2: Why SIBO Happens

Episode 2: Why SIBO Happens

In this episode, we’re diving belly-first into bloating — specifically the kind linked to SIBO (Small Intestinal Bacterial Overgrowth), when bacteria (or even fungi) set up shop where they shouldn’t and start throwing a gas-producing party in your small intestine. Think: hydrogen, methane, hydrogen sulfide… and a whole lot of discomfort.

We break down:

• Why you might look 6 months pregnant by 6 p.m.
• The sneaky triggers behind SIBO (PPIs, antibiotics, GLP-1s, stress, surgery, hormones, infections, pregnancy, endometriosis, gallbladder removal — the list goes on)
• Why symptoms can look like constipation, diarrhea, reflux, early fullness, fatigue, brain fog, skin flare-ups, and even nutrient deficiencies
• Common myths — including why gas doesn’t automatically mean SIBO, and why a negative breath test doesn’t always tell the whole story
• Practical things you can start now: meal spacing, walking after meals, belly breathing, and avoiding food fear

Most importantly, we zoom out and ask the bigger question:

Why is your gut vulnerable in the first place?

Because SIBO may be the smoke — but it’s not always the fire.

Come curious, leave empowered — and maybe a little less bloated.

Because better gut health changes everything.

00:00 Welcome to Team Gut Girls
01:01 Why SIBO Matters
02:04 What SIBO Is
02:35 Bloating Location Clues
03:16 Conveyor Belt Motility
04:08 SIBO Gas Types
04:32 Four SIBO Patterns
06:17 Causes and Risk Factors
10:36 Common SIBO Symptoms
14:10 Myth SIBO Causes Everything
16:08 Myth Diet Fixes SIBO
17:28 Myth Breath Tests Are Final
21:04 Myth Antibiotics Cure SIBO
21:20 Relapse Root Cause
22:45 Probiotics Myth Explained
26:38 Gas Doesn’t Mean SIBO
27:24 Stress Brain Gut Link
29:46 How SIBO Bloating Feels
31:25 Recurring SIBO Myth
33:02 Beyond Digestion Symptoms
33:35 When to Suspect SIBO
35:51 Simple Motility Habits
39:03 Talking to Your Doctor
41:02 Wrap Up and Next Steps

---

Team Gut Girls Episode 2: Why SIBO Happens

Dr. Christina Carew, ND: today we wanted to talk about bloating in a way that might be something you’ve read a ton about and know that your Instagram or listening to these podcasts, we’ll generate a whole bunch of new information in your social. Posts and in the ads that you’re served. So please be mindful of always checking where the information comes from.

But today we’re gonna talk a little bit about small intestinal bacterial overgrowth, which is sometimes depends on your reasons of why you’re getting bloating, but could be a very common reason why sometimes people get bloating or sometimes is a default of the doctor that you’re seeing is that they assume everything is from small intestinal bacteria overgrowth.

And so, hopefully. Today’s discussion tells you a little bit more about what it is and you, what it isn’t but also how to even broach your health [00:02:00] practitioner about even investigating if this is something that might be going on. So, if we’re talking about bloating that’s related to small intestinal bacteria overgrowth so what, what is that?

Right? So bacteria that should be in your large intestine. So a large intestine is from your hip bone on your right side, all the way up and around under your belly button and down the other side. So it’s it’s the largest part of your intestinal tract from a width perspective. And it. It sucks a lot of the water out of it and makes a stool.

When we have bloating that is related to bacteria overgrowth, it actually usually feels like it’s in between the hip bones. Sort of from the belly button down to the underwear line, that pouch in the middle where sometimes people will say, oh, I feel like I have a basketball in there. I feel like I’m pregnant.

And so the. Intestines. If you see them, hopefully you’ll never have to see them on a cadaver. But if you have seen them on a cadaver, they’re actually quite flat. And when food [00:03:00] goes in them and it starts to ferment and move along, it like pushes up and then flattens back out. So think about it like a worm kind of inching along.

And so there’s no point where the entire thing, 21 and a half feet should be. Filled where you’re getting that bloating. It should also always be, I always talk about it in practice, like a conveyor belt. So I think about it like you make an online order, your order goes in, the conveyor belt starts, something gets off the shelf, goes onto the conveyor belt in the box with your name on it.

And it goes along, right? And as long as the conveyor belt is moving well, then it doesn’t get backed up in any one part of the factory. But we’ve all certainly had online orders that got lost. And so think about it in that way, we’re like, okay, I kind of understand, like things should keep on moving. Yeah, I actually watched a video once and that’s why I put that in my mind.

So there you go. Perfect. So the bacteria are, instead of moving things along, starting. Starting to like ferment and hold things [00:04:00] in place, then that’s one of the reasons why we might get more gas or more delay in transit moving, or sometimes that sensation of bloating. And so those gases can be hydrogen gas.

