The Connection Between Lupus and SIBO

by | May 9, 2019 | Lupus Blog | 0 comments

For as long as I remember, I’ve always had digestive issues since an early age. 

Little did I know then what I know now about gut permeability and how we can alter the course of our disease.

I’ve struggled with gut issues and continue to work proactively to promote healthy balance.

This is because as soon as I veer off course, my gut tends to get irritated, fast.

As an autoimmune patient, I am very careful with what I put into my mouth. 

I’ve had multiple courses of antibiotics and various medications for Lupus over the last 19 years.

I’ve learned that as long as I can keep my gut health in check, all signs and symptoms of Lupus are eliminated.  

In functional medicine, we know that if a patient has an autoimmune condition, especially Lupus, then they have gut permeability issues.

This issue is commonly known as leaky gut.

I don’t know about you, but I have strong aversions to various foods.  My gut is very unpredictable.

My gut can get bloated and irritated most commonly with wheat, proteins, certain vegetables, and fruits.  

But I believe the severity of these issues also depend on my stress level when eating.

Food is Not the Enemy

I’ve been obsessive about eliminating foods so much so that sometimes I feel I don’t eat enough of the good foods that my body desperately needs.

The more I learn, the more I realize that it’s not ok to forever eliminate the foods that cause you to react. 

The whole point to therapeutic intervention is to be able to eat just about any foods that you are used to eating, without having to deal with the consequences.

My wish for you is that food no longer is the enemy. 

We should be able to enjoy a slice of cake, glass of wine, or a cup of coffee in the morning without feeling like you have to make a run to the bathroom or pay for such pleasures for days with terrible symptoms.

So if you are prone to digestive issues and suspect you have some food sensitivities, you just may have SIBO.

What is SIBO?

SIBO is an acronym for small intestinal bacterial overgrowth.

Normally, most of our microbiome or gut bacteria (both good and bad) reside in our large intestine.  For those affected with SIBO, we see an overgrowth of bacteria in the small intestine. 

The problem with SIBO is that such bacteria react with poorly-digested, fermentable carbohydrates. This reaction produces uncomfortable symptoms such as bloating, gas, abdominal pain, diarrhea and/or constipation.

The effects of SIBO can extend beyond gut symptoms. 

As those bacteria continue to thrive where they don’t belong, they excrete acids that can cause neurological symptoms, including brain fog and fatigue. 

This can eventually lead to leaky gut, causing bacteria and undigested foods to trigger the immune system, ultimately leading to various other symptoms and disease.

It also can trigger food sensitivities in certain individuals, creating more complex health problems long term.

Over time, such individuals are at risk for nutrient deficiency because the bacteria begin to impede on one’s ability to absorb much needed nutrients such as B12 and iron. 

Such deficiencies commonly present as anemia and can alter one’s ability to absorb fat soluble vitamins.  

We now know and understand that patients with SIBO also tend to have altered immune secretions in the gut, which is proof that SIBO directly alters immune activity in the gut.

What Causes SIBO?

There are three primary causes of SIBO.

1. Digestion delay

Our gut is a smooth muscle that contracts to propel ingested food along its pathway. 

It’s vital that there’s no stagnancy in the intestine. Disruption of digestion encourages bacterial overgrowth and prevents excess bacteria from clearing out of the small intestine.

2. Fast digestion

On the other hand, if food passes through the bowel too quickly, such as in short bowel syndrome, it can also be a problem since there is not enough time for proper digestion and absorption.

3. Altered digestive secretions

We need sufficient stomach acid, bile, and enzymes to maintain healthy bacterial levels in the small intestines.

If those digestive secretions are compromised, an imbalance results and is primed for bacteria to flourish.

What Triggers SIBO?

Research implies the following can serve as triggers for SIBO:

1. Hypochlorhydria (low production of hydrochloric acid in the digestive track)

2. Chronic antacid therapy (especially with PPIs or H2-blockers)

3. Gastroparesis (secondary to diabetes type I or II): motility of the stomach is abnormal or absent

4. Gallbladder/bile dysfunction

5. Pancreatic enzyme deficiency

6. Slow-transit constipation

7. History of bulimia

8. Multiple courses of antibiotics

9. Ileocecal valve incompetence

10. Diet rich in sugars and simple carbohydrates

11. Heavy alcohol use

12. Stress

Predisposing Factors of SIBO

1. Hypothyroidism

Because thyroid function is vitally important for all cells of the body, including the cells of our gut, hypothyroidism can cause digestion delay.

