Why does SIBO cause pain and inflammation?
The production of gas, especially methane, is highly irritating to the small intestine and causes pain, inflammation, and damage to the mucosa. This causes leaky gut, whereby bacteria and their metabolites leak into the bloodstream causing widespread inflammation that is seen in the skin. It also affects the normal absorption of nutrients.
Methane produces constipation and weight gain.
Not everybody has methane-producing bacteria, but those that do, and have SIBO, will often put on weight.
Methane producers are very effective fermenters and extract high amounts of energy from food and are sometimes called obesogens. Even when eating normal amounts of food this can cause significant weight gain.
High methane can cause constipation. This has numerous knock-on effects. As well as causing discomfort it means that we are not getting rid of toxins in the body. When we treat SIBO patients who have constipation we often use magnesium citrate to improve the constipation before starting treatment. Killing off the excess bacteria can release toxins and if the toxins are not being removed because of constipation this can cause further inflammation and feeling unwell.
Intestinal methanogen overgrowth (“IMO”), cholesterol, and weight gain
Methane producers are not technically bacteria, but single-celled organisms with no nucleus, called archaeons.
Therefore when methane producers, like methanobrevibacter smithii, are the dominant microbe the condition is now called IMO.
A study in 2016 showed that these microbes cause significant nutrition issues. When the M. smithii was treated it led to lower total cholesterol, lower LDL cholesterol, better insulin levels, and lower glucose levels in patients with prediabetes.
Candida overgrowth (“SIFO”)
As well as bacteria, fungi (especially candida) can also overgrow.
Candida love simple carbs and sugar and after eating can cause dramatic gas and flatulence.
When candida are being killed off they can produce a syndrome called “die off”, when they release a toxin that makes you feel unwell (aka sugar craving). When you eat sugar the candida stop dying off and the craving goes. Getting past this stage is one of the reasons it can be difficult to wean off a high sugar diet, especially in cases with constipation.