They can be a methane gas. So methane, think about like Calverts, that’s sort of super smelly gas. They could be a sulfur based gas. They might be related to candida or fungal overgrowth, which will have a whole nother episode on. But when the gas has nowhere to go, it causes like distension pressure, pain, and.

So there as far as we know currently, there seems to be about four kinds of small intestinal bacteria overgrowth. So there’s the hydrogen based one. And the way I always think about this is it seems to be more of the first one that people get. So this is as a result of something happening. We’ll talk about some of the reasons next, but that creates the initial gas, which for many people.

At least in my experience results in a lot of [00:05:00] diarrhea or urgency around going to the bathroom.

The, that gas kind of makes a second gas because it feeds a different type of bacteria, which is more methane gas and the methane gas. I always think about it. We alluded to it in our, one of our earlier episodes about incomplete bowels.

You’re going to the bathroom and then some time passes or some air passes and you gotta go again. Methane gas is sometimes this one that’s more you know, forming gas in between pockets of food which sometimes makes this incompleteness. The hydrogen sulfide or sulfur based gas, this one’s typically easier to diagnose based on the symptoms.

So this is, bowels that smell like matches or rotting eggs, or definitely having difficulty with foods that are higher in sulfur like. Beef or eggs or wine could be an option. And then our fourth time, which is very untestable unfortunately, is the fungal overgrowth, which, does have lots of common features of the others, but also [00:06:00] is really fed by the.

High carbohydrate, high stress, high rich foods lots of sugar. And sometimes because they all can show up together, it becomes really complicated for someone to even think about this as a potential diagnosis. So maybe today the first thing we’ll talk about are like, what are causes or contributors to sibo?

So if this is something that you think might be going on. What are some of the things that the patient or you as a person who’s considering this as bloating in your body might have had an exposure to or had something that happen. Maybe we’ll just go around and kind of start building a list.

Dominique, what would be some causes that you commonly see might be contributing to this condition?

Dr. Dominique Vanier, ND: Yeah, like some of the questions I’ll ask are, what we, what we know are like actually in the literature causes, which would be like, have you been on a proton pump inhibitor for a long time? So a PPI proton pump inhibitor is a drug that will suppress acid [00:07:00] production.

It’s the main drug that’s prescribed in gerd, which is reflux. And so that acid suppression is able to increase the likelihood of bacteria migrating into the small intestine causing sibo. But some other things too that maybe are not necessarily condition related are like, have you tried everything?

I’m interested in what their path is to this point. Mm-hmm. Like, which is how, you know, have you tried changing your diet? Have you tried doing other things? What have you responded well to? What have you been aggravated by? And, and coming putting together like a picture.

And sometimes that actually can lead to somebody having, being more likely to have sibo.

Dr. Christina Carew, ND: What about you? What are other things that you would put on the have these things happened to you prior to this sensation?

Dr. Whitney Baxter, ND: So this conveyor belt analogy as a winner. I think of it as that exactly what has slowed down someone’s gut enough that they’re getting like something.

Stalling or not flushing through, why is there bacteria in the [00:08:00] small intestine? Mm-hmm. So if they’ve had any abdominal surgery, if there’s any scar tissue adhesions I think about hypothyroidism. So slowing down the gut in that sense, blood sugar dysregulation, diabetes can change the motility of our guts.

Pregnancy C-sections, again, an abdominal surgery. Yeah. So what’s going on? Kind of like expand their health history and really asking around this like slowed motility of their gut. The pro proton pump inhibitors GLP ones, tirzepatides

Dr. Christina Carew, ND: Yeah. Certainly antibiotic use on medication side of things, chronic pain medication. Lots of them cause motility issues. And even

Dr. Dominique Vanier, ND: the way the brain communicates the gut too, right? Like it can be. Not even gut centric or gut. Gut, like first. Right. So like a traumatic brain injury could be one of them.

Dr. Christina Carew, ND: Yeah.

Dr. Dominique Vanier, ND: Mm-hmm. Yeah. Mm-hmm.

Dr. Christina Carew, ND: Yeah. Lots of people with concussion that also then have issues. Yes. It can also come with other gut issues. [00:09:00] So we certainly see people that have Crohn’s or have had radiations or cancer treatments. They certainly will sometimes this is a secondary thing a byproduct of having that.

Certainly mold exposures or heavy metal exposures, things where the intestinal tract is slowed down gallbladder removal even hormone conditions like endometriosis or anything where the intestinal tract has maybe changed, even if in its shape or how it’s adhered. And then there’s the more obvious reasons, which would be things like food poisoning or a traveler’s diarrhea or a gastro infection, or lots of vomiting with pregnancy.

Where we’re actually physically getting a shift of the bacteria from one place into another in the body that may not actually rebalance or rectify.

Dr. Whitney Baxter, ND: Mm-hmm.

