Bloating, abdominal pain, belching, reflux, diarrheoa and or constipation, headaches, migraines, skin flushing, hives, eczema……..these are SOME of the symptoms of SIBO and histamine.
What is SIBO?
Small Intestinal Bacterial Growth (SIBO) occurs when there’s an increased number and / or abnormal type of bacteria in the small intestine. This is called dysbiosis.
SIBO is the major cause of irritable bowel syndrome (IBS).
The small intestine naturally contains bacteria, but fewer in number than the large intestine. When the number and / or abnormal type of bacteria increases in the small intestine, carbohydrates are fermented by these bacteria causing the release of methane and hydrogen gasses. These gasses cause many of the symptoms of IBS as well as damage the intestinal wall (leaky gut).
Signs and Symptoms of SIBO
- Frequent belching especially after meals
- Abdominal pain or discomfort
- Diarrhea or constipation
- Foul smelling gas
- Lactose intolerance
- Fructose intolerance
- Gluten intolerance
- Multiple food sensitivity
- Joint pain
- Chronic fatigue syndrome
- Interstitial cystitis
- Headaches or migraines
- Restless legs
- B12 deficiency
- Iron deficiency
- Acne rosacea
- Probiotics or prebiotics make symptoms worse
- Fibre makes constipation worse
- Significant improvement in symptoms from taking an antibiotic. Then within 1-3 weeks symptoms come back
What causes this overgrowth of unwanted bacteria in the small bowel?
- Use of proton pump inhibitors (medication used for reflux) which causes low stomach acid
- Overconsumption of processed carbohydrates
- Overuse of antibiotics
- Chronic stress causing low stomach acid
- Chronic constipation
- Post infectious gastroenteritis
- Bile acid insufficiency (this can be due to methylation issues as methylation is needed to make bile acids)
- Chronic pancreatitis
- Opiates including morphine and codeine
- Small bowel diverticula
- Crohn’s disease
- Short bowel syndrome
- C-section birth and no breastfeeding
SIBO & Histamine Link
Dysbiosis in the small bowel causes inflammation and the subsequent release of histamine from mast cells. The DAO enzyme in the small bowel which degrades histamine is then overloaded with histamine and can’t get rid of it all. Histamine then gets into the bloodstream causing numerous issues including:
- Headaches and migraines
- Night sweats
- Heart palpitations
- Shortness of breath
- And much more
SIBO, MTHFR & Methylation
There is a very interesting link between methylation and SIBO.
Methylation is needed to make phosphatidycholine which makes bile acids.
Bile acids regulate the pH of the small intestine. When the pH is altered due to low bile acids, dysbiosis and SIBO occurs.
This can become a huge self perpetuating problem, as SIBO reduces Vitamin B12 absorption. Vitamin B12 is an essential nutrient in methylation required for the remethylation of homocysteine to methionine along with methylfolate for the formation of SAMe (the major methyl donor). It’s these methyls that produce phosphatidycholine!!
Furthermore, if you have MTHFR and inadequate methylfolate, the body will use choline to re-methylate homocysteine to methionine via the BHMT enzyme which will deplete your stores of choline which is needed to make phosphatidylcholine.
- Support stomach acid with betain hydrochloride.
- Support bile acid production with taurine and phosphatidycholine or supplementation with ox-bile (essential if you have had your gallbladder removed).
- Support methylation for long term bile acid production.
- Reduce the overgrowth of unwanted bacteria in the small bowel with garlic and / or berberine.
- Reduce histamines in the diet to take the load off the DAO enzyme.
- Supplement with the DAO enzyme before meals.
- Correct nutrient deficiencies in the short term with supplementation (B12 in particular as this is essential for methylation).
- Repair the damaged intestinal wall with glutamine, zinc, vitamin A and Vitamin D.
- If you have constipation dominant SIBO, get the bowels moving with high dose magnesium (approx. 600mg) per day whilst working on all the above.