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10 ways to prevent SIBO or a recurrence

Updated: Oct 14, 2023

How can you prevent SIBO or a recurrence?

Relapses after treatment for SIBO are high due to numerous factors discussed in a previous article. However, there are ways to improve outcomes, which are highlighted below.

10 ways to prevent SIBO or a relapse:

1. Reduce stress

Excessive stress down-regulates digestion, increases the permeability of the gut (makes the gut "leaky), inhibits motility and slows food transit in the stomach and small intestines.

Whether you reduce stress through meditation, exercise, or music, this is an important step. The self-hypnosis app Nerva , which is designed to help you retrain the gut-brain connection is valuable tool. Other more simple and free stress-relieving tools can be found here.

Man with abdominal pain and irritable bowel symptoms

2. Try intermittent fasting or at least avoid snacking between meals

Decreasing your eating window allows more time for the MMC contractions that sweep the small intestine to take place. It is also particularly important to avoid eating right before bed.

3. Get moving!

Movement is possibly the number one way to support gut motility. Ideally, your day needs to be broken up with movement as long periods of sitting reduce blood flow to the digestive tract, which slows the rhythmic contractions of the gut.

If your day often involves long periods of sitting, set timers for every 40 minutes to encourage you to get up and move. Even if it is just for a yoga stretch or two.

Woman stretching at desk

4. Have your ileocecal valve assessed.

Dysfunction of this valve, which sits between the large and small intestine, can interfere with movement of the intestinal contents. It can be improved with gentle soft tissue manipulation in your lower abdomen and a spinal adjustment / correction. Some chiropractors, visceral massage therapists, applied kinesiologists and functional medicine practitioners know the procedure.

5. Consider an abdominal massage

A visceral manipulation therapist can also be helpful for those with adhesions and scar tissues after abdominal surgery. Adhesions and scar tissue can impede the movement of the intestines and their contents.

Professional abdominal massage

6. Avoid refined sugar, processed foods, alcohol and excess carbohydrate consumption e.g. pastas, breads, cakes, biscuits, fast foods. These products feed unhealthy microbes and can trigger a bacterial imbalance.

Plant-rich, nutrient-dense food feed the beneficial bacteria which is essential for a healthy gut.

7. Improve digestive juices and make sure you have adequate stomach acid

This is not just about improving digestion but preventing infection. Hydrochloric acid in your stomach helps to kill unwanted pathogens, such as bacteria, viruses and parasites, that can trigger a relapse.

Lemon ginger drink

Taking herbal bitters or raw unfiltered apple cider vinegar before meals may help increase stomach acid production. Click here for a great drink to sip before meals or at least every morning before breakfast. (This is not recommended if you have a stomach ulcer).

For the body to make stomach acid it requires adequate zinc, vitamin B6 and B1 levels, so your diet plays an important role. Supplementation may be required.

8. Avoid certain medications whenever possible

Antacids, proton pump inhibitors (e.g. Losec and Omprazole) and broad spectrum antibiotics (eg. amoxicillin, penicillin, erythromycin, doxycycline, ciprofloxacin or norfloxacin) are the most important to avoid.

Proton pump inhibitors (PPIs) and antacids reduce stomach acid, increase your risk of infection, and therefore can be a SIBO trigger. Interestingly, SIBO may be the actual cause of reflux and heartburn symptoms that PPIs are prescribed for. The gas released with a bacterial overgrowth can overwhelm the sphincters in the stomach allowing stomach acid to reach and damage the oesophagus.

9. Take Prokinetics

Prokinetics improve the motility of the gut and sweep the bacteria from the small intestine back down into the colon.

Iberogast herbal supplement

Common natural prokinetic supplements include:

  • Iberogast herbal liquid

  • Ginger

  • Artichoke extract

  • Triphala

  • 5-HTP (A precursor to serotonin and can be given as a supplement. It is not always appropriate for those on SSRI anti-depressants).

  • MotilPro by Pure Encapsulations

  • GI Motility Complex by Enzyme Science

10. Work with a qualified health professional

Treating SIBO can be challenging and frustrating, particularly if a recurrence occurs. Having a supportive, experienced, and qualified practitioner to help you navigate the gut healing journey can increase your chance of success and save you time, money, and suffering.

The SIBO breath test and comprehensive stool tests are only available through qualified practitioners, along with access to a larger range of high-quality supplements.

Furthermore, practitioners can delve into any underlying conditions or lifestyle factors that may prime you for recurrent SIBO.

Having clear instructions and support can be a game changer when it comes to addressing SIBO for a long-term solution.

Keen to work with me to address your IBS or SIBO symptoms? Book a complimentary discovery call.

The Nourish to Flourish IBS Solution with Dr Georgina


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