, but how to tell if your cycle is normal, and how to really get to know your body!
Contributing Factor #2: Antibiotic Use
About a month before my SIBO symptoms really started I had to take an antibiotic for a urinary tract infection (UTI).
I didn’t know it at the time, but any antibiotic use, no matter how short of a course, has both a short-term and a long-term impact on the health and diversity of the gut microbiome.
The problem with antibiotics is that they aren’t able to selectively target only the pathogenic bacteria that are causing your UTI or ear infection, but they instead wipe out all of the bacteria in your body, the majority being in our gut.
The short-term impacts of this include things like antibiotic-associated diarrhea, where there is an unfavorable shift in your microbiome that causes diarrhea as a result of antibiotic use.
But over the long-term, if certain species of bacteria are wiped out by an antibiotic, they may never be able to fully re-colonize in your gut. Leaving you susceptible to a host of digestive dysfunction.
This article is super helpful in detailing the effects of antibiotic use on your gut microbiome, as well as the impact of certain antibiotics on normal intestinal bacteria.
In fact, according to the research, the specific antibiotic that I took (ciprofloxacin) is associated with a strong suppression of enterobacteria (or gram-negative bacteria), which were actually non-existent on my first stool test after taking the antibiotic.
This lack of good bacteria, or dysbiosis, likely caused some of my digestive symptoms, as well as decreased my general gut function opening the door for SIBO to develop.
Since there is no way to go through life without ever needing to take an antibiotic, I would recommend a taking a good quality probiotic both during and after your antibiotic treatment.
Try to find a probiotic with a variety of well-researched strains and with a CFU count of at least one billion.
My favorite probiotic is the spore-based Just Thrive Probiotic.
Taking a probiotic won’t eliminate the negative effects of the antibiotic on your gut microbiome, but it will definitely help to minimize the damage and enable your good bugs to bounce back a little quicker.
Contributing Factor #3: Stress
I know, we hear this all the time, stress directly impacts gut health, but it's so true!
During the time leading up to and during the beginning of my SIBO symptoms I was under a huge amount of stress.
I had just planned a wedding, I was being asked to move into a project management role at my job, I had an almost hour long commute to and from work, and I was navigating my role as a new wife.
I don’t know if these stressful life events would have been enough to throw my gut out of balance by themselves, but along with my other contributing factors, stress (both physical and mental) definitely played a role.
There has been enough scientific research done to say that there is a bidirectional relationship between the brain and the gut-microbiome (called the gut-brain axis). Meaning that changes in your gut bacteria can affect how you think and feel, and changes in how you feel (or your level of stress, for example) can affect your gut bacteria.
Stress has been shown to be a direct cause of leaky gut (or intestinal permeability), and as the lining of the gut becomes more and more compromised, inflammation in the gut can occur.
As the permeability of your gut worsens, inflammation increases, and your body turns on its system-wide stress response, putting you in a constant state of stress.
This was definitely the case for me, as I would have trouble sleeping and often feel tired during the day, two signs of a taxed stress-response system.
Stress also impacts the diversity of the microbiome. Chronic stress has shown to negatively impact the diversity of bacteria in your gut, as well as shift the population of gut bugs to favor more dysbiotic, potentially-pathogenic bacteria.
Unfortunately, stress cannot be avoided, but I’ve found that implementing several stress-reduction techniques have definitely helped me decrease the impact that stress has on my body.
I started meditating every night before I go to bed. This has helped me not only fall asleep faster, but also to unwind and declutter my mind after a long day.
I have also increased the frequency of yoga that I do during the week. I used to be a hardcore “hot yoga or die” type of person, but I have found that implementing a slow, flowing practice a few times a week does wonders for my stress response.
Most importantly, I have been able to shift my mindset from one of needing to control everything, to one where I can just rest in the moment and trust that I am taken care of. This mindset shift has been critical in dealing with my stress and allowing my gut to heal.
Contributing Factor #4: High Refined Sugar and Carb Diet
Although I was eating a strict gluten free diet before I developed SIBO, and thought I was making healthy food choices, looking back, I was miles away from the truly healthy diet that I eat today.
