Hannah Aylward (00:00.088)

SIBO is just the downstream result of other things happening upstream and it’s not your primary issue. So if you feel like you’ve tried multiple SIBO protocols, you’re not broken and you’re not stuck. There’s a lot more that we can do. We just have to shift the perspective from how do I kill off these bacteria to how do I repair my digestive function? So the environment is not conducive to allowing heavy bacterial overgrowth to even take place in the first place.

Hannah Aylward (00:33.976)

Welcome to the Nutrient Dense Podcast. I’m your host, Hannah Aylwarde, holistic health coach, functional gut health practitioner, and the founder of Han. So many people are continuously failed by conventional and alternative health care. We are here to do it differently. Alongside my team of functional registered dietitians, I’ve helped hundreds of women around the world overcome their chronic digestive issues when nothing else worked.

I’ve learned a thing or two about what it really takes to transform your health from the inside out, and I’m here to share it all with you. Please keep in mind that this podcast is for educational purposes only and should never be used as medical advice. Now, let’s dive in. Your transformation is waiting.

Hello, hello everyone. Welcome, welcome. I’m excited to be here with you today. Today we’re gonna be digging into SIBO, small intestinal bacterial overgrowth, and why many SIBO protocols fail. So I will go ahead and break down what SIBO is to begin with, and then what kind of leads to SIBO and why so many people relapse and/or protocols just really don’t work so well. So

That’s what we’re gonna be getting into today. I think there are a lot of many misconceptions when it comes to SIBO and small intestinal bacterial overgrowth and people unable to really get over the hump with it and stay feeling better. I’ve personally had SIBO myself, so I know just how tough it can be. I had it years ago at kind of at the beginning of my gut health journey and and part of what got me into all of this work and

I would say with SIBO, it just causes a lot of chronic GI issues and you just like never feel better and you’re super reactive to everything that you eat. And it’s a it’s a constant thing, right? So you can be eating the healthiest diet in the world and you’re like bloated and gassy and descended. And it’s just not fun. It’s not fun at all to deal with. I’ve been there. So let’s kind of di dig into it, dig into the deeper underlying root causes and how we can actually get over get over the hump and feel a lot better. Okay, guys. Welcome, welcome. So

Hannah Aylward (02:35.744)

If you’re new here, my name’s Hannah Aylward. I’m a functional health coach and I’m the founder of HAN, and I lead a team of functional practitioners. And we really support women in overcoming their chronic gut and digestive issues by taking a root cause approach to repairing GI function, digestive health, that kind of thing. We’ll use functional targeted labs, we’ll use customized supplement interventions, we’ll use targeted nutrition to repair function at the root cause level and support the body’s underlying physiology.

So you can tolerate more foods with less pain going forwards. You can feel better. So you can overcome the bloating, constipation, the diarrhea, all of that. Really fun stuff. I had chronic gut and digestive issues for like seven plus years that no one could figure out. That’s how I got into all of this work. It was very much like you have IBS, we don’t really know what’s wrong. You have high cortisol. I was like, okay, I’m stressed. Is anyone not stressed? They didn’t really know what to do with me. And I was eating the healthiest clean diet ever. I was like,

All organic, no gluten, no dairy, no sugar, no processed foods. I was exercising multiple times a week. And I was still looking, I’d look four to six months pregnant with belly bloating after eating like anything. Like I would look pregnant with bloating after eating an apple or a sweet potato. I did all of the things and nothing ever worked for me. And that’s kind of how I got into this work today. So if that resonates with you, you’re in the right place. Unfortunately, I know how that feels.

But we are we’ll get dig into kind of some strategy and get you some tips for that today. All right, let’s dive in. So, what is SIBO kind of to begin with, right? SIBO is what happens when it’s really conditioned when we get an overgrowth of bacteria in the small intestine. Now, the majority of your gut bacteria reside in your large intestine or your colon. Your gut encompasses many different kinds of digestive organs. So most people are talking about the intestines.

Those trillions of bacteria that you hear about when it comes to gut health, like probiotics, and you’re made up of more bacteria than you are, you know, DNA and that kind of thing, are usually happening in and taking place in the large intestine, but you have a your small intestine and you have your stomach that are also not entirely sterile. So these contain different microorganisms as well. So your gut microbiome houses trillions of different microorganisms, not just bacteria.

Hannah Aylward (04:47.992)

We also have archaea, we have yeast, we have naturally occurring parasites. Those are all kind of a naturally part of the gut microbiome. Now, when you take something like a probiotic, for example, you really want that to go to the large intestine or the colon to support, you know, the proliferation of those good gut bacteria. However, there’s a lot to get into with probiotics that I don’t need to get into, but for the purpose of today.

See what’s what happens when it comes to SIBO is we get an overgrowth of bacteria in the small intestine when the majority of these should be in the large intestine. So there’s an abnormal increase in the number of bacteria in the small intestine that can lead to a variety of different issues here. So it’s kind of like we’re getting an overgrowth of bacteria in the wrong place, right? Sometimes the bacteria that are overgrown are not even necessarily bad gut bacteria. So it’s not exactly like an infection. It’s not

necessarily an overgrowth of the wrong bacteria. It’s that we have a location issue. So at its core, SIBO is more so a breakdown in gut motility than it is a bacteria issue in and of itself, right? So you want the majority of your gut bacteria to hang out in the large intestine or the colon. And in the case of SIBO, we get that overgrowth in the small intestine. This causes lots of different issues, right? Because we absorb the majority of our nutrients in the small intestine.

So it will very often lead to different nutrient deficiencies, right? So it’s very common to see those with SIBO have like low B12, low iron, poor absorption, fatigue, skin issues, inflammation of the skin, that kind of thing. It doesn’t just set say gut issues, but it will lead to more systemic inflammation. And when we have an overgrowth of those bacteria in the small intestine, that will then cause issues in our gut barrier. And that will then kind of trigger that systemic inflammation. That’s kind of the

Simplest way that I can I can put it for you is we have an overgrowth in the wrong place, right? So what’s very common when it comes to SIBO or small intestinal bacterial overgrowth is we’ll have the chronic bloating, we’ll have abdominal pain and discomfort, we’ll have a lot of like gas, burping, belching, we can have diarrhea, constipation. It can go either way. So certain types of bacteria produce certain gases. So we can have certain bacteria produce methane, we can have certain bacteria produce hydrogen.

