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What is SIBO?

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What is SIBO? with Dr Nirala Jacobi

Bloating, foul-smelling wind, chronic abdominal discomfort, nausea, even malnutrition. These are all symptoms of SIBO - Small Intestinal Bacterial Overgrowth.

Unlike the large bowel, the small intestine is ordinarily home to much more modest numbers of bacteria under normal conditions. SIBO is largely caused through poor diet and digestion, overuse of antibiotics and antacid medications, or some physical abnormalities. Its characteristic symptoms often don’t respond to traditional GIT therapies making it essential to have an expert to guide you through treatment.

This is where Dr Nirala Jacobi comes in. Educated in the US, where naturopaths undergo pre-med before specialising in natural medicine, Dr Jacobi takes us through this rapidly emerging field of SIBO, including how to test, how to treat and where to gain further education in this area. 

Covered in this Episode

[00.50] Meet Dr Nirala Jacobi
[01:58] What is SIBO?
[02:35] Understanding SIBO Pathogenesis
[04:36] What is vinculin?
[06:13] What is the most common risk factor for the development of IBS?
[07:58] The problem with Proton Pump Inhibitors (PPIs) - particularly in youth
[08:50] Is SIBO recognised in the Rome Criteria?
[10:25] Can SIBO be prevented?
[12:06] Differentiating between SIBO from IBS
[13:45] Associated conditions in the SIBO
[15:06] Testing options to identify SIBO and other GIT disorders
[15:45] Understanding the lactulose and glucose breath test
[19:32] How is the SIBO breath test different to the breath test for H. pylori?
[20:03] Lets explore the body of evidence
[22:40] SIFO (Small Intestinal Fungal Overgrowth)
[23:02] The connection with Zonulin
[25:16] Is testing necessary - should we just treat without testing?
[26:13] What kind of bacteria are you dealing with? Understanding methane-dominant vs hydrogen-dominant bacteria
[27:18] Credit to Dr Allison Siebecker, Naturopathic Pioneer of SIBO
[29:00] Key treatment options - blending naturopathic with conventional medicines
[31:40] The Bi-Phasic Diet for SIBO - more than just FODMAPs
[33:48] Pro-Kinetics: improving motility 
[34:32] FDA recently approved a specific antibiotic therapy for SIBO 
[36:09] The effectiveness of natural treatments
[38:50] A call to action
[39:00] SIBOtest.com - online testing service & resources in Australia
[39:40] Australian Naturopathic Summit & the SIBO Summit
[41:30] Changes in mucosal composition in the small vs large bowel
[44:14] Is there a possible connection with non-coeliac gluten sensitivity?
[46:22] Where to from here? Opportunities to learn more


Resources Mentioned in this podcast

Dr Nirala Jacobi is the owner and medical director of SIBOTest, based in Byron Bay Australia.

As mentioned in the podcast, SIBO is recognised by the "Rome Criteria" - a diagnostic tool for clinicians for the recognition of "Functional Gastrointestinal Disorders" (FGID). 

The Rome Foundation is an independent not for profit organization that provides support for activities designed to create scientific data and educational information to assist in the diagnosis and treatment of functional gastrointestinal disorders.

 The Bristol Stool Chart is available as a PDF download from the Bladder and Bowel Foundation website



Nirala gives credit to Dr Alison Siebecker and mentions that her website: siboinfo.com is a great resource for SIBO information. 



The information provided on FX Medicine is for educational and informational purposes only. The information provided on this site is not, nor is it intended to be, a substitute for professional advice or care. Please seek the advice of a qualified health care professional in the event something you have read here raises questions or concerns regarding your health.

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