My typical meals would consist of oatmeal and berries for breakfast, a turkey sandwich with grapes for lunch, and some sort of grain and protein with a few veggies for dinner. And to top it off my husband and I would often polish off an entire pan of brownies or cookies in one sitting on the weekends (woah!).
I was definitely addicted to sugar, and my diet was sorely lacking those amazing, nutritious vegetables that I have come to love.
A diet high in refined sugars and fats, and low in a variety of vegetables has been shown to produce negative shifts in the gut microbiome, which can leave you susceptible to all kinds of health problems, including SIBO and dysbiosis.
The bacteria in your gut feeds off of the the insoluble fibers found in its purest form in vegetables and some fruits.
Vegetables that are high in this indigestible form of fiber are broccoli, sweet potatoes, brussel sprouts, asparagus, spinach, and onions, just to name a few. And when you fill your plate with these amazing, health-promoting foods, your gut bacteria do the happy dance!
But when you don’t feed the bacteria in your gut, they cannot survive and continue to colonize, and their health-protecting benefits are reduced.
One byproduct of the bacterial fermentation of insoluble fibers are short-chain fatty acids (SCFAs). SCFAs serve a multitude of health promoting roles such as influencing gut motility, reducing colonic inflammation, and protecting against intestinal permeability, all of which help to preserve the integrity of the microbiome.
Since my SIBO diagnosis, I have completely shifted the way I eat. I now include a variety of vegetables at every meal, and I have all but eliminated refined sugars and grains from my diet.
I would recommend eating at least 1-2 servings of vegetables with every meal (I know, it was so hard for me to switch to eating “non-breakfast food” at breakfast, but the results have been so worth it).
Here’s what some typical meals look like for me if you’re looking for some inspiration!
And remember the wider the variety of vegetables you can eat, the greater the diversity of the bacteria in your gut. Different strains of bacteria feed of off different types of fibers, so keeping a large variety of vegetables in your diet will only benefit your gut and overall health.
Contributing Factor #5: Autoimmune Disease
I developed Celiac Disease (an autoimmune condition where your body reacts to the protein in gluten by attacking the villi of the small intestine), four years before I developed SIBO.
It is likely that people who are genetically predisposed to Autoimmune Disease have gut microbiomes that will influence the onset of the disease. Meaning that, people who are genetically linked to an Autoimmune Disease may inherently have more commensal (or potentially pathogenic) bacteria in their gut than someone who is not genetically susceptible to an Autoimmune Disease.
The numbers of pathogenic bacteria have been shown to be higher in patients with untreated Celiac Disease than in the normal population. But it is unclear whether the gut dysbiosis is a cause or a consequence of the disease.
Nevertheless, it is clear that all Autoimmune Disease (even non-gut related diseases such as Hashimoto’s Thyroiditis) have a relationship to the gut microbiome.
I’m not sure if my gut would have still been compromised if I did not have Celiac Disease, but I know that my genetic susceptibility definitely played a role in my dysbiosis.
Now, there is no way to prevent an Autoimmune Disease if you have the genes for it, but it is important to know your family history. If you know you are susceptible, you can work to be as nice to your gut as possible (eat all the fermented foods, reduce your stress, avoid antibiotics, etc.) but unfortunately this is one factor that we just don’t have much control over.
The Bottom Line
So, looking back, it really isn’t surprising that my gut health and function took a nosedive when it did. I had so many lifestyle factors that were perfectly aligned to contribute to the development of SIBO and dysbiosis.
The bottom line is: be aware of the many factors that can contribute to gut disorders, but don’t stress (see contributing factor #3!) over everything that might potentially, some day cause health issues. We just can’t control every little thing in our lives, and we weren’t made to take on that burden.
I hope this glimpse into some of the factors that contributed to my SIBO was helpful in your own health journey. I know gut health can be a difficult and confusing beast to tackle, so hopefully the research and ideas in this article was able to shed some light on your own situation.
Let me know in the comments if you enjoyed this article and want to see more like it, or tell me some of the lifestyle factors that you are aware of that contribute to your gut health!
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