Hannah Aylward (07:02.814)

And that that can lead to different GI issues. So typically what we’ll see with methane-dominant SIBO is we’ll see more of a constipation pattern. With hydrogen-dominant SIBO, we’ll see more of a diarrhea pattern. With that being said, I see it go both ways all the time. That’s kind of what the science shows us. That’s not necessarily what I see. I see people with methane have diarrhea. I see people with hydrogen dominant have constipation. It doesn’t really super, super matter, right? So we have an overgrowth of these bacteria.

Our interventions for these bacteria will vary depending on the type, but the issue is still that we are getting this overgrowth in the first place. So we can have, like I said, bloating, abdominal pain, discomfort, burping, lots of food sensitivities and intolerances. So we’ll commonly see, like you’ll be super reactive to fiber-rich foods, prebiotic rich foods. So it’s very common that you start eating healthier.

You’re eating more whole foods, you’re eating more fruits and more veggies, and you’re looking more bloated and you’re feeling more gassy and you’re dealing with more stomach cramping and potentially even constipation or maybe even breakouts. So it can feel very tricky because you’re like, I’m trying to eat a healthier diet and I’m ending up with more bloating and gas due to the overgrowth of bacteria in the small intestine. This is where, once again, it can feel it can feel really tricky for people because they’re like, I’m eating super healthy, I’m eating super clean.

I don’t eat gluten, I don’t eat dairy, I don’t eat sugar, I barely drink alcohol, like what’s going on? The food is not the problem here. The gut environment, that overgrowth of bacteria in the small intestine is the actual problem. So you don’t want to just pull out a bunch of foods. It’s not actually going to heal anything. We have to deal with the gut environment that’s causing the reactions to the foods. So SIBO can also come with nutrient absorption, right? Because we absorb the majority of those nutrients in the small intestine, which will then cause.

Thyroid issues, fatigue, brain fog. we can see it even nausea due to that kind of getting like that gas buildup in the intestines. it can also cause chronic bad breath, even when you’re brushing your teeth, using mouthwash, that kind of thing. So there are some studies that show that up to sixty percent of individuals that have been diagnosed with IBS actually have SIBO or that small intestinal bacterial overgrowth as an underlying root cause of their quote unquote IBS. In the case of IBS, we just

Hannah Aylward (09:22.498)

The bowels are irritable. We don’t know why. So it in it really requires just some deeper investigation to see what’s actually causing the bowels to be irritable. SIBO can be one of those underlying root causes. However, SIBO in and of itself is not a root cause. So that’s really the point of today’s training, right? SIBO will absolutely, when we have that overgrowth of bacteria, yes, that will lead to bloating and gas and distension and pain.

No question, but we have to ask what allowed the bacteria to overgrow in the small intestine when they should be moving through the intestines and kind of proliferating in the large intestine or the colon. That’s where the majority of those microbes kind of hang out. So it’s less of a bacteria issue and it’s more of a gut motility issue. So let’s let’s kind of get into this here.

The biggest thing that I want you to understand through this training is that SIBO is the result of other stuff going on, which is why when we take a round of antibiotics, which is kind of that first line intervention for something like SIBO. So say you go to your gastroenterologist and they’re like, okay, they may test you, they may not. Sometimes they don’t test you. I don’t always love that. We we would like to test you first and foremost. You can get a breath test to be tested for SIBO.

which will give us more insight into the gas levels being produced, which can help us kind of understand what overgrowth is taking place. So, first off, I would recommend, I would recommend testing. But sometimes they’ll test you, sometimes they won’t. And then they’ll just kind of give you a an antibiotic, something like Rayfaxamin, maybe neomycin. They’ll kind of write you the script for that. They’ll say, take this for seven to ten days, and then you’re fine. But SIBO is the result of other things. So attacking just the bacteria in the intestines is not.

Actually, going to lead to long-term sustainable results because all we’re doing with that antibiotic is we’re coming in and we’re lowering those bacteria levels. And sometimes you’ll get relief with that, right? If you’ve been treated for SIBO, if you’ve worked with your doctor and they’ve given you an antibiotic for SIBO, did it help? Sometimes it helps. Sometimes it helps for like two to four weeks. Sometimes it helps for like two months and then it comes right back. And sometimes it doesn’t really help at all. And there are many reasons for that too, that we’re gonna kind of get into today.

Hannah Aylward (11:39.468)

But especially if there’s no testing being done, you know, and we’re giving you that antibiotic, we don’t even know why we’re taking it. Are we looking at SIBO? Are we not looking at SIBO? So there are lots of areas where things can kind of like fall, fall down here. But very commonly it’s like, okay, you have SIBO, you get the antibiotic. The antibiotic is addressing the overgrowth of bacteria. However, we’re not addressing why the bacteria was able to overgrow in the first place. This is the key.

