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Bacterial overgrowth in the small intestine

Bacterial translocations

Bacterial translocations are the migrations of intestinal bacteria to other organs, such as mesenteric lymph nodes, liver, kidneys and blood.

Translocations are caused by:

  • imbalances in intestinal environment, which cause bacterial growth, for example when the pancreas does not produce a sufficient amount of gastric juice, or the liver produces too little bile
  • increased permeability of intestinal mucosa
  • nutritional deficiencies in the body

SIBO – Small Intestinal Bacterial Overgrowth

One of the types of bacterial translocations is the SIBO (Small Intestinal Bacterial Overgrowth) syndrome. The migration of bacteria from the large to the small intestine produces symptoms similar to “short bowel syndrome.” It is responsible for organ changes: fatty liver, followed by fibrosis and cirrhosis of the liver, or inflammation of the pancreas. They can cause sepsis, or systemic inflammatory syndrome caused by an infection. They also lead to hypoxia (underoxidation) of tissues, and to lactic acidosis.

In children with autism, often an elevated level of lactic acid can be observed. Doctors usually do not know the cause, and they assume that one of the reasons may be a congenital disease called mitochondrial myopathy. However, one fact not always considered is that lactic acidosis may also be caused by bacterial translocations.

Some of symptoms of SIBO are:

  • bloating, nausea, vomiting, appetite loss
  • weight loss, or stunted growth in children
  • nutritional deficiencies, including iron, vitamin B12, biotin
  • steatorrhea (fatty stool)
  • tiredness, muscle and joint pains, memory disorders

Due to SIBO, many of autistic patients experience issues with height. Also particular to SIBO is a distension of the upper abdomen.

The reasons for small intestine bacterial growth include peristalsis disorders (constipation), celiac disease (gluten intolerance) and other food intolerances. Other contributing factors may be surgery or anatomical anomalies, as well as inflammation of the pancreas or bile deficiency, which cause imbalances in intestinal environment, or immunity disorders, including decreased immunoglobulin A (IgA) levels.

Providing a definitive diagnosis is based on aspirates, or tissue samples taken from the intestine. Additional available options are breath tests and a relatively new test for metabolites (organic acids) in the urine. The last is a very good indicator of bacterial overgrowth in the intestine in case of SIBO.

Treatment of SIBO is based on:

  • administering antibiotics and cycling them, in order not to allow for immunity to develop
  • treating the cause of the disease, e.g. inflammation of the pancreas, or lowered immunity
  • adhering to a proper diet with lowered carbohydrates (SCD diet)