Dr. Christina Carew, ND: Anything else we haven’t put on this list? I would say certainly anyone who has a complex [00:10:00] chronic illness, so lots of fatigue, Lyme disease, anything where you’re lying down a lot, you’re not getting a lot of like gravitation and movement.

Mm-hmm. That can certainly be a piece of the puzzle.

Dr. Whitney Baxter, ND: Mm-hmm. Mm-hmm.

Dr. Christina Carew, ND: Lots of reasons for sure. And I would say a big one is stress. Stress makes everything worse, right? It doesn’t matter if it’s this type of bloating or any other type of bloating, but certainly stress can amplify anything.

And so being in a stressful period of life or having a stressful period of time or having health stress can actually just make other health stress worse for sure. What about symptoms? So if we were trying to tell someone to consider SIBO as a potential consideration in their diagnostic list, what are things that you guys see as common symptoms amongst the patients that you do see that end up having sibo?

Dr. Dominique Vanier, ND: Mm-hmm, mm-hmm.

Dr. Christina Carew, ND: Beyond blo.

Dr. Dominique Vanier, ND: Bloating. Yep. It’d be like changes to bowel movements. Right. So they’re, [00:11:00] they could be more constipated, they could be having more diarrhea. Like, again, it depends on kind of what the, the dominant gas production is. If it’s more hydrogen or methane based. Could be mixed presentation too, which we go into this at a different episode, but which is a little bit more actually constipation where the body isn’t trying to catch up.

But certainly like a change to the bowel movements or like non-optimal bowel movement motility is one of the big hallmarks. Yeah.

Dr. Whitney Baxter, ND: Like those upper GI or gastrointestinal symptoms of like fullness, right under your ribcage. It’s happening pretty quickly after you eat. Or maybe as you’re eating, you’re starting to feel like maybe swollen inflammation or bloating, whatever symptom, however weight you describe it, like heartburn, regurgitation, or reflux, just based on the location of what’s, where’s going on.

Dr. Christina Carew, ND: Yeah, I would say certainly some people, one of the things for me, or when I would consider this on my DDX [00:12:00] list, that my consideration list would be anyone that comes in with a low iron, low, B12, low vitamin D. So we’re seeing some kind of like malabsorption. Sometimes with that they’ll also have things like.

Fat in their stools. So, one of the questions I ask is do you use a lot of toilet paper? Do you have a lot of wiping? Like, so that’s a part of that maldigestion or pungent odor. Some of those questions that we talked a little bit about earlier on the sulfur smelling or foods that are bothering you.

Dr. Dominique Vanier, ND: Mm-hmm.

Dr. Christina Carew, ND: And then one of the things that Whitney referred to earlier was like the FBAs diet. And people that had only felt better when they were on a five maps diet, certainly as boring as that is sometimes can be a clue.

Dr. Whitney Baxter, ND: Mm-hmm. Mm-hmm. Yeah. That’s like a good test.

Dr. Christina Carew, ND: Yeah.

Dr. Whitney Baxter, ND: Not long-term treatment, but it’s a great test if you remove these foods that are feeding the bacteria and they’re fermenting.

And you feel way better, then let’s [00:13:00] investigate some sibo. Mm-hmm.

Dr. Dominique Vanier, ND: Mm-hmm. Mm-hmm. And there’s overlap too with skin and brain, right? Like feeling fatigued you know, having like skin rashes, like eczema, hives. Whatever. Right? Like we can see, we can, the digestive system is so complex and it speaks to other systems.

So we can see this like branch out happening. Respiratory symptoms sometimes. That’s an interesting one. I’ve actually had at least one patient. Mm-hmm. Where there was, there was like, it was sibo definitely. And it was causing. Like difficulty breathing, and that’s because of, I’m not actually sure the patho, the pathophysiology there, but it may have been like a pressure thing because there, there was a feeling of bloating.

Vagus nerve also, possibly. Yeah. It’s interesting.

Dr. Whitney Baxter, ND: That’s cool.

Dr. Christina Carew, ND: Yeah. Bad taste in the mouth sometimes. That’s also a clue for constipation, but SIBO can be a reason why people are getting constipation. And certainly anything that delays the movement in the body can cause a bacterial [00:14:00] overgrowth, which may result in this, but it may not.

And so that’s part of the next piece is it sounds like all of these symptoms are what everyone has with gastrointestinal problems. And maybe myth number one is SIBO is the root cause of everything. Does do either one of you wanna take that one on.

Dr. Whitney Baxter, ND: I think we’re putting people at a disservice and a risk if we’re just assuming that it’s SIBO and we’re going down that path.

Because what we should be doing is considering all these broad, broad symptoms, right, like reflux, bad taste in your mouth, maybe nausea, maybe this bloating like that could be h pylori. That could be. That could be something else going on. You’re anemic and you have indigestion. Have you ruled out Crohn’s colitis?

