Do you have an older loved one in your life who seems to be wasting away no matter what you do to keep them nourished and healthy? This may be due to a condition called SIBO, or small intestinal bacterial overgrowth. SIBO happens when bacteria that normally belong in the large intestine travel backwards to colonize the small intestine. The small intestine is where we absorb the majority of our nutrients. Because SIBO inflames and damages the small intestine, this prevents these vital nutrients from being absorbed. As a result, the body and brain cannot function efficiently and it is difficult to maintain weight.
For most people, symptoms of SIBO are straightforward. One of the most common symptoms is bloating after eating, particularly after eating grains, desserts, or other starchy foods. Other SIBO symptoms include gas, belching, indigestion, heartburn, nausea, abdominal pain and cramping, and either constipation, diarrhea, or both.
Doctors often misdiagnose SIBO as irritable bowel syndrome (IBS), as the symptoms are so similar. In fact, SIBO has been found in more than 80 percent of patients diagnosed with IBS.
Most doctors and patients haven’t heard of SIBO and blame such a rapid decline in the elderly on aging. However, researchers have identified SIBO, which is treatable, as the leading cause of malabsorption, and thus wasting away, in older adults.
SIBO doesn’t always result in malabsorption and wasting away. People can fall anywhere along a range of symptoms, from asymptomatic to the severe. But those who fall in the middle of the spectrum can become progressively worse. That’s why complaints of bloating and gas after meals should be taken seriously and not thought of as normal.
As SIBO and malabsorption worsen, nutrition status can plummet. Levels of B vitamins drop, which impacts many functions in the body, including brain function. Inflammation may also increase as the body’s ability to regulate immune function deteriorates. Also, it seems no matter how much older adults suffering from SIBO supplement, they cannot improve their low vitamin D status or persistent anemia.
The most devastating consequence of untreated SIBO and malabsorption is that it profoundly affects brain health and function, increasing the risk of dementia. It also saps energy and vitality. When an older person complains of bloating and distention after meals, it should not be dismissed as a minor complaint but rather regarded as a red flag indicating for more serious problems down the road.
A variety of things can cause SIBO, including antibiotic use, poor diet, and digestive damage, such as from a long-standing undiagnosed celiac condition.
In older adults (and in those who have sustained a concussion or brain injury), another cause to watch out for is declining brain function. The digestive tract depends on healthy brain function to work properly. When signals from the brain to the gut are inadequate, the ileocecal valve which separates the large intestine from the small intestine, may weaken and allow contents from the large intestine to travel backward into the small intestine, where they colonize. It is not the bacteria themselves that cause SIBO symptoms, but the byproducts they produce. These bacteria also compete with the host for protein from food.
Treatment for SIBO includes a strict diet to starve the bacteria, as well as targeted botanicals to kill them. Doing specific exercises to improve communication between the brain and the gut can also help prevent SIBO from perpetuating.
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