2. Diabetes

Diabetes causes oxidative damage due to high blood sugar, which can lead to deterioration of vision, kidney function, and peripheral blood vessels.

This ultimately slows digestion, causing a delay.

3. Chronic stress

When the body is stressed, its gut function is altered. 

This also affects the enteric nervous system (part of our nervous system responsible for our digestion) which controls the propulsion of food along the digestive tract.  

4. Immune system compromise

SIBO compromises our immune system by reducing IgA secretion in the gastrointestinal tract, which assists in preventing bacterial proliferation.

5. Abdominal adhesions

Abdominal adhesions, otherwise known as scar tissue, can result from chronic inflammation (e.g. Crohn’s Disease), infection or surgery. 

This can create an obstruction or disruption to the intestines and/or impair the digestive capability, both of which can predispose one to SIBO.

Small intestinal bacterial overgrowth has become a significant health problem in clinical practices.

SIBO in patients with irritable bowel syndrome (IBS) ranges from 4-78% (higher prevalence in diarrhea-predominant IBS) [1].

It is understood to be almost as high in many other disorders of the digestive tract.

SIBO is clinically defined as an increase in the concentration of bacteria of more than 100,000 colony-forming units per mL in the small intestine.  

SIBO can lead to malabsorption and malnutrition that simulates celiac disease, or milder symptoms similar to IBS – all indicative of a disruption of natural protective mechanisms of the gut.

These factors predispose the gut toward dysbiosis.

Testing for SIBO

Testing for SIBO is most often through a less invasive breath test that detects both methane and hydrogen sulfide gases, using one of two sugars (glucose or lactulose) to induce the gas production.

Since methane and hydrogen sulfide are not produced as metabolic byproducts of human cells, the expired gas during a three-hour breath test is generated by bacterial fermentation as the provoking solution travels through the gut.

Treatment of SIBO

Conventional treatment for SIBO is antibiotics, however the response to these regimens is variable and inconsistent.

A study from Johns Hopkins Hospital compared the effects of rifaximin (1200 mg/day) to daily, concentrated herbal therapy for 4 weeks in patients with newly diagnosed SIBO. [2]

The herbal therapy intervention included a concentrated berberine formula and concentrated aromatic essential oil formula. Study results are as follows.

Herbal therapies were as effective as rifaximin for resolution of SIBO.

For rifaximin non-responders, the herbal therapies were as effective as triple antibiotic therapy for SIBO rescue therapy.

Many adverse side effects were reported in the rifaximin treatment arm, while only 1 case of diarrhea was associated with the herbal therapy intervention.

In conclusion, the herbal therapies demonstrated equal effectiveness for SIBO resolution as compared to the antibiotics regimen.

Furthermore, the herbal therapies were associated with significantly fewer, milder side effects. [2]

Alkaline Solution for SIBO

As a Lupus patient, I’ve struggled with IBS, diverticulitis, and SIBO over time. 

I’ve been given various antibiotic treatments for such symptoms which caused worse side effects. This then led me to be more susceptible to the initial issue of leaky gut.

The link between autoimmunity and gut permeability is valid. As such, we must start to heal our leaky gut to reverse the symptoms of autoimmunity.

The prevalence of autoimmune patients is astounding.  We are seeing a surge of autoimmune disorders clinically and we need to think differently about addressing our symptoms.

The old paradigm of putting a temporary bandaid over a problem is no longer viable.  

As patients, we must be proactive in our healthcare to take responsibility, rather than be subject to ineffective treatment protocols.

What makes logical sense is to REMOVE the triggers, REPLENISH the gastric secretions, such as hydrochloric acid, pancreatic enzymes, herbals, and probiotics, and REBALANCE your lifestyle by decreasing stress, eating healthy whole foods, and exercising.

We’ve got the full blown Alkaline Detox Protocol I’ve created and applied for myself as well as thousands of my patients.

Our hope is to help you not only reverse your symptoms, but help you to thrive.

If you suspect you suffer from SIBO and would like to schedule a consult, get tested, and treated, please email [email protected] or call us at 678-335-5566.

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See you next time.


[1] Ghoshal UC, Srivastava D. Irritable bowel syndrome and small intestinal bacterial overgrowth: meaningful association or unnecessary hype. World J Gastroenterol.2014;20(10):2482-2491.

[2] Chedid V, Dhalia S, Clarke JO, et al. Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth. Glob Adv Health Med. 2014;3(3):16-24.

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