Histamine intolerance and SIBO

SIBO stands for "Small Intestine Bacterial Overgrowth" and refers to an overgrowth or miscolonization of bacteria in the small intestine (colonic bacteria).

These bacteria can be excessively disease-promoting and inflammatory, and some of them are even strongly histamine-producing.

Due to histamine production and the overload on the intestine, SIBO can be a cause of histamine intolerance.

The normal or health-promoting frequency of intestinal bacteria in the small intestine per milliliter of small intestinal fluid is up to 1,000 bacteria/ml.

Under normal circumstances, the small intestine is responsible for the metabolism of nutrients. This results in only a slight reflux of gases from the large intestine into the small intestine. In small amounts, these gases are not a problem for the body, as they can be absorbed and transported away by the blood.

In the case of SIBO, the frequency of small intestinal bacteria is between 100,000 and 1 million intestinal bacteria/ml.

This overgrowth in the small intestine leads to the following processes

• The bacteria in the large intestine must now metabolize the food, as the small intestine can only perform minimal metabolism
• As a result, the chyme is fermented in the large intestine
• This process generates gases
• These gases reach the small intestine through reflux
• The small intestinal wall expands due to the gases
• Development of pain

Possible causes of SIBO

Compared to the large intestine, the small intestine is relatively low in bacteria. The small and large intestines are separated from each other by a valve (the ileocecal valve). If there is increased gas formation in the large intestine (large intestine bacteria ferment food, which leads to the formation of gases), the pressure on the ileocecal valve increases, which can cause it to open. As it opens, bacteria from the large intestine move into the small intestine.

Furthermore, the intestine cleans itself several times a day, and especially at night, through so-called cleaning waves. These are downward-directed contractions caused by intestinal peristalsis (the intestinal tract), which, on one hand, move the chyme forward and, on the other, clean the intestinal wall. Through this process, bacteria can also be moved back from the small intestine into the large intestine.
This cleaning process can be impaired by the following factors and influences:

1. Frequent snacking between main meals
2. Lack of physical activity
3. Stress
4. Medications

In addition, irritable bowel syndrome (IBS) can be a cause of SIBO due to altered intestinal motility; conversely, SIBO can also cause an irritable bowel.

Typical symptoms of SIBO

• Bloating, flatulence
• Diarrhea
• Nausea
• Vomiting
• Nutrient deficiencies (the body absorbs nutrients poorly)
• Weight loss
• Exhaustion and fatigue
• Headaches
• Altered stool frequency
• Pressure on the bladder/bladder pain
• Blemished skin
• Food intolerances (histamine, gluten, lactose, fructose, sorbitol, salicylates)

Testing is possible via a breath test (similar to that for fructose intolerance). It is best to make an appointment with a gastroenterologist for this.

SIBO types and their treatment

Did you know that 3 different types of SIBO have now been researched? Two of them can already be measured in Germany using a lactulose breath test. These include:

• Hydrogen SIBO (H2): There is often a reaction to starch in food
• Methane SIBO (CH4): Foods with a high FODMAP content can trigger symptoms

The third form is somewhat less well-known and is called hydrogen sulfide SIBO (H2S). In this case, sulfur-containing foods should be avoided. The various SIBO types can occur individually or in combination, and the symptoms are similar for all 3 forms. Therefore, the type can only be identified through a test or an elimination diet.

Even with SIBO, selected bacterial strains can play a role in your personal routine. Our BioticFit S combines three spore-based bacterial strains with acacia fiber and zinc and, thanks to the practical capsules, is easy to integrate into everyday life.

Since tolerance in SIBO can be very individual, you should always pay attention to your body and your personal tolerance.

NEW: Natural SIBO treatment

There are new findings regarding the treatment of both hydrogen SIBO and methane SIBO – and not just through medication, but also naturally through diet and the right nutrients! This involves starving and killing the gas-producing bacteria that have colonized the intestine in excessive numbers. The various SIBO bacteria feed on different components of our food, such as starch or certain types of sugar. In addition, there are natural antibiotics that can be taken.

Sources

• Posserud I, Stotzer PO, Björnsson ES, Abrahamsson H,Simrén M. Small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Gut. 2007;56:802–8.
• Phillips SF, Quigley EM, Kumar D, Kamath PS. Motility of the ileocolonic junction. Gut. 1988;29:390.
• Roland BC, Ciarleglio MM, Clarke JO, et al. Low ileocecal valve pressure is significantly associated with small intestinal bacterial overgrowth (SIBO). Dig Dis Sci. 2014;59:1269.
• Rubio-Tapia A, Barton SH, Rosenblatt JE, Murray JA. Prevalence of small intestine bacterial overgrowth diagnosed by quantitative culture of intestinal aspirate in celiac disease. J Clin Gastroenterol. 2009;43:157–61.
• Khoshini R, Dai SC, Lezcano S, Pimentel M. A systematic review of diagnostic tests for small intestinal bacterial overgrowth. Dig Dis Sci. 2008;53:1443.
• https://link.springer.com/content/pdf/10.1007/s00112-002-0507-y.pdf