To getting better and staying better and actually like feel feeling better while on it and keeping those results, right? So oftentimes when we’re giving given something like an antibiotic, we’re more so addressing the SIBO like it’s an infection. Like it’s like, you know, you have this ear infection. So here’s an antibiotic, and then it kind of goes away and it stays away, right? But SIBO is the result of other gut issues, kind of underlying other gut issues. So we

That is what leads to the spectral overgrowth just coming right back. You can think of it like a garden, right? And you have weeds in your garden. And if we want to get rid of the weeds, we can, sure, we can just like pull those weeds out. But if we don’t actually address the conditions that led to the weeds overgrowing, they’re just gonna come right back. They’ll they’ll be gone for a couple of weeks, maybe, but then they’ll just kind of come right back and we’ll get that overgrowth all over again. So instead of asking, how do I

you know, kill off the bacteria that are overgrown that are causing the bloating and gas and ascension. We have to ask what allowed the bacteria to overgrow in the first place. Why are they overgrowing there? Which is why at its core, SIBO is a motility issue more than it is a bacteria issue. Yes, the bacteria are causing the bloating, the gas, the pain totally. And also what led to that? That’s the key to getting better and really staying better. So big reasons why

Most SIBO protocols fail, is we’re really just using antibiotics, even herbal antimicrobials, right? Maybe we’re using the low FODMAP diet, which does not actually eradicate SIBO. It does not get rid of it. definitely not long term. It’s not a long-term solution. It is a temporary intervention at best, because what it’s doing, the low FODMAP diet, is it’s just reducing your intake of fermentable carbohydrates. That’s what FODMAPs are, right? So FODMAPs are just fermentable carbohydrates.

Hannah Aylward (13:57.42)

That exist in a lot of like really healthy foods, and they’re actually good for your gut. These foods help to support your good gut microbes. We run into issues with these foods be when we have an overgrowth of those bacteria in the first place. So it’s like our gut environment is all out of whack. We have an overgrowth of these bacteria. Then we’re feeding these bacteria, these FODMAPs, and then we’re getting like really gassy, bloated, and distended. So FODMAPs in and of themselves are not the problem. They’re actually really good for your gut.

And reducing those intake the intake of FODMAPs, sure, it can help reduce bloating and gas temporarily, but it is not a long term solution because it’s not addressing what led to that bacterial overgrowth in the first place. And it’s super restrictive, right? Like it’s very difficult to maintain this diet long term. And it’s also not been shown to actually get rid of SIBO. So it’s not, it’s not addressing anything at the core level.

So many protocols when it comes to SIBO look like low FODMAP diet and antibiotics or low FODMAP diet and herbal antimicrobials. But there’s and there’s nothing really like inherently wrong with these tools. However, we’re not addressing what led to the overgrowth in the first place: a breakdown in gut motility, digestive function, immune function, thyroid function, bile flow, stomach acid production. These things also need to be addressed because these are those like underlying deeper root causes.

That led to the SIBO being there in the first place. So let’s talk about gut motility. Motility is just the movement of food through your GI tract. So it’s kind of like the rate at which food moves through your GI tract. That’s what we would call your gut motility. We don’t want it to be too fast. So things are kind of moving through the GI tract too quickly. You’re unable to absorb the nutrients from your food efficiently. In cases of like chronic diarrhea, like you eat something and it goes right right through you.

When that happens too quickly, you can’t actually absorb the nutrients from the food that you’re eating. So that that is a big problem. And when motility slows down too much, that’s when we’ll we’ll likely end up with things like constipation. And food is just sitting in the GI tract longer than we want it to. The longer that food sits in the GI tract, the more it’s going to feed these bacteria, the more that these bacteria are going to overgrow, and then these bacteria are going to give off gas. And then that looks like

Hannah Aylward (16:11.702)

Abdominal distension, burping, bloating, you know, flatulence, that kind of thing. All of the really fun stuff that you deal with when you have chronic GI issues. So we don’t want food sitting in the GI tract too long due to slow gut motility. That’s gonna lead to this overgrowth of bacteria in the GI tract. So when we’re talking about gut motility, slow gut motility is one of the biggest reasons why SIBO never fully goes away or why it it relapses, right? So healthy intestines constantly move.

Food downstream through things like peristalsis or the muscular contractions of food through the GI tract. And then also your migrating motor complex or your MMC. And your migrating motor complex is, you can think of it as like a broom that sweeps the debris through the small intestines and into the large intestine. So it’s it’s one of your guts built-in like natural self-cleaning mechanisms. I have a podcast episode all about the MMC, if you want to dig into that.

It’s on the Nutrient Dense podcast. You can like plug it in and learn more about the migrating motor complex. But it’s a nerve-regulated function. And it it basically like you can picture once again that broom sweeping undigested food particles, proteins, and things through the GI tract and out of the small intestine and into the large intestine or the colon, where the majority of those gut microbes actually exist. So when we have a breakdown in our migrating motor complex function.

Things aren’t going to, we’re not getting that that broom sweeping through the debris and sweeping the debris through in the small intestine, which will then lead to that microbial overgrowth. And one of the things that really impacts the migrating motor complex is constantly snacking or your are taking things in, even drinks, even liquids. So your migrating motor complex is a neuro regulated function and it only happens in a fasted state. So if you are eating something, even the smallest thing, even like a

a tiny candy or something, or maybe you’re drinking coconut water, or maybe you’re you’re just intaking things all day long. You’re interrupting that migrating motor complex and its its ability to do its job and continue to sweep particles and food debris through the small intestine. So we want to make sure that we’re spacing our meals and we’re supporting our migrating motor complex function. It turns on at about 90 minutes and we want to give it ideally a couple cycles

Hannah Aylward (18:32.61)

To really push that food debris through the GI tract. So ideally, we want to space our meal like or our food like three to four hours so the migrating motor complex can actually do its job, right? So if peristalsis slows down, if the MMC function is impaired, bacteria will start to accumulate, overgrow, and they’ll overgrow in the wrong place, right? And this is when we end up with something like small intestinal bacterial overgrowth.

Or SIBO, which once again is like chronic bloating, gas, burping, doesn’t matter how healthy you eat, doesn’t matter what you’re doing, you’re always bloated and distended. So we also want to ask what led to the breakdown in this in this function. Sometimes it’s snacking too much, it’s eating too regularly, to kind of like I I want to be mindful when I say this because I never want anyone to not eat when you’re hungry. You should always eat when you’re hungry. The key here is balancing your blood sugar and eating enough at each meal.

