May 8, 2023
SIBO is a condition that affects bacteria in the small intestine, causing symptoms like bloating and diarrhea. Fecal microbiota transplantation (FMT) has not yet been studied for SIBO but its effectiveness in treating other microbiome related conditions suggest that it could soon be explored as a treatment for SIBO.
We will explore the potential of FMT for SIBO in the following sections.
Before we jump into the possibility of FMT to treat SIBO, let’s break down what exactly SIBO is.
SIBO stands for Small Intestine Bacterial Overgrowth and it is a disease involving excessive bacteria in the small intestine. SIBO occurs when bacteria from the stomach and large intestine make their way to the small intestine, grow and eat up resources meant for the microbes of the small intestine.
This may result in weight loss and malnutrition in its sufferers, among other symptoms such as indigestion and gas.
SIBO occurs when bacteria from other parts of the gut start to grow in the small intestine. The bacteria present can start to eat up nutrients and cause malnutrition in SIBO sufferers. Though there is no known cause of the bacterial overgrowth, certain conditions may predispose you to developing it. They include:
SIBO has also been associated with pH changes in the bowel, a compromised immune system and issues with the muscular functions of the small intestine.
The symptoms of SIBO are almost entirely restricted to the gut. Symptoms of SIBO are characterized by their persistence and their appearance is often onset by the consumption of irritating foods.
The common first step in treating SIBO is antibiotic use. Antibiotics are prescribed to control the growth of the unwanted bacteria in the small intestine. Many find relief from symptoms by following specialized diets. Probiotics may also be prescribed in an attempt to regulate the bacteria in the gut.
Though antibiotic use can provide temporary relief from the condition, they won’t address the underlying issue causing the invasive bacteria leading to recurrence in many people with the condition. In fact all the current treatments of SIBO are not particularly effective long term solutions for the condition. FMT presents potential long term relief of the symptoms of SIBO.
The microbiome plays a key role in human health and the upset of microbial balance in the body can lead to a plethora of health issues. Many diseases associated with SIBO are linked to dysbiosis of the gut, but it has not yet been determined if SIBO itself, is also affected by dysbiosis of the microbiome.
The microbiome is communities of bacteria, protozoa, viruses and fungi that exist on and inside our bodies. They play crucial roles in the function of our digestive system, immune system and even the functions of our brains. Microbiomes exist within niches, for example there is a gut microbiome, oral microbiome and skin microbiome.
Microbiome dysbiosis is common in many of the comorbidities common with SIBO. Dysbiosis of the gut microbiome may itself be a contributing factor to the small intestine bacterial overgrowth. There is growing evidence to suggest that there may be a link, but more research is needed to understand this interplay.
There have been no studies on FMTs efficacy for treating SIBO. Though SIBO is associated with a lot of conditions that have been found to respond to FMT. And because SIBO effects bacteria within the small intestine, and FMT is used to balance the microbiome, it is not a stretch to think FMT might be worth studying.
FMT is a treatment in which stool is taken from a healthy donor and implanted into the gut of a sick person. Fecal transplants work by engrafting the colon of a sick person with good bacteria from the donor. The good bacteria then has the potential to help balance the bacteria in the gut, reversing dysbiosis.
As SIBO often has comorbidities that are microbiome related, treating SIBO symptoms with FMT may be a possibility. FMT is used to treat dysbiosis in the gut microbiome and SIBO itself is a form of microbiome dysbiosis. The question that must be answered before FMT can be considered for SIBO is what causes it in the first place, as of yet the mechanism of how SIBO occurs is not well enough understood.
A study looking at the efficacy of fecal transplants for the treatment of chronic intestinal pseudo-obstruction (CIPO), of which 30% of patients also suffer from symptoms of SIBO, was performed at Nanjing University’s School of Medicine. In the study 9 patients received FMT through nasojejunal (NJ) tubes for 6 consecutive days and were followed for 8 weeks after.
The studies results state that SIBO was eliminated in 71% of the subjects. Though the study was undeniably very small and the focus was not particularly on SIBO, it is interesting that SIBO in most of the CIPO patients was relieved.