The connection between bile and SIBO lies in understanding the antimicrobial properties of bile.
Bile is a soap-like substance that aids in the emulsification of fats. Bile also has antimicrobial properties.
The connection between SIBO and bile
Bile is antimicrobial and helps to keep the terrain of the small intestine clean. Having enough bile prevents bacteria from the colon from colonizing the small intestine. Bile is your body’s natural defence to prevent SIBO.
While there can be other underlying causes of SIBO having a sluggish gallbladder and low bile flow is one reason why someone can develop SIBO.
SIBO is just as the name implies “small intestinal bacterial overgrowth”. While the colon contains large numbers of bacteria the small intestine is not meant to house large numbers of bacteria.
Small intestinal bacterial overgrowth can be an overgrowth of bacteria from the colon or pathogenic bacteria. SIBO can also be an increase in the normal bacteria that are meant to be found in the small intestine. It is the overgrowth of any bacteria strains that causes symptoms of SIBO.
Some common symptoms of SIBO include
- upper abdominal bloating
- stomach pains
- loose stools.
How to support a sluggish gallbladder to prevent SIBO
One of the big contributing factors to developing SIBO include poor bile production or low bile flow from the gallbladder.
Bile is produced in the liver by the hepatocytes and is stored in the gallbladder. The primary function of the bile is to emulsify fats so that the pancreatic enzyme lipase can further breakdown fats.
The second function of bile is to disinfect the small intestine to prevent SIBO. The antimicrobial properties of bile to prevent SIBO is often missed by many practitioners.
The production of bile requires amino acids taurine and glycine, cholesterol, vitamin C, and lecithin. Vitamin C is needed for the enzymatic conversion of cholesterol to bile salts. Taurine and glycine are conjugated with bile salts.
Phosphatidylcholine is crucial for bile flow support by preventing sludgy bile. Sunflower lecithin contains phosphatidylcholine which keeps bile flowing easily out or the gallbladder.
Phosphatidylcholine also helps to prevent gallstones from forming by preventing cholesterol from solidifying and forming gallstones in the gallbladder. It is very important that the phosphatidylcholine to cholesterol ratio is in balance to prevent gallstones.
The formation of gallstones can block bile flow from the gallbladder. Thus, phosphatidylcholine is crucial for bile flow support and the prevention of gallstones.
The gallbladder is stimulated by the hormone CCK to release bile when dietary fat is eaten. Having adequate phosphatidylcholine ensures the bile flows easily from the gallbladder.
light or grey-colored stools
- alternating between constipation or loose stools
- right shoulder pain
- abdominal discomfort
- greasy stools
- floating stools
- fat malabsorption
These symptoms of low bile flow alongside SIBO symptoms indicate poor bile flow is an underlying cause of SIBO. Supporting a sluggish gallbladder is crucial to prevent SIBO overgrowth and relapse.
Low Bile Production and Constipation
Low bile production and constipation is a common symptom I see associated with SIBO. Bile helps to stimulate peristalsis in the intestinal tract. If someone has poor bile flow the bowels are often sluggish leading to constipation.
I am always thinking about the gallbladder as a root cause of SIBO if someone has constipation and SIBO. Supporting the gallbladder with sunflower lecithin for bile flow often helps to relieve constipation. One of the primary benefits that I see with clients using phosphatidylcholine is improved bowel movements.
To prevent SIBO it is necessary to have both the ability to produce enough bile and to have adequate bile flow out of the gallbladder.
The purpose of bile for SIBO
You can think of bile as dish soap with 2 key properties.
#1 The purpose of bile in the digestive process is to emulsify fats from the diet. Dietary fats can then be further broken down by pancreatic enzymes and absorbed. Bile also helps with the absorption of the fat-soluble vitamins A, D, E, K.
#2 Bile is antimicrobial which prevents bacteria from growing in the small intestine. Optimizing bile flow is key to maintaining an environment in the small intestine where SIBO cannot thrive.
There are many underlying causes of SIBO. But it is crucial to take low bile flow into consideration and look at the body from a holistic approach. The antimicrobial properties of bile are huge for inhibiting small intestinal bacterial overgrowth.
Everyone may have different underlying factors that are contributing to SIBO. A sluggish gallbladder and poor bile flow are often missed when people are treated for SIBO.
Getting rid of SIBO is not as easy as just taking a round of antimicrobials or antibiotics for SIBO. Especially for anyone who has a sluggish gallbladder. SIBO will often return for those who never addressed poor bile flow in there SIBO protocol.
The best way to prevent SIBO from occurring or reoccurring is to have optimal bile flow.
I pinpointed a sluggish gallbladder and liver as the cause of my SIBO. Since using phosphatidylcholine and ox bile I no longer experience heartburn which was one of my primary ‘symptoms’ of SIBO.
My digestion has massively improved since targeting the liver and gallbladder as the root cause of my SIBO symptoms. The liver and gallbladder were the digestive organs that needed the most support in my body.
How to use ox bile for SIBO
Using ox bile for SIBO in conjunction with the phosphatidylcholine were the two supplements that I used to kick my SIBO. It makes sense though when you think about it. Instead of using all sorts of antimicrobial supplements, you can just support your antimicrobial defences by providing bile flow support.
The reason why ox bile works for reducing SIBO is due to the antimicrobial factors found in bile.
I used ox bile on an empty stomach for its antimicrobial properties to reduce SIBO. The dosage for ox bile will vary for each individual.
Taking too much ox bile can cause diarrhea. I used 125 mg of ox bile from Seeking Health on an empty stomach to help get rid of my SIBO. I tolerated this amount just fine.
Many ox bile supplements come in 500 mg. When using a supplement for the first time it is always best to start low and increase as needed.
To help support fat digestion ox bile is best taken with a food that contains some fat. Before using ox bile I always like to support the body with nutrients to make healthy bile and promote bile flow first.
If low bile flow is one of the primary underlying causes of SIBO for you then you may experience a die-off reaction. Hitting the nail on the head can cause a die-off reaction. This means to go slow with the supplements.
When bacteria die they can release endotoxins and histamine that cause die-off reactions. Using a binder such as activated charcoal or bentonite clay helps to absorb toxins. Optimizing the terrain of the small intestine with antimicrobial bile is crucial to prevent SIBO.
Seeking Health’s Optimal PC (phosphatidylcholine) helps to support the flow of bile from the gallbladder. It is also a key component that makes up bile. This supplement is best taken with food.
Gallbladder nutrients provide the liver with the nutrients to make healthy bile along with promoting bile flow. This supplement is crucial for maintaining a healthy gallbladder.
Taking a digestive enzyme with meals is also very beneficial to reduce SIBO. Pro Digestion Intensive helps to break down all food including difficult to digest legumes, beans, fiber, sugars, and gluten.
Digestive enzymes ensure there are no excess undigested starches in the small intestine for bacteria to ferment upon.
If you are struggling with SIBO Dr Nirala Jacobi from the SIBO Doctor has a very informative patient SIBO success course to beat SIBO for good. This course covers
- additional underlying causes of SIBO
- testing for SIBO
- Symptoms of SIBO
- types of SIBO
- biphasic SIBO diet
- antimicrobials for SIBO
and much more!
Dr Nirala Jacobi has been my go-to resource for information on SIBO. There is so much to know about SIBO and the SIBO success plan covers all the essentials that you need to know about SIBO so you can beat SIBO for good.