Have you ruled like really looked at autoimmune function, other infections instead of just assuming this like great answer, which sounds great, but yeah, we have to [00:15:00] be mindful.

Dr. Dominique Vanier, ND: I think that’s, and that’s a good point, right? ’cause like sibo, it’s pretty much all non-specific symptoms, meaning that like. They, the symptoms that SIBO presents with overlap with so many other digestive conditions and other non digestive conditions even so, like when we say that it’s the root cause of everything that, that implies that it there actually hasn’t been a good diagnostic workup to land at sibo.

We haven’t, we haven’t adequately ruled out potentially everything else that could be leading to those symptoms too.

Dr. Whitney Baxter, ND: Right.

Dr. Christina Carew, ND: And it’s amongst the things. So we’re also looking, or the practitioner you’re seeing should also be looking at like motility and nervous systems signaling and hormone fluctuation and structure and function and all these other pieces.

So you know, it can be. It can be a likely diagnosis for someone, but in, in absence of checking everything else out, it’s sort of just like throwing everything at the kitchen sink. It’s sort of [00:16:00] like, everyone should eat this type of food, or everyone should have this kind of diet. Same kind of idea. Is that.

Knowing more certainly helps. Okay. Myth number two is that I guess that kinda leads into it. If you eat the right diet, your SIBO will just go away.

Dr. Dominique Vanier, ND: I’ll speak to that. What we know about bacteria now is that we don’t, they don’t just go away, we just starve them. Yeah. And so you know what some of the research says is like, depending on the type of bacteria, they can just burrow into your mucus layer, right? Which is like they’re hungry, so they’re gonna try to eat something and then they can actually make this.

They can make the situation so much worse because now they’re choosing what fuel source they really want, not the food that you’ve been giving them. So diet will like, like it will reduce symptoms, but it doesn’t resolve SIBO on its own. And we’re talking about like low fodmap, like the SCD diet, which is the specific carbohydrate diet, the carnivore diet elemental, they will [00:17:00] quiet the gas.

They are not going to resolve the issue.

Dr. Christina Carew, ND: Yeah, so like as soon as you eat those foods again, everything comes back. But also not eating those foods can cause you to have more issues because you may also have nutritional difficulty or you might lose a lot of weight, or you’re, you may create new conditions on top of your current condition.

Okay. What about myth number three? A negative breath test means you don’t have sibo.

Dr. Whitney Baxter, ND: So the SIBO breath test. The cool thing about gut health is there’s new research like every week, so we used to think that this, it was this great test. It was a breath test. Okay, so the gas is getting emitted through.

It’s like exiting the lungs. So we can test this through a breath test so we can understand which species is causing what. However, it’s not, we don’t like super trust it. [00:18:00] It’s not perfect. There’s a lot of fa false negatives that can happen. So if you’re having, if you’re constipated, so if there’s slow transit, the timing doesn’t quite line up with the test and where we’re seeing the spike in gas it’s a really tricky prep.

You gotta like eat rice and chicken and people come back to me depressed and sad. And it’s just really tough to get your gut and like the microbes ready to test.

Dr. Dominique Vanier, ND: Yeah.

Dr. Whitney Baxter, ND: And then there’s other microbes that we can’t test for because they’re consuming the gas. So we’re not getting a perfect picture of what’s going on in this section of the gut, unfortunately, with these breath tests.

So I’m not always confident in recommending them, seeing the results. You’re paying out of pocket for them. So there’s a lot of things that go into these tests.

Dr. Dominique Vanier, ND: And one thing I’ll add too is like the substrate that you swallow, so like the, I mean, part of the test is you have to, you have to drink [00:19:00] or swallow this thing.

We will call it like a biomarker and it’s, and depending on which one you choose, you will get different results. So there’s a lot of error that can happen at multiple steps throughout the entire process, which is like. Prep whether somebody stopped their PPIs, like what they’re actually swallowing before the test.

If it’s like, if it’s on an empty stomach. There’s so many, there’s so many things. The interpretation of the test and when we end up having all these points that can lead to error is feeling confident about the results ends up getting affected.

Dr. Christina Carew, ND: Mm-hmm. I would say also just for anyone who’s not familiar with the test, the test is a three hour breath test.

It’s typically done at home. But some, some places might do it in, in their office or in a lab. It is a breath sample after a very restricted diet the day before first thing in the morning, and then you drink a solution, which Dominique referred to, which could be Lactulose, it could be [00:20:00] glucose.

It then you both before and after, you keep measuring breath samples and you basically blow into a bag and you have a test tube that you need to attach to the side. And part of the challenge is that you actually have to blow some of the air into the bag and then put the test tube on to catch sort of the middle air or the end air which is where the gas that’s like above where it might have been fermenting is being captured. So you don’t want it from like your mouth or from your esophagus. You like want it lower. And so all of those pieces are sometimes tricky because what it, you know, how long do you wait and how much air can you blow out? And certainly did you attach the tube well.