So you can easily go three to four hours in between meals as opposed to not eating enough and then feeling hungry in an hour, right? So in no way am I saying like eat less. That’s not what I mean at all. What I mean is eating enough, eating adequate protein, adequate fiber, adequate fat, carbohydrates at each meal. So you can easily space these meals out three to four hours. And balancing your blood sugar will help support you here. It’s a game changer and it’ll help your mood, your energy, your digestion, your skin, everything.

And the key here is really eating enough protein, but also fiber and fat really help there too. So you can go to that next meal without much thought, right? So you can you can kind of go right into eating your next meal without feeling hungry or a blood sugar crash or anything like that. Other things that can impact this, chronic stress, fight or flight, suppressing digestive function, poor digestive signaling, reduced vagal tone. So your vagus nerve also impacts that migrating motor complex as well.

So all of these things can impact your gut motility. Other things that can impact your gut motility, which is once again that deeper root of something like chronic SIBO, would be previous food poisoning. So this is kind of more so for the case that maybe you were out eating somewhere, you got food poisoning, and your gut has never been the same. So if that resonates with you, this may be what’s going on for you. However, it’s always good to like run some testing and see what’s actually at the core of all of this.

Hannah Aylward (20:51.49)

So when we have, when we get food poisoning or we get foodborne illness, we can develop what they would call post infectious IBS, right? So what can happen is the food poisoning comes in, you develop these antibinculin antibodies, and that will end up damaging your migrating motor complex or that flow of or that nerve, right, that helps to push that debris through the small intestines. So sometimes we get that food poisoning.

The body develops these antibodies that then damage our gut motility, that then leads to something like recurring SIBO. And in this case, we can actually test for it. So there’s something called the IB, IBS Smart SIBO breath test that can test to see if you have these antibodies. And that’s what’s actually causing this recurring SIBO to take place. That’s basically showing us that your motility is damaged and we need to support that long term.

So sometimes people will need more supplemental support, or you could even consider talking to your doctor about a prescription to support your gut motility more long term if food poisoning led to this. What I would say what we see in in our like practice is that’s probably like 15% of people. A lot of other people are experiencing SIBO due to just like years of other underlying stuff happening. It’s less of kind of that one.

one instance, that acute instance that then ticks it off. And it’s more so things breaking down over time. But if it resonates with you and you’re like, my gosh, yeah, I got this food poisoning and my stomach has never been the same since, could have an infection, could be Helicobacter pylori, could could also be damage to your migrating motor complex and and your gut motility that’s then leading to this overgrowth of bacteria in the small intestine. So when we’re talking about gut motility, right, we have to optimize MMC function, we have to optimize peristalsis function.

We can consider things like food poisoning. And then another thing that can happen here is our thyroid function impacting our gut motility as well. So your gut and thyroid are like this: your gut influences your thyroid, and your thyroid influences your gut. So when we have something like hypothyroidism, or we have that sluggish thyroid function, your thyroid kind of like slows down. That will then lead to slower stomach emptying. It can lead to constipation.

Hannah Aylward (23:08.802)

And it can lead to slower intestinal movement, it’s gonna basically just slow down your gut motility. So when the thyroid takes a hit, everything’s gonna move a little slower, which is why some of the main signs of something like hypothyroidism are constipation, right? Weight loss resistance or weight gain, your metabolic function is slowing down, everything’s starting to slow down a little bit. Hair loss, right? Because hair regrowth can slow down. And there are many issues or excuse me, reasons why this could happen too that we can dig into.

but when your thyroid slows down down, that can then slow down your gut motility and lead to that overgrowth of bacteria in the small intestine. So we have to take a a really good comprehensive approach when we’re looking at someone that has bacterial overgrowth in the small intestine, right? It’s not just take an antibiotic and wipe out the bacteria. We have to ask what’s allowing this bacteria to overgrow in the first place? How does the thyroid look?

How does our gut motility look, right? What what actually led to this? Was it an instance of food poisoning damaging our gut motility, or was it something else? So we when it comes to thyroid function, this can directly impact your gut motility and your gut and your gut health can directly impact your thyroid health. One of the simplest, kind of easiest ways to understand how there are many different mechanisms through through which it impacts your thyroid.

But we have a portion of our thyroid hormone actually converted through our gut bacteria. So thyroid hormone is converted from inactive to active in the liver and through your gut bacteria. So gut issues heavily influence thyroid function. Then we also have nutrient absorption occurring in the gut. The thyroid needs a ton, a ton of different nutrients to properly work, right? To help support inactive to active thyroid hormone conversion.

so things like iodine, things like iron, things like B vitamins, magnesium, selenium, these are all super important when it comes to thyroid health. Now, if you have these chronic gut and digestive issues and you’re not able to absorb the nutrients from the food that you’re eating efficiently, which is incredibly common when it comes to SIBO, because it damages those villi along the s the small intestinal lining, damages your microvilli, which is where you absorb those nutrients. So this is why.

Hannah Aylward (25:24.738)

Gut issues don’t say just gut issues, right? This is why we see women with gut issues that look like a lot of chronic GI issues, like bloating and gas and constipation, but also look like chronic fatigue, look like skin issues, look like painful periods, right? Because it’s gonna impact everything due to the gut issue is gonna then impact nutrient absorption, which will impact, I mean, basically everything, right? It’ll impact liberty talks and and all kinds of things, thyroid function, et cetera.

So the gut influences thyroid once again through the bacteria that actually convert thyroid hormone through nutrient absorption. Absolutely. And then certain gut infections can actually contribute to what we would call like molecular mimicry that can then influence thyroid antibodies. There’s a big connection here, right? Your gut’s also gonna impact your liver, your liver is gonna impact your gut, and your liver is where you’re converting the majority of that thyroid hormone. So when we’re looking at slow thyroid function and/or gut and digestive issues or something like SIBO.

We have to look at these things like one in the same, right? They’re they are influencing one another, and it’s important that we dig into that in order to get you feeling better and really staying better.

