WHAT IS BACTERIAL OVERGROWTH?

El small intestine bacterial overgrowth (sibo) is characterized by an increase in the number or a change in the type of bacteria that grows in the small intestine. SIBO can be marked by the overgrowth of pathogenic bacteria or beneficial bacteria, but any form of increased intestinal flora it becomes detrimental to gastrointestinal and systemic health.

SIBO has been a topic of interest in the international gastroenterology community since the late 1990s, and awareness of what augmented bacterial flora means has spread rapidly in the last decade. Despite the general medical consensus on causes, manifestations, and treatments for SIBO, many aspects of this condition remain a mystery.

 

WHY IS THERE BACTERIAL OVERGROWTH (SIBO)?

Causes sibo they are varied and are still under active investigation. It is known that the bacterial overgrowth syndrome It develops when one or more defense mechanisms against bacterial overgrowth are compromised.

These defense mechanisms include:

• Hydrochloric acid to destroy bacteria in the stomach.
• Intestinal motility to keep intestinal contents moving forward.
• Immunoglobulins and pancreatic proteolytic enzymes to stop bacterial growth.
• The ileocecal valve intact to prevent the reflux of the contents of the large intestine into the small intestine.

Thus, the risk factors for SIBO are those that can compromise the different defense mechanisms: achlorhydria, chronic use of acid-blocking drugs, chronic pancreatitis, diabetic neuropathy and immunodeficiency, alteration of the migratory motor complex (MMC), creating waves of smooth muscle contraction to cleanse the gastrointestinal tract, is another major risk factor.

SIBO has also been found to be more prevalent in patients with other gastrointestinal disorders, such as celiac disease, Crohn's disease, and irritable bowel syndrome (IBS), than in the general population.

 

DISORDERS THAT IT CAUSES:

What is meant by increased intestinal flora translates into symptoms derived from three different aspects that can develop depending on the intensity and prolongation of the problem over time:

-Symptoms derived from the fermentation of short chain carbohydrates (sugars): they usually involve nonspecific digestive symptoms. Chronic diarrhea, constipation, bloating, cramps, nausea, acid reflux, flatulence, and belching are common. The digestive symptoms of SIBO are often indistinguishable from the digestive symptoms of IBS or other functional digestive disorders.

-Symptoms derived from a defect in absorption: as SIBO progresses or is prolonged over time, signs of malabsorption may predominate, such as steatorrhea, weight loss, malnutrition, or osteoporosis. In some cases, abnormal laboratory results are the first clue to the presence of SIBO: iron deficiency anemia, marked by low levels of ferritin, can be the result of a combination of occult blood loss and bacterial absorption of iron through intestinal level. Vitamin B12 deficiency can also be the result of bacterial absorption, producing macrocytic anemia. Malabsorption contributes to fat-soluble vitamin deficiencies, including vitamins A, E, and D. Conversely, levels of vitamin K and folic acid can increase as a result of bacterial synthesis.

-Systemic symptoms may also appear due to the alteration of the function of the intestinal barrier. that is, increased intestinal permeability, with joint pain, skin rashes, mood swings, fatigue, hypersensitivity processes and food allergy or autoimmune diseases coexisting.

 

HOW CAN I KNOW IF I HAVE BACTERIAL OVERGROWTH?

Breath tests are based on the concept that ingested sugars will be fermented by bacteria in the small intestine, creating gases (hydrogen and / or methane) that diffuse into the bloodstream and are released into the exhaled air. Hydrogen and methane are produced exclusively in the large intestine in healthy humans, but they are also produced in the small intestine in SIBO patients.

Certain bacteria, including Enterobacteriaceae, Bacterioides, and Clostridium, produce primarily hydrogen rather than methane. Other bacteria, called methanogenic, produce mainly methane. These are members of the Archaea domain, including the Methanobrevibacter and Methanospaere species. The United States Consensus Group recommends that hydrogen, methane, and carbon dioxide be measured simultaneously during breath tests.

That said, the test can be performed using glucose, lactulose or lactitol as a substrate.