So it’s not a perfect test, but it’s mm-hmm. Can be helpful. Mm-hmm. And so it’s like part of the challenge I think in the gut world is like that there aren’t great tests. We have lots of types of tests and more coming out all the time, but none of them are slam dunks. And so it’s super frustrating for anyone, both as a practitioner and as [00:21:00] a patient who’s like, what’s going on?

Dr. Dominique Vanier, ND: Right. Yeah.

Dr. Christina Carew, ND: Okay. Myth number four is antibiotics or herbs can cure sibo. Dominique, you wanna take that one on?

Dr. Dominique Vanier, ND: Yeah, they, well, they certainly can reduce bacterial load, but they’re not gonna fix what we call like the environment, right? Or the terrain. So. I think the question is like, why did this start to begin with?

And you know, especially when we can kind of point to like a cause, like a bowel resection or you know, like I mentioned earlier being on PPIs long term, we really wanna look at those kind of upstream or causative factors. But other things like need to be considered, right? Like what’s, what’s somebody’s motility support?

Like even if we do a whole round of antibiotics or herbs, we need to look at their motility support, how their brain is communicating to their gut through central nervous system. So like nervous system regulation addressing other drivers, right? Like if, if their, if their TSH is like above. Four or [00:22:00] five, and we’re looking more at like a hypothyroid picture, and that is going to affect motility in their gut health inflammation, hormones, et cetera.

So, so there is, there is a very known relapse rate that tends to be higher. So people that let’s say have significant improvement after one round of sibo they may end up. Having symptoms slowly creep up back, or they may even need multiple rounds. So yeah. Killing bacteria without fixing like the issue or the flow doesn’t always, doesn’t, yeah.

Doesn’t always lead to like a hundred percent fix,

Dr. Christina Carew, ND: like mowing your lawn and not actually pulling the roots out of the weeds. Mm-hmm. They just come back. Mm-hmm. Um, I like visuals. That’s my, that’s my jam.

Dr. Whitney Baxter, ND: A good one.

Dr. Christina Carew, ND: So myth number five is probiotics are good for sibo. In fact, probiotics are good for every gut issue that people have, and probably the most recommended thing by medical doctors.

And why is that maybe a myth. [00:23:00]

Dr. Whitney Baxter, ND: Well, we’ve got this, this area of the gut that’s overloaded with. You know, too much bacteria where they shouldn’t be. And Dominique just alluded to, it’s an environment. So if we’re adding in more. Bugs to this environment that could worsen symptoms. It’s a small space, right?

And it’s an area where we need to absorb our nutrients. And so if we’re adding in probiotics, it could worsen bloating, could worsen the diarrhea, it could worsen the symptoms, could add fuel to a fire of maybe there’s like histamine creation and the skin reaction and the itching and the brain fog and it could just worsen things.

So. Like those probiotics are tools, not vitamins. Yeah, it’s not, it’s not like a vitamin C that we know. We know a dosage, we know the mechanism of action. There’s so many different brands and cultures and species and amounts and all of these. Brands and even if it’s from a [00:24:00] really great company, it’s not necessarily gonna be great for your gut and the environment that’s going on in your gut.

So there’s always a time and the place, and there are some good studies, sometimes they’re in like animals, so we can’t always extract that study in the world of probiotics to your gut. Yeah. We have to be really, you have to be careful with probiotics. Yeah. And sibo. But I,

Dr. Dominique Vanier, ND: I’m gonna one thing we need to think about too is so for example, for somebody who’s got longstanding constipation or like even a red redundant colon where like they are going to be constipated, like from like a physical standpoint when we’re constipated or if we have slower motility, we’re more likely to have SIBO and some probiotics help.

Lower down, right? Like they’ll, so we’re talking about the whole system. If we can improve constipation, so we’re able to, with the, like the bath and the bath water, if where SIBO is up here and we’re allowing the drain to empty better, like we may actually see improvement in, in what is sibo. So we, I think we need to think about the entire picture and we can have concurrent things [00:25:00] happening at the same time.

And that’s where, yeah. That’s where cases are not like, they’re not clear cut.

Dr. Christina Carew, ND: Yeah. It’s, it’s more around like there isn’t a magic treatment.

Dr. Dominique Vanier, ND: Yes.

Dr. Christina Carew, ND: Even within a SIBO diagnosis. So if someone does give you a SIBO diagnosis, it doesn’t mean that the treatment that they give you is going to be right for you because your situation or the causes of your situation.

May be different than someone else’s. And so definitely I would say more often than not, a lot of the patients that I see, and I’m not sure if, if you guys see it too, is like a lot of the people that they see before they got to me say, you know, increased fiber, add in a probiotic and everything will get better.

