Speaking SIBO with Dr. Michael Ruscio

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In this episode of The Functional Medicine Radio Show, Dr. Carri’s special guest Dr. Michael Ruscio explains everything you need to know about SIBO – Small Intestinal Bacterial Overgrowth.

Dr. Ruscio is a naturopathic doctor and expert in Functional Medicine. In addition to being in private practice, he also researches and lectures nationally to doctors and students. Dr. Ruscio is also currently writing a book on Hypothyroidism and Hashimoto’s. He is a leader in the functional medicine movement to focus on treating the cause of disease rather than medicating symptoms.

Main Questions Asked:

How did you get into functional medicine?
What is SIBO exactly?

What are some of the signs and symptoms of SIBO?
What are the real ‘red flags’ that make you think your patient has SIBO?
How do we test for SIBO?
What are the treatment options for SIBO?
Where does SIBO come from in the first place? What is the root cause?

Key Points made by Dr. Ruscio:

SIBO stands for Small Intestinal Bacterial Overgrowth.
SIBO symptoms are very similar to IBS (irritable bowel syndrome): gas, bloating, constipation, diarrhea, or abdominal pain.
Non digestive symptoms include: fatigue, joint pain, or depression.
There should be no bacteria in the small intestine. SIBO can cause damage to the intestinal lining similar to celiac disease or full blown gluten allergy.
My ‘red flags’ for SIBO are: digestive upsets, skin conditions, headaches, fatigue, rheumatoid arthritis.
Basically if you’ve changed your diet and still have symptoms then it’s time to get checked for SIBO.
If you feel worse after taking probiotics this is another ‘red flag’ that you may have SIBO.
Rosacea, fibromyalgia, restless leg syndrome, painful periods, high cholesterol, obesity can all be caused by SIBO.
SIBO testing is done by a hydrogen breath test. You drink a solution and then collect breath samples over 2-3 hours. If too much hydrogen or methane (or both) are found then you have SIBO.
Testing can be done at home with a convenient test kit.
Benefits of testing: you know if you have SIBO or not; and we know how easy or difficult it is to fix!
Mild cases of SIBO usually take one round of treatment to clear.
Moderate cases of SIBO take 2-3 rounds of treatment.
Severe cases of SIBO can take more than three rounds of treatment to clear.
Treatments to kill off or starve the bacteria include: herbal antimicrobials like oregano, grapefruit seed extract, and berberine; pharmaceutical antibiotics (Rifaximin and Neomycin); or a liquid diet called the Elemental Diet.
Once you’re done with treatments it’s important to retest to make sure the SIBO is actually gone (even if you’re feeling great!) or the SIBO will grow back.
The root causes of SIBO include medications (like painkillers and acid blocking medications), and impaired motility/movement in the small intestine causing the area to go stagnant and breed bacterial overgrowth.
Once people clear SIBO it’s really important to prevent the SIBO from growing back. Dr. Ruscio will be doing a formal research study on this so if you’re interesting in being in his study contact his office directly.