The bacterial overgrowth test with lactulose is identical to that of lactitol since they are two substrates that act identically, so from now on everything that refers to the lactulose test will also be valid for the lactitol test.

Glucose test

It is based on the fact that glucose will be fully absorbed in the small intestine of all people. That is, glucose will never reach the large intestine. In this way, what happens when the bacterial flora is increased in the small intestine is that, after the ingestion of a controlled amount of glucose, there will be a peak in the concentration of hydrogen and / or methane due to the fermentation produced. at this level and therefore we would obtain a positive glucose test for SIBO.

Lactulose test

Unlike the glucose test, it is based on the fact that lactulose is not absorbed at all in the small intestine and the entire amount ingested will reach the large intestine intact. Thus, in a positive lactulose test, two peaks will be obtained in the concentrations of hydrogen and / or methane, one corresponding to the fermentation produced by the excess flora of the small intestine and the other to that of the flora of the large intestine.

One of the advantages of the lactulose test over the glucose test is that, as SIBO is more likely to develop in the more distal portion of the small intestine, as glucose is absorbed in the proximal small intestine and lactulose traverses all the way until the colon, it is possible that using the glucose test some SIBO is not detected because it has been absorbed before making contact with the area in which the flora is increased.

 

WHAT ADVANTAGES DOES OUR BREATH TEST PROVIDE FOR BACTERIAL OVERGROWTH?

It is the aspirated air test that has the great advantage of evaluating hydrogen, methane and carbon dioxide at the same time. This circumstance allows AIRTEST to significantly reduce the number of false negatives and have control over the quality of the sample, compared to other breath tests that only quantify hydrogen.

 

PATIENT CONDITIONS

• Not having consumed any antibiotics, performed colonoscopy, barium enema, capsule endoscopy or enteroscopy during the 30 days prior to the test.
• 24 hours before you have to follow a diet without fiber (you cannot eat fruits, vegetables, legumes, cold cuts, carbonated drinks and whole foods).

You can eat grilled meat or fish, eggs, pasta without sauces, white rice and toast. For dinner you can only eat grilled meat or fish and a French omelette.

• Do not brush your teeth, smoke, paint your lips, drink water, or eat food for 8 hours prior to the test.
• Do not do physical exercise for at least 30 minutes prior to the test.
• If you are suffering from diarrhea, it is better to postpone the test or consult your doctor.

 

WHAT DOES IT CONSIST OF AND HOW LONG DOES THE TEST LAST?

This test consists of measuring the hydrogen and methane concentration in the exhaled air before and after administering a solution with a certain amount of lactitol orally, at intervals of 25 minutes to 175 minutes, for which the patient will stay for approximately 3 hours. In our instalations.

 

RESULTS

Results will be available in 7 business days.

 

I NEED A BACTERIAL OVERGROWTH NETWORK (SIBO) WHAT SHOULD I DO?

 

To perform a BACTERIAL OVERGROWTH NETWORK (SIBO):

 

• Comply with the conditions prior to carrying out the AIRTEST.
• We will contact you to give you an appointment.

WHAT IS INTESTINAL PERMEABILITY?

The intestine plays a fundamental role in maintaining our health since it is one of the main ways of contact between our internal environment and the environment through everything we eat. For the proper functioning of the intestine, the functions developed by the intestinal mucosa and by the flora or microbiota are extremely important.

One of the tasks performed by the wall of the small intestine is to absorb or assimilate micronutrients such as vitamins, trace elements, amino acids, fatty acids, ... essential to achieve optimal health.

The role of the small intestine will be optimized, or not, depending on the state of the cells that make up its wall. The intestinal wall behaves like a filter, allowing microelements to pass through and preventing the passage of macromolecules.

An increase in intestinal permeability is due to alterations in the villi and microvilli that are part of the intestinal epithelium composed of a single cell layer and, above all, to alterations in the intercellular spaces of this intestinal epithelium. This alteration causes:

-Massive entry of bacterial or food antigens, entry of pathogens, massive entry of toxins and semi-digested food molecules (peptides, lipids, polysaccharides, ...)