And I think what we are hoping that people understand through listening, hopefully to multiple episodes of our podcast. So if, if you like us, subscribe and follow and follow us on Instagram, but but that we are [00:26:00] able to help to understand that there are lots of different reasons why these things are happening, even if they’re the same.

Diagnosable condition and so the treatment and the follow through is gonna be different, and so mm-hmm. There is no magic pill that will just make things better. If there was, you wouldn’t be listening to this podcast.

Dr. Whitney Baxter, ND: No. It

Dr. Dominique Vanier, ND: was you it out on your own already. Yeah.

Dr. Whitney Baxter, ND: And I always say that to my patients too.

I wish there was a template I could give you. This is your protocol, but your body is different than every other body. So we need to find your toolkit.

Dr. Dominique Vanier, ND: Yeah. Like it.

Dr. Christina Carew, ND: Okay. Myth number six. Anyone with gas has fermentation, which must mean that they have sibo. And I think we talked a little bit about this, that, you know, not all bloating.

If you listen to episode one is about bacterial overgrowth and it can come from a whole bunch of different reasons. So, hormonal pelvic floor, [00:27:00] distension. Diaphragmatic movement, constipation, muscle activity. Certainly we’re gonna talk about all of those in upcoming episodes. But there isn’t one cause and so there is also not really one suspect.

So gas isn’t the only thing that tells us that someone has sibo. I mean, can be coming from all kinds of different reasons.

Dr. Dominique Vanier, ND: Mm-hmm. Mm-hmm. Yep.

Dr. Christina Carew, ND: Okay. Myth number seven. Stress doesn’t affect sibo. It’s a gut infection. Anyone wanna take that one on?

Dr. Dominique Vanier, ND: Yeah, we can’t really look at stress and isolation anymore.

Right? No. Like we, we have so much evidence on the brain gut connection and how that is involved in like, pretty much every digestive condition. Do you wanna think of it like as a system? So stress is like, it’s not just emotional, it’s, it’s neurological. Like your central nervous system like plays such a massive role in.

Like the function of your gut. We know chronic stress will [00:28:00] suppress, like the migrating motor complex, which is involved with motility. There can be an impact on stomach acid. Stress can alter like your vagal tone, it can impact intestinal clearance. So if we’re just looking at this in terms of like an antimicrobial approach that’s not the full picture we do need to look at.

What’s going on with somebody’s nervous system? Like is there background anxiety? Do they have even a history of trauma? Like we have so much evidence there too, and how that impacts somebody’s gut. So we really need to look at like the entire thing and the treatment plan needs to address it from multiple angles in that way.

Dr. Christina Carew, ND: I would say a big one too. I always talk to patients about like the idea of being an adrenaline. So adrenaline is one of our stress responses is like, you know, just power on through. And I’m certain that there’s probably some women who are in their, thirties to sixties who have just gotten it done because they had people [00:29:00] depending on them, whether that was their kids or their.

Work or their family members. And so as long as you just keep going, things are okay. And when I think about that kind of patient or that kind of life moment, everything stops. Like if you’re running from a bear, you don’t have to take a poo. And that’s how our amazing teachers, I don’t know how they do it, but those women and men never go to the bathroom while they’re in class.

And certainly that’s like a big contributor to like things like overgrowth or delay or motility issues, right? It’s that stress response that’s overcoming a natural system to just be like, not now.

Dr. Whitney Baxter, ND: Mm-hmm. Mm-hmm.

Dr. Christina Carew, ND: Mm-hmm. It was certainly a big piece of that. So maybe we can talk a little bit about how like, SIBO bloating feels different and so not all bloating is SIBO bloating, but when people, these are some of the things that someone might say to me that makes [00:30:00] me think of it.

And, and you guys can add to your list. So I would say. Generally if someone says it starts within like 30 to 90 minutes of eating because that’s sort of when we might see something get into the small intestine. When someone says Hey, it starts as soon as I eat, or it’s like I get it from drinking water, then becomes less of a likelihood of a primary diagnosis for me.

Certainly if some things are like, oh I can’t eat watermelon, I can’t eat onions, I can’t eat some of those like high FODMAPs foods. Or if they say, as the day goes on, the bloating gets worse and worse or becomes visible, sometimes people will show me like pictures. And if they, if they do remove those high FODMAP foods, they feel like that it’s better, but it’s not perfect.

So those are kind of some hot, the higher ones that I would be like, oh, okay. Maybe, or they’ve also had a. History of a traveler’s diarrhea, gastritis, something that has has thrown their system into havoc.

What else would be high on your list to [00:31:00] consider this if someone came in and shared with you some info?

