Intestinal methanogen overgrowth (“IMO”) formerly SIBO-C or SIBO methane – often associated with constipation and weight gain
Some of us have methane producing bugs in our gut that can also overgrow in the gut.
As previously mentioned these are not technically bacteria but prokaryotes, archaeon, single celled organisms that produce methane.
The most common of these is methanobacter brevi smithii is responsible for 95% of the methane produced, however there are some other small groups.
These organisms do not ferment food but instead absorb the hydrogen gas produced and turn it into the highly irritable methane.
This in turn causes lots of inflammation in the small gut and elicits a strong immune response.
It is thought that this also affects the integrity of the gut wall allowing leakage of some of the contents of the gut into the body.
One of these contents is LPS lipopolysaccharide that is part of the cell wall of gram negative bacteria that has been isolated in the blood of SIBO patients.
This LPS provokes a very strong immune response and may be responsible for the brain fog and inflammation that is associated with SIBO and clears up when it’s treated.
So not only does the overgrowth cause discomfort but it also causes structural damage to the gut.
This is important to remember when treating the gut, it’s not just about treating the bugs but it’s also important to support the gut when it returns to a more healthy state.
A less common type of bacterial overgrowth is one where hydrogen sulphide is produced. This is characterized by the same symptoms of SIBO but during the breath test both hydrogen and methane levels appear very low. Commercial tests for hydrogen sulphide are not yet available.
As mentioned previously it is not just bacteria and archaea that complicate overgrowth but also fungi in particular candida. These hydrogen producers are nearly always present and 23% have been shown to be the dominant problem.
When candida infections take hold they can be difficult to diagnose, an expensive urine test can look for metabolites. Signs of other fungal infections are key ie skin infections, athletes food, corners of mouth etc.
When fungal infections have “taken hold” they can be difficult to treat. The fungi will often produce a protective film around themselves that is hard for antimicrobials to penetrate. Agents that will break down the biofilm are often required alongside the antimicrobial treatment.
When fungi are dying off they release a toxin that can often cause unpleasant symptoms ranging from headaches, aches, feeling low and irritability to strong sugar cravings.
If these symptoms occur it’s important to understand what is happening but other therapeutics can be used to help. Charcoal and zeolites have been shown to “mop” up these toxins and reduce die off.
As previously mentioned one of the causes of overgrowth in the small intestine is a dysbiosis or unbalanced microbiome in the large intestine.
This can be caused by many things however the most common is the prolonged use of antibiotics or when strong antibiotics have had to be used.
The lack of presence of the house keeping bacteria like lactobacillus to produce lactic acid means that fungi can flourish and when this happens they or other bacteria can overgrow into the small intestine.