-The repeated introduction of food antigens through the intestinal mucosa could be responsible for immune responses mediated by IgG or IgE antibodies, resulting in a chronic inflammatory reaction.

 

WHAT DOES THE INTESTINAL PERMEABILITY NETWORK CONSIST OF?

In order to determine the existence of altered intestinal permeability, we have a non-invasive test. This is an analysis that consists of making the patient absorb a solution that contains 2 sugar-alcohols, which are not degraded or metabolized by the body and are of different sizes:

• Lactulose: a large molecule (9,5 A), which represents the macronutrients that, under normal circumstances, do not cross the intestinal barrier.
• Mannitol: a small molecule (6,7 A) that represents the micronutrients that, under normal circumstances, are absorbed by the microvilli of the enterocytes.

The urine of the patient is collected in its entirety during the 5 hours after taking this preparation, meanwhile the patient remains fasting and is only allowed to drink water in the last 2 hours of the test.

Once the molecules in the urine sample have been quantified, it is considered that:

• If lactulose, a large molecule, is obtained in a greater quantity than expected, it is considered that the intestinal mucosa has allowed the passage of this excess molecule as a consequence of an increase in its permeability.
• If mannitol, a small molecule, is obtained in a lower quantity than expected, it is considered that it has been poorly absorbed through the intestinal mucosa as a consequence of a decrease in intestinal permeability, which may be related to problems of malnutrition
• If levels of the two molecules considered normal are obtained, it is understood that the intestinal mucosa has normal permeability.

SYMPTOM

• Various inflammatory diseases.
• Autoimmune diseases.
• Allergies
• Eczema.
• Asthma.
• Colitis.
• Joint and / or muscle pain.
• Headaches
• Abdominal swelling
• Diarrhea.
• Crohn's disease.
• Halitosis.

 

PATIENT CONDITIONS

• Urinate on an empty stomach (minimum 6 hours of fasting) and do not save urine.
• Keep fasting until the end of the test.

 

HOW IS THE TEST DONE?

• The patient should drink the recommended amount from a bottle provided by laboratory personnel that contains the sugars necessary to perform the test.
• Then he will collect all the urine during the 5 hours following the ingestion of the solution, using a graduated container for the subsequent measurement of the total volume.
• You can take absolutely nothing for the first three hours. during the last two hours you can only consume water.

The duration of the test will be 5 hours.

 

RESULTS

Results will be delivered within 3 weeks.

I NEED A BOWEL PERMEABILITY NET WHAT SHOULD I DO?

• Comply with the conditions prior to conducting the Test.
• We will contact you to give you an appointment.

WHAT IS INTESTINAL DYSBIOSIS?

Intestinal dysbiosis is an imbalance of the intestinal flora that reduces the absorption capacity of nutrients and causes vitamin deficiencies. This imbalance is caused by a decrease in the number of good bacteria in the intestine and an increase in bacteria capable of causing disease.

WHAT IS INTESTINAL DYSBIOSIS NETWORK?

To reveal intestinal dysbiosis, the assessment of organic metabolites in urine is recommended. This technique provides precise indications regarding fungal or bacterial proliferation at the intestinal level. It consists of identifying and quantifying a series of molecules produced by fungal (yeast and fungi) or bacterial metabolism, which are not produced by human metabolism or modified by its enzymatic system and which are also eliminated through urine. Thus, depending on the metabolites detected, the presence of one or other dysbiotic microorganisms will be distinguished in this test.

SYMPTOM

The main symptoms of intestinal dysbiosis are:

• Nausea
• Gas and belching
• Hair loss
• Weak nails
• Abdominal distension
• Altered periods of diarrhea and constipation
• Poorly formed stools
• Headache
• Tiredness
• Recurrent candidiasis

PATIENT CONDITIONS

Collect the first morning urine (preferably on an empty stomach) in a sterile container.

RESULTS

Results will be available in 3-4 weeks.

I NEED A BOWEL PERMEABILITY NET WHAT SHOULD I DO?

• Comply with the conditions prior to conducting the Test.
• We will contact you to give you an appointment.