SIBO also known as small intestinal bacterial overgrowth is one of the underlying causes of acid reflux. Poor upper digestive function in the form of low stomach acid, insufficient enzyme production, poor liver gallbladder function and poor bile flow can allow for bacteria to proliferate in the small intestine and contribute to the uncomfortable symptoms of acid reflux and indigestion.
How does SIBO cause acid reflux?
When there is an excessive amount of bacteria in the small intestine as in the case with SIBO these bacteria produce gas which builds up and puts pressure on the small intestine and stomach (hello bloating). When enough pressure builds up it can push the acid from the stomach up into the esophagus causing the common symptom of acid reflux. Fermentation from bacteria in the small intestine is how SIBO can cause acid reflux
Symptoms of SIBO
Acid reflux is one of the symptoms of small intestinal bacterial overgrowth. Other common symptoms of sibo include bloated stomach, burping, upper abdominal bloating, diarrhea, heartburn, indigestion, excessive gas, bloating after eating, stomach pains and intolerance or increase of symptoms to prebiotics such as resistant starch found in bananas and potatoes or high FOD MAP foods such as onion, garlic and asparagus.
Foods to avoid with heartburn
While most people notice that spicy or acidic foods may trigger heartburn due to an inflamed gut lining or release of histamine in response to high histamine foods what people often miss is that it is the fermentable carbohydrates and difficult to digest carbohydrates and refined carbohydrates that are really problematic when sibo is the cause of heartburn.
Highly fermentable carbohydrates are resistant starch’s found in bananas and potatoes or high FOD MAP foods such as onion, garlic and asparagus. Corn, legumes, wheat and high fiber are are also often problematic, therefore these are foods to avoid if someone has SIBO and acid reflux or if you notice any of these highly fermentable foods as your trigger.
High refined carbohydrate foods are full of sugar which is fuel for bacteria to feed upon and grow in excess so if you notice that your acid reflux or abdominal bloating occurs after eating these foods or act as a trigger for heartburn it is likely that sibo is the underlying cause to your acid reflux.
Understanding the SIBO and acid reflux connection
When the terrain of the small intestine gets out of balance due to poor digestive function bacteria that is meant to thrive in the large intestine begin to grow in excess in the small intestine causing small intestinal bacterial overgrowth also known as SIBO. These bacteria are fed by prebiotics which are undigestible fibers that are fermented by gut bacteria and are fuel to our microbiome. These high FOD MAP, prebiotic fermentable foods become problematic when there is an excess of bacteria in the small intestine that ferment upon these fibers and thus produce excessive gas that puts pressure on the stomach causing acid reflux and bloating.
Following a low carbohydrate (especially refined carbohydrates) and low fermentable diet for a period of time can be beneficial by limiting the fuel needed by bacteria to thrive.
How to prevent heartburn naturally
If Sibo is underlying your heartburn symptoms then the answer to relieving your reflux starts with improving your digestive function and terrain of the small intestine to prevent the overgrowth of sibo in the small intestine.
Improving bile production and flow is key to preventing small intestinal bacterial overgrowth as bile is our bodies natural anti-microbial that helps to sterilize and keep the small intestine clean and free of excess bacteria. Seeking health’s liver nutrients helps to improve bile flow along with optimal pc
Providing digestive support in the form of seeking health’s digestive enzymes is key in ensuring the breakdown of all food, carbohydrates while also helping to breakdown fibers so that there isn’t undigested carbs for bacteria in the small intestine to proliferate and ferment upon. Fermentation from bacteria in the small intestine is how SIBO can cause acid reflux.
Slippery elm for heartburn
If you are currently experiencing acid reflux symptoms and want a natural heartburn remedy you can take 1 tsp of slippery elm in a cup of warm water and drink that to help coat and soothe the upper digestive to prevent stomach acid from irritating the esophageal or intestinal lining. Taking 1 scoop of Optimal Gi Powder is another option for soothing the digestive lining. Keep in mind that you will still want to address the underlying cause of your reflux and not just the symptom of acid reflux.
I personally used to suffer from acid reflux regularly. Utilizing enzymes and liver gallbladder support (optimal PC) was a game changer for reducing my sibo and improving my digestion. I can finally say that I no longer get acid reflux at all or need slippery elm as I addressed the root cause to my acid reflux.
For more information on how high fermentable foods and SIBO cause acid reflux I highly recommend reading Heartburn: Fast Tract Digestion by Norman Robillard.