What would that,

Dr. Whitney Baxter, ND: I think what you just said is the history, right? Like, yeah, what’s, did you have food poisoning? Have you had abdominal surgery? Like, is there something slowing down your gut? It’s like something that could lead to the function of dysfunction or like, you know, leading to dysfunction and leading to sibo.

Dr. Dominique Vanier, ND: Yeah, yeah, yeah. Yeah. I think you covered it. Yeah, exactly.

Dr. Christina Carew, ND: I think there’s also like another myth that sometimes comes out of that is that once you’ve had sibo, you have, you always have it, like you have to constantly be treating it and you have to constantly be aware of it.

Dr. Dominique Vanier, ND: Yes.

Dr. Christina Carew, ND: I have a patient in particular that I think it of, and she always says it.

You know, ’cause my SIBO comes back, my SIBO comes back. And I, and I think that there certainly are, there’s tons of Facebook groups and posts within Reddit that talk about people who have recurring symptoms. And when I think about recurring symptoms, I usually think that the reason that this happened really kind of got missed, [00:32:00] which is some of what we talked about earlier.

So like is actually a motility issue or a hormone issue or a structural issue, you know, did someone actually do the entire treatment? Was the treatment, the right treatment for them?

Dr. Whitney Baxter, ND: Mm-hmm.

Dr. Christina Carew, ND: I have plenty of people that have it, have had it, and lots of them are just much, much better because they learned along the way what was their trigger and what was going on.

I do have a woman that, treated it was much better and then got a food poisoning her partner actually came into the video screen and was like, oh, and she didn’t get one food poisoning. She ate the food, threw up, put the food back in the fridge, and then ate it again the next day.

And he is like, so she did it twice. We’re like,

Dr. Dominique Vanier, ND: scenario.

Dr. Christina Carew, ND: We’re like, oh, okay. Well that’s probably a pretty clear reason. And it was like very short after her treatment, but a lot of her symptoms came back and we were able to get rid of it very quickly. But yeah, like it, it happens. Things happen.

You get a gastro, you travel, you [00:33:00] drink some bad water.

Dr. Dominique Vanier, ND: Yep. Which is a good, good segue into I think like, well, sibo, another myth, which is SIBO only affects digestion. Yeah, yeah, yeah. ’cause it is a whole body issue, like we’ve talked about. Right? We’re not, we’re not just seeing digestive issues, we’re seeing the brain fatigue.

Brain fog, anxiety, sometimes histamine symptoms. Sometimes we even see like nutrient deficiencies like vitamin D or iron or B12. Yeah, sometimes blood sugar issues. So yeah, like we can see these downstream symptoms happening. Yeah.

Dr. Christina Carew, ND: So maybe a quick list for our listeners of like, when should they ask about SIBO or get considered to be tested for sibo or even talk to a practitioner about sibo.

Certainly anyone that has chronic diarrhea, chronic constipation, and nothing else has helped, I would say that’d be on my list. Anyone that has IBS that isn’t improving, especially if they’ve tried things that help [00:34:00] temporarily, like the low FODMAPs diet or they find that they’re like really restricting.

So people that have. You know, if you’re, you’re moving more than one or two things off your food list, then that certainly is a sign that something else probably might be the signal. Most people aren’t reactive to most foods. If people had reactions to probiotics or fiber, so, that kind of could be back to sort of what Whitney had had led to earlier about, you know, fueling overgrowth or fueling bacteria.

What else would you guys add to that list?

Dr. Dominique Vanier, ND: Probably history of gut slowdowns or disruptions. Things like, well we just mentioned like food poisoning. Oh, repeated antibiotics. That’s an important one. Like, is that part of somebody’s history and it doesn’t necessarily need to be recent. There was this like a recent re study that just came out, I think.

Like a month ago that looked at antibiotics can affect the gut for up to eight, eight years after. So it doesn’t need to be a recent recent usage of antibiotics, chronic [00:35:00] stress or burnout. Again, like that can affect your digestive motility. Hypothyroidism, endometriosis like adhesions, abdominal surgery.

SIBO loves sibo, loves like motility issues. That is, that is a good environment for it.

Dr. Whitney Baxter, ND: Mm-hmm. And then like, yeah, if you are taking your iron supplements, if you eat a diverse variety of foods, you’re not plant-based, but you still have the iron deficiencies, the low B12. Fat soluble vitamins. So vitamin A, D, E, K.

So just like your skin is dry, you feel tired, maybe you’re getting sick often, like maybe you’ve got some nutrient deficiencies that have come up on blood work. Think of SIBO is happening, so it’s our small intestine. That’s where everything’s getting absorbed and delivered to the rest of the body. So that could be a good indicator.

Dr. Christina Carew, ND: So maybe some practical takeaways for people who are trying to narrow down, you know, is this something that’s going [00:36:00] on? We talked a lot about SIBO in, in motility issues or go hand in hand. And so some things that we could suggest if you’re listening to this and you’re trying to figure out, is it my motility?