Hannah Aylward (26:34.968)

We are big fans of eating enough protein over here on Team Han. Protein is essential for muscle repair, a strong gut lining, balanced blood sugar levels, and so much more. For most of our clients, we like recommending around 100 grams of protein per day to start, and adding in a good quality protein powder can be super helpful for hitting those numbers. It’s an easy add-in, you can throw it into a smoothie or even add it to oatmeal. Choosing the right protein powder can feel so overwhelming.

Half of them are full of fillers and crap ingredients, and the other half, honestly, just taste bad. Equip protein is one of my go-to recommendations for our clients and one of my personal favorites. We love it because it only has a small handful of ingredients. It’s 100% carefully sourced, real foods, no additives, allergens, chemicals, fillers, or other junk. It’s gluten-free and it contains 21 grams of protein per serving. Equip’s prime protein also offers.

a complete amino acid profile. It’s also independently tested to make sure that the protein powder is free of harmful amounts of heavy metals and toxins like glyphosate, which is honestly super hard to find. Equip prime protein is a grass-fed beef protein. So it is animal-based, but it’s dairy free, unlike whey or casein protein powders. Grass-fed beef protein is packed with collagen, gelatin, and micronutrients that your body needs.

We also see that it’s typically much better tolerated in our clients with chronic gut and digestive issues over something like a plant-based protein powder. In addition, some of their flavors do contain natural flavors, but they’re distilled vapors from natural and organic compounds or fruits like vanilla, coconut, and strawberry, and are processed without any chemicals, fillers, binders, or artificial ingredients, which once again is incredibly hard to find. Personally, I buy both the chocolate and the vanilla.

Flavors of the Equip Prime Protein, but honestly, they have like so many other incredible flavors out now. If you’re interested in trying out Equip Prime Protein, you can use the code HANNAHAYLWARDHHC at checkout for 15% off. And we’ll pop that code in the show notes of this episode for you as well. So once again, you can go to equipfoods.com, choose the flavor of protein powder that you want, and then use code HANNAHAYLWARDHHC for 15% off. So let’s just recap.

Hannah Aylward (28:52.472)

Quickly, what we’ve covered, because I know it’s a lot. I feel like I’m talking fast. I’m gonna slow down a little bit here, but I’m trying to get through a lot with you guys. So we have peristalsis, we have the breakdown in the MMC, we have previous food poisoning, we have hypothyroidism. The other thing that can very commonly lead to recurring SIBO is chronic stress. And I know, like, we’re all like, yeah, yeah, yeah, we know stress is not good for us. But here’s actually what’s happening when that’s a part of your picture, right? So

Digestion is really a nervous system-regulated process. It starts in the brain. It doesn’t start in your stomach, it starts in the brain. So you have to be in that rest and digest state in order to optimally break down and digest your food. When you are in that more sympathetic dominant state, that fight or flight state, what happens in this state is digestion becomes an afterthought. Blood flow goes away from your GI organs. It’s not prioritized. Digestion is not considered.

necessary for survival. So your body prioritizes these other things because it’s incredibly intelligent. It’s doing this to support you, right? It’s doing this to support you in staying alive when you feel very stressed and you’re in that fight or flight state. So it’s like, it’s not bad. And and it’s important to remember these things, right? Because it’s very easy to feel like our bodies are betraying us and they never work and they’re never cooperating. But it’s like your body’s always listening and it’s so incredibly designed, innately designed and it knows what it’s doing.

So if you’re feeling chronically stressed, if you’re overwhelmed all the time, if you are never resting, if you’ve been burning the candle at both ends for way too long, if you’ve been undereating, undernourishing, over-exercising, not prioritizing sleep, all of these things are stressors. They’re filling that stress bucket that will then lead to a breakdown in gut function. So we will see let once again, blood flow go away from the GI organs in this case. We will see low stomach acid production occur.

That will then influence enzyme production and bioflow. It will impact your gut motility. It will impact your vagal your vagus nerve as well. That helps to support movement of food through the gut. So it’s like stress doesn’t say stress because it impacts everything down the chain. So if we are living

Hannah Aylward (31:08.77)

In a chronically stressed body, which many of us are, especially because we’re never stopping anymore and we’re constantly engaging in things and we’re constantly scrolling or listening or this or this or this. It’s like we’re answering our emails while we’re like eating our lunch at our desk, typing with one hand and shoveling food in our mouths with the other hand. Not only are we not properly actually chewing our food in that case, but the body doesn’t even know that it’s eating. We haven’t even like shifted out of.

That go, go, go state and into that rest and digest state so you can optimally digest your food. So over time, this will lead to bacterial overgrowth because it’s going to lead to slower gut motility, less stomach acid production, poor bioflow, low enzyme secretion, slowing everything down. And it’s creating that environment for bacteria to overgrow. Now, I I think having this conversation about stress is very, very, very important because there are many different stressors. There are like,

Mental and emotional stressors. There are physical stressors. There are environmental stressors, things like environmental toxin exposure, heavy metal exposure, mold exposure, right? Then we have the stress, the kind of stress that we normally think of, like my to-do list never ends, and I gotta pick my kids up from school, and then I gotta do this, and we got this bill in the mail I didn’t see coming, and all of that kind of stuff. That’s totally stressful. And then we have physical stressors.

Undereating, nutrient deficiencies, irregular erratic blood sugar levels, not sleeping enough, overtraining without adequate recovery. All of these are different stressors on your body. So we need to address all of these things in order to really get you feeling better and staying feeling better, right? Stress is not just mental and emotional, can be physical, gut infections can also increase cortisol in the body. They can lead to higher stress levels. I have a whole podcast episode on that too. If you want to dig into that.

Just go binge the nutrient dense podcast. I’ve got episodes for everything for you guys or on everything for you guys. But that stress piece absolutely can cause this recurring gut issue to take place and something like SIBO, right? So it’s important to have this conversation. I will also say, I think that right now in the holistic health space, everyone’s like, it’s all your nervous system. It’s all your nervous system. It wasn’t SIBO. It wasn’t this. It was just my nervous system. And I don’t.

