SIBO PART II: Further Analysis of the Gut
Muscle Relationships
Muscle test for the abdominal muscles
The small intestine has a direct muscle relationship with our abdominal muscles, specifically the internal oblique, external oblique, and rectus abdominus. These muscles connect our rib cage to the front of our pelvis at different areas of insertion and are major components of our core. If these muscles are unable to fire properly due to some dysfunction in the small intestine, like say SIBO, we can feel pain not only on the front of our body but in our back as well. The abdominal muscles help hold our pelvis in place and keep it stable, but without their support, the pelvis can shift out of place and cause low back pain. Patients often find that they have back pain when bending over, indicating that the issue is coming from the front of the body and referring pain to the low back. As we will discuss later in the article, bacteria will often spill into the small intestine from the large intestine, so it is common that the large intestine is also involved when you have SIBO. The large intestine has muscle relationships with the quadratus lumborum (QL) and tensor fascia lata (TFL), both major back muscles and pelvic stabilizers. Large intestine dysfunction will also refer pain to the low back so it is important to determine which organ is the primary issue and the one that needs to be treated as it is not always the small intestine.
The Ileocecal Valve
The small intestine has a direct connection to the large intestine through the ileocecal valve (ICV). Connecting the cecum of the small intestine to the ileum of the large intestine, the ICV is supposed to be a one-way valve that allows food to move from one organ to the other once proper digestion is complete. It is very common for the ICV to become dysfunctional for multiple reasons. If there is a bacterial infection in the large intestine that goes unchecked for long enough, the bacteria can spill into the small intestine pushing through the valve meant to keep it out, resulting in the valve becoming stuck open. Our ICV can either become stuck open or closed, and what exacerbates SIBO is an ileocecal valve that is stuck open. Common offenders that can cause this are:
- Inflammation
- Food allergies
- Toxicities
- Gut infections
Gut Microbiome
We have more than just bacteria in our gut, the other most common microbe being yeast, which is a fungus. Yeast has a similar role to bacteria where we have good and bad yeast with the good yeast aiding in the protection of the gut and enhancing the immune system. Fungus can also spill into the small intestine causing SIFO, or small intestinal fungal overgrowth. The symptoms and condition are similar, so while we are talking specifically about SIBO in this article, everything written here also applies to anyone suffering from SIFO.
We can also have parasites and viruses present in our gut, and though they are less common, if present they can pose a serious threat. This brings up the possibility of having more than one infection going on in our gut at once, which is quite common. This can lead to a compromised environment in the intestines over time and cause other microbes, like bacteria to grow out of control leading to SIBO. So, even if you test positive or show symptoms of SIBO, these multiple infections must be addressed in a very specific, sequential order to resolve SIBO. Treating the bacterial infection with herbs or antibiotics may resolve symptoms temporarily, but if there is a different underlying infection that caused the SIBO in the first place, symptoms will just return after treatment. This is why antibiotics may help initially but are making the problem worse by killing off good and bad bacteria while allowing a potential yeast or parasitic infection to linger on, later resulting in the reoccurrence of bad bacteria to flourish.