Is there something else? Like trying to eat regular meals where you actually have time. For everything to pass through the system instead of adding more in like constantly. So people that sort of like picnic or graze all day they’re more likely to kind of have something always in the intestinal tract versus people who have some.

Breaks like three to four hours between a meal so that they actually have time for things to move through the system. I would say that’s like a good place to start. And it’s also a common reason why people have high insulin. People have. More issues with a alertness and energy and fatigue.

So certainly if we can as a society try to eat like three really good meals that are spaced apart, that can certainly be one piece to be like, oh, [00:37:00] is my bloating from that? Certainly we can take a tip from our European colleagues, which is like walking after a meal, just like getting things moving and it doesn’t have to be super long.

Lots of times they’ll tell people like, walk to your mailbox and come back and walk and come back, like just like get a little bit of movement. If you don’t wanna go super far, it’s dark outside or you’re hesitant.

Dr. Whitney Baxter, ND: Mm-hmm.

Dr. Christina Carew, ND: What else would we tell people to try before going too far down the rabbit hole?

Dr. Whitney Baxter, ND: Easy things you can do like right before, during a meal. Just deep belly breathing. If you’re feeling stressed or if you’re used to eating while working. Just like taking a moment with our meal and taking like five deep belly blocks. It massages the vagus nerve. It gets our, it switches into like. Okay, I’m good.

I’m switched outta like gotta run from this bear mode. My body can digest this meal. Super easy to do and it’s not another supplement, which I [00:38:00] always really enjoy. And then, yeah, just like movement. Maybe you’re a person who just needs to turn off the podcast and go outside and just be present.

Dr. Christina Carew, ND: Mm-hmm.

Dr. Whitney Baxter, ND: Listen to the birds and be present during your walk again, sometimes rest and

Dr. Christina Carew, ND: digest. Yeah.

Dr. Dominique Vanier, ND: Yeah. And I think another one is, is just being really mindful of like what, what you have what somebody has removed from their diet so far. Like, we don’t wanna jump right into extreme restriction for reasons that we’ve, you know, already already covered. We just wanna notice patterns, right? Like the foods, the timing, stress, hormones, where you are in your cycle and really avoiding cutting out entire foods.

’cause truly, when it comes to like microbiome health. The health is very much dependent on the input into somebody’s diet, right? Which is like the more diverse somebody’s diet is typically that leads to more like a stronger microbiome health. Because the foods that we eat dictate the species that are in our gut.

So we want species that are diverse and we want, like, we have plentiful species. So [00:39:00] those are, those are some things to think about.

Dr. Christina Carew, ND: And so if we thought about how, how, so using all this information that you’ve now gathered and there is a transcript, so you don’t have to all listen back in 0.5 we can take some of this information and talk to our practitioner, whether that’s a naturopathic doctor or medical doctor, a gastroenterologist or nurse practitioner.

Different people have different understanding and different levels of, understanding of the gut. And so you may have to tell your story a couple of times. But really if, if you’re curious about is this a piece of the puzzle, instead of going into your practitioner and saying, Hey, I have a, I heard this on a podcast, or I saw it on the internet, or I chat GBT, that all of which frustrate them to no end.

I would say it might be easier to go in and say something like, given my history of, you know, endometriosis or thyroid issues [00:40:00] or food reactions, or all these antibiotics I had to use, or my constipation and diarrhea, some of the things we talked about today. I wonder if my motility or my, or a bacteria overgrowth could be causing some of my symptoms.

How, how do you as a. Practitioner, how would you evaluate that? Or, or if you’re not familiar with this, do you have a recommendation of someone that I could see? So in, so kind of bringing, I always say like, bring the information that you collected to the, to the practitioner. And certainly part of, part of the challenge is just like.

We see lots of patients every day, and we do our best to remember all the things that you’ve told us, but we’re not perfect. And so the more things that you catalog or experience or can share with us that help you to lead to what you want investigated can be helpful. Even if you told it to us before, we’re not mad that you’ve told us before.

We’re like, oh yeah, that’s this person. People look similar and their stories are similar and sometimes we forget what we’ve done along the way. [00:41:00]

Dr. Whitney Baxter, ND: Yeah.

Dr. Christina Carew, ND: Okay, so I think we’ve done some pretty good deep diving onto SIBO today. It’s not everything that there is to know, but it’s enough to get you started to say, Hey, is this a piece of my bloating that maybe hasn’t been evaluated?

Or the reverse, this is the thing that I’ve been told that I have, but it maybe that’s not the case. Or I’ve been treated for this 10 times. And certainly things aren’t improving. What are some other things that I can consider? And. As always, we welcome your questions and your feedback so that we can help you to get the information that you need to be able to feel better and to to do anything because better, but gut health changes everything.

Dr. Dominique Vanier, ND: Absolutely. Yay.