Hannah Aylward (33:22.966)

I don’t really agree with that if I’m being honest. I think there’s lot more to it because stress doesn’t stay stress. If you’ve sure, it absolutely impacts your digestion, your digestive digestion and your digestive function, but stress doesn’t say stress. It impacts stomach acid. It impacts gut motility, it impacts your gut barrier. It impacts how you actually break down to digest your food and your gut environment. So once we get to that point, we’re not looking at just stress anymore. We’re looking at bacterial overgrowths. We’re looking at higher risk of infection.

We’re looking at maldigestion patterns and we have to deal with that too in order to get you feeling better. In my humble opinion of doing this for almost 10 years. So that’s what I would say. It’s both, right? We have to look at nervous system and we have to look at the result of nervous system dysregulation. So these are all things that will lead to recurring SIBO. And I hope at this point you can tell that like an a round of antibiotics is not addressing any of these, right? An antibiotic is coming in and it’s decreasing.

Levels of bacteria, which is great, which is why you may feel a bit better. But we have to address what led to that, right? In order to get you feeling better and actually staying better. Now, the other thing I wanted to touch on with you guys is this stomach acid piece. So when we’re looking at recurring SIBO, recurring gut infections, things like parasites or anything, stomach acid plays a huge role here. So your stomach acid is really your first line of defense.

And when you have lower levels of stomach acid, bacteria will start to overgrow, proteins are not going to be efficiently digested, minerals and different nutrients won’t properly be absorbed. So we can see low stomach acid contribute to something like chronically low ferritin issues. Not all low ferritin is due to low stomach acid, but sometimes it can lead to that. So it requires further investigation, right? Pancreatic enzyme secretion is not properly signaled when we have.

Lower stomach acid levels and low stomach acid will decrease the amount of bile that’s being released as well. So stomach acid helps to protect your gut from infections, it helps to break down proteins, and it helps to support your gut motility, and it also helps you absorb certain nutrients from the food that you’re eating. So when we have low levels of stomach acid due to something like hypothyroidism, due to a gut infection like Helicobacter pylori.

Hannah Aylward (35:49.73)

Due to chronic stress and nutrient deficiencies, your body needs different nutrients to produce adequate stomach acid. Due to chronic PPI use, that’s neutralizing stomach acid over time. This is going to set up that environment in the gut for bacterial overgrowth to take place. So this is a really important piece of the puzzle here. Once again, simply taking antibiotic for SIBO is not addressing this at all. So it’s very likely that that overgrowth will just come right back.

If we’re not actually breaking down the food that we’re eating efficiently, and stomach acid plays a huge, huge role there. I always say too, you can think of it like the conductor in the orchestra. So stomach acid actually signals the release of your other digestive juices. It influences the release of bile and enzymes. And these are digestive juices that help us to actually break down our food and absorb the nutrients from our food.

When you’re not properly breaking down your food, we’ll end up with that overgrowth picture. We’ll end up with gut intestinal permeability or quote unquote leaky gut. We’ll end up with like distension, feeling like there’s a brick in our stomach, bloating, heaviness, potentially even nausea in these cases. So you can think of it, you can think of it like this. When you go to, if you’ve listened, if you’ve listened to my podcast, you’ve heard me, you’ve heard me use this example before. But for anyone that’s new, I’ll break it down for you. So

When you go to something like a pond, right? Say you’re say you go to a pond and the water is still and it’s not really moving. You’re gonna see that bacterial film on top of the pond. You’ll get that like bacterial buildup. It’s like a biofilm, and you’ll see it, and you don’t really want to like put your foot in that because it’s you see all the bacteria right on top of it. Because there’s no movement. The water’s not moving at all, right? This is what will happen when you have slow gut motility and inadequate digestive juices.

Things are sitting there in the intestines longer than we want them to, building up, overfeeding those bacteria that are then producing those gases. So this can lead to that bacterial overgrowth picture. As opposed to when you look at when you go to like a waterfall or like a rushing river or something, the water is more clear. We have movement. So the bacteria are building up as much. You’ll see some bacterial build up on the rocks or whatever.

Hannah Aylward (38:02.146)

But that water is clear. You don’t have, it’s not still stagnant breeding those bacteria. It’s moving. Your digestive juices are what keep things moving. Once again, we don’t want it to happen too quickly in the case of like chronic diarrhea and poor absorption of nutrients, but we also don’t want it to happen too slowly because that’s going to lead to that bacterial overgrowth. So we have to optimize digestive function in order to prevent bacterial overgrowth from taking place again in the future.

So when it when we’re talking about any type of overgrowth in in the gut, we can have fungal overgrowth, we can have bacterial overgrowth in the large intestine, in the small intestine, doesn’t really matter. Our digestive function is influencing this overgrowth, no question, which is why antibiotics are not going to do the full job and even herbal antimicrobials aren’t going to do the full job either. So you can take oregano oil, sure, but I would not recommend taking this blindly because it can do more damage if you don’t know what’s going on.

But you can throw antimicrobials at it. That’s whatever, right? But it’s just gonna come right back. If your digestive capacity is breaking down, we’re gonna have that pond situation, right? It’s just a matter of time. It’s like you’re wiping off the top and then it’s just gonna regrow right back. So we have to look at our actual ability to break down and digest our food, which is essentially stomach acid, bile flow, and enzyme secretion. All of these things play a huge role when it comes to how SIBO even happened in the first place.

So I talked a lot about kind of stomach acid there. And then the other piece here is going to be bile flow, which I which I touched on, but I wanted to go into that a little bit more because it’s it’s super important. So I want you guys to kind of understand it. So when it comes to bile, bile is one of these digestive juices. Bile helps us to break down fats and absorb fat soluble nutrients. It also is important when it comes to like clearing histamine. It’s important when it comes to clearing toxins overall, mycotoxins from mold.

It’s really important when it comes to clearing excess estrogen. So if you have kind of more of an estrogen-dominant picture, supporting bioflow is really, really important here. And bile is produced in the liver and it’s secreted by the gallbladder at mealtime. You can think of it as like this soapy substance that gets pushed into the small intestine to kind of keep the small intestine relatively sterile. Not entirely sterile, but somewhat sterile, because once again, those bacteria are in our large intestine. They shouldn’t, we shouldn’t have too many of them in the small intestine.

Hannah Aylward (40:27.596)

So bile is antimicrobial in nature. It kind of acts like a soap. Think of like squirting tauntish soap into your pan, right? And helps you break down the fat and the food residue in the pan so it’s clean again. Bile kind of acts like that. It helps to keep things clean. Now, when we have poor liver function, or when we have our gallbladders then removed, maybe we’re gonna have issues with bile flow. And that’s going to then lead to bacterial overgrowth in the small intestine.

Bile, in my opinion, is like the unsung hero of digestive function and it doesn’t get enough credit. But that’s just that’s just my opinion. It’s so important, right? It helps to excrete excess toxins. It basically gets pushed into your intestine and it binds to toxins. So you then poop them out. That’s it’s kind of as as simple but not simple as that, or as glamorous and not so glamorous as that. You’ll just excrete these toxins out via your stool and excess hormones like estrogen via your stool.

So we’re gonna run into a lot of issues if bile isn’t working properly. So we have to look at bile flow when it comes to any case of small intestinal bacterial overgrowth, or dysbiosis overall, or hormone issues, hormonal acne, chronic period pain, excess estrogen levels, mold detoxification. Bile plays a huge role in this. And poor bile flow can contribute to bloating, constipation, recurrent SIBO, fat malabsorption.

Another thing to look out for here would be like if your vitamin D levels are always super low and you’re supplementing and the levels aren’t going up, we may want to take a look at bile because that’s how you actually it helps you absorb those fat-soluble nutrients, something like vitamin D. So I have a whole episode, more recent podcast episode on bile as well. If this is resonating with you, go listen to it. It’s on the Nutrient Dense podcast. You can binge. I’ve got episodes on all this stuff. Go, go binge away and learn learn a lot to support yourself. But bile is a really important piece of the puzzle when it comes to.

What’s what looking for? Kind of avoiding recurrent SIBO and actually overcoming this bacterial overgrowth that takes place in the small intestine. So those are digestive juices play a big, a big, big role here. Other things that can go miss when it comes to small intestinal bacterial overgrowth. so things like mold exposure, we will see cause recurring SIBO regardless of what people do.

Hannah Aylward (42:45.794)

So, mold exposure can drive inflammation. It can lead to immune dysfunction. It can lead to slow gut motility because it will negatively impact bile flow. And it will lead to an overgrowth of bacteria in the small intestine and we’ll get an overgrowth of fungi or yeast in the small intestine, oftentimes as well. So when we have this mold exposure, that can lead to a breakdown in gut function and then contribute to that overgrowth of bacteria in the small intestine.

I look for mold exposure in people that are like, I’ve done everything. I’ve done multiple herbal antimicrobial protocols. I’ve done multiple rounds of antibiotics. I have a lot going on and I’m just not getting better. I start to dig deeper here. Mold is a is a big underlying root cause as to why like nothing ever works for people. At least that’s what I see time and time and time again. You will feel super sensitive to things, you’ll feel very reactive to things.

And we will run mycotoxin testing with some of our clients to see if they are being exposed to mold toxins and what those levels look like. And detoxifying from those mycotoxins, getting out of the exposure, all of that is going to help. And then doing some gut cleanup after that will be really supportive. Mold was a part of my personal story when it came to my chronic gut issues too. I had no idea. I had no idea. I would have never taken it seriously. I was like, mold, like what do you mean? You like wipe it off.

Little did I know it was the reason why I was doing everything. Like I was like antimicrobials, enzymes, L-glutamine, you know, elimination diet for years, all of the things. And I would just was never getting better. I’d feel a little bit better, it would come right back. I’d feel a little bit better, it would come right back. And I was living in a moldy apartment and I had no idea. And once again, I would have never taken it seriously because I didn’t even understand how it could impact your health. And it was a big reason why my chronic GI issues just were not, my gut like couldn’t recover with these conditions. So

If you want to dig into the mold conversation, I have a whole podcast episode for you on that and exactly how the mold impacts your gut microbiome. So you can dig into that on the Nutrient Tense podcast too. Just like type in Nutrient-Itense Podcast mold, it’ll come right up for you if you want to learn more about that. But this is a big underlying root cause. So we’ll see clients like we get a lot of clients that work with us after they’ve worked with many other people, like naturopathic doctors, functional medicine doctors, their primary care physician, their gastroenterologist. They’ve worked with a dietitian, they’ve worked with tons of people.

Hannah Aylward (45:08.954)

And no one has really helped them truly address things at that root cause level, and or no one’s really caught these other things that are contributing to the breakdown in the digestive function. And mold can be a big reason as to why it keeps happening and you never are fully getting better. So just something to explore here. It’s not the root cause in everyone’s case, that’s for sure. But I like to always ask questions when I’m first speaking with someone so I can understand like what actually led to the breakdown in digestive function here. And sometimes.

Mold exposure can be playing a role there. So just something, something to note, not to like freak you out, but it does heavily impact your gut function, impact your thyroid, it’ll impact bioflow, it will impact your gut microbial balance overall as well. So something to definitely take into consideration. The other thing here is going to be an infection. So there’s something called an Helicobacter pylori infection. It’s a bacteria, it comes on in, it burrows into your stomach lining, it can contribute to inflammation, and

It will damage the parietal cells that produce stomach acid. So I spoke about stomach acid earlier, right? Stomach acid is we need adequate stomach acid to properly break down and digest our food. What is causing low stomach acid? Sometimes we’re looking at something like a Helicobacter pylori infection. It will lead to poor digestion and it can kind of set the stage for SIBO. So when we’re working with clients, we’re testing people, right? We’re running functional soul testing, we’re seeing

What infections are present, or if parasites are present, bacterial overgrowths, bacterial undergrowths, fungal overgrowth, and also looking at digestive function, because all of this is necessary to get you really feeling better and staying feeling better. So H. pylori and mold can can be underlying contributors to things like recurring SIBO. And then also we have things like adhesion. So

For people who have had C-sections or abdominal surgeries or maybe endometriosis, things that would contribute to adhesions, you can think of these as like kinks in the hose. They start to they’re like physical restrictions that impair your gut motility. So this is more of a physical issue than it is a microbial issue, but it’s a the adhesion that kink in the hose can lead to slow gut motility that then contributes to that overgrowth of bacteria.

Hannah Aylward (47:24.694)

in the small intestine and in the large intestine. So things like adhesions after surgeries, like scars, C-sections, things like endometriosis can contribute to adhesions here as well. That will then basically impair the flow of the digestive process and then lead to that bacterial overgrowth. So that can be an underlying root cause for some people as well that never goes, you know, we never even take into consideration if things keep coming, keep coming back, adhesions can play a role there too.

And then we can also have something like diabetes because neuropathy can actually slow down your intestinal motility. So when we’re looking at these reasons why most SIBO protocols fail, you are told you have SIBO, you go in for the antibiotic, and it maybe helps you feel a little bit better, or it doesn’t help you feel better at all, or it helps you feel better and then it kind of comes right back. There are many reasons why this can happen. It’s not the same, not it’s not the same answer for everyone either, which is why working with someone is so incredibly important here.

Because we need to customize interventions based on your data. So we have things like slow gut motility due to something like slow thyroid function or impairment of your migrating motor complex, that MMC. We can have chronic stress, that gut brain connection, chronic stress leading to low stomach acid production, poor bioflow, low enzyme secretion, then leading to that bacterial overgrowth picture.

We can have food poisoning, which is kind of more of like a one-off event, damage to your gut motility. And then that kind of slows everything down. Your body starts to produce antibodies that then damage that gut motility. We can also have low stomach acid production, poor bile flow, low enzyme production as well. You’re just unable to break down your food efficiently. So have these maldigested chunks of food, overfeeding your gut bacteria and giving off gas and and bloating and things like that.

And then we have mold exposure, some other like hidden root causes, mold exposure, different infections, parasitic infections, or a Helicobacter pylori infection. And then we have adhesions, right? That can also kind of create this like kink in the hose that then impair your gut motility and lead to that bacterial overgrowth picture. And then something like diabetes can also contribute to it because it can it can slow that intestinal motility. So there are many underlying reasons why the SIBO may keep coming back.

Hannah Aylward (49:44.652)

Which hopefully at the end of all of this, because I know we’ve been going for close close to an hour, there’s a lot to say because health is nuanced and it’s complex and it’s not super simple. It’s not a one supplement thing and everyone’s body is different. So I just like to be very, very transparent with that. I think anyone that’s like this one probiotic is gonna fix it all. It’s just like completely untrue. Everyone’s body is unique and different. But there’s a lot that goes into this, right? Which hopefully gives you hope and reassurance.

Because if you’ve done the antibiotic and it hasn’t really worked and it’s come right back, it’s it’s okay. There are so many other things that we can explore to get you feeling better and staying feeling sustainably sustainably better long term. You just need a better strategy. We just have to dig in a little bit deeper and see what actually led to led led the con to the conditions that allowed that bacterial overgrowth to take place in the first place.

So SIBO at its core is not, it’s not really a bacteria issue. Yes, the bacteria is there. Yes, that’s causing bloating and distension, but it’s not a bacteria issue at its core. It is a breakdown in your gut motility, and we have to dig into what led to that, right? Mold exposure, thyroid issues, low stomach acid, pore bile flow, chronic stress, under-eating for a long period of time, all of those things can contribute to that breakdown in gut motility. Other big reasons why.

Protocols don’t work would be that after we bring down those levels of gut bacteria, there’s no rebuilding happening. So maybe you’ve taken herbal antimicrobials, maybe you’ve taken an antibiotic and you were just kind of like wiping out bacteria, but no one is helping you rebuild your good gut microbes, which is really important because your good gut microbes help to maintain a healthy ecosystem. They help keep out an overgrowth of fungus or yeast or something like candida, right?

They help to keep out the bad gut bacteria. So we need adequate levels of our good gut bacteria to kind of keep the like homeostasis in that gut microbiome as well. So if you’re not rebuilding a digestive function and then B, your gut microbiome, it’s likely that something can kind of just come come right back. And if you’re not working on supporting gut motility more long term through many different things, right? Like lifestyle, supplementation, nutrition, stress management, all of these things matter, optimizing thyroid function.

Hannah Aylward (52:05.656)

Then that overgrowth can really just come, can just come right back, right? So SIBO has an incredibly high relapse rate. They say like 40 to 65% of people relapse within a year of taking something like an antibiotic. I think it’s probably higher. I mean, we see higher, but we specialize in digestive issues. So I’m my data is skewed, right? We’re seeing people that have recurring digestive issues. That’s who’s coming to us. But the relapse rate is super, super high. And that’s because

We’re only throwing things at the problem that are bringing down bacteria levels. We’re not addressing digestive function, gut motility, thyroid function, environmental toxin exposure, what led to the overgrowth in the first place, right? Chronic PPI use can contribute to it. Overuse of antibiotics can contribute to it. There’s a lot that goes into it. So if you feel like you’ve taken the antibiotic and you haven’t really gotten very far with that.

It’s okay. There’s so much more that we can do to optimize your digestive function and get you feeling a lot better. So what we want to do is repair function and rebalance your gut microbiome and really build and support a digestive system that is more resilient overall, that can tolerate more foods overall, that’s more resilient to infections, that’s more resilient to overgrowths taking place in the first place. And there’s a lot that goes into that.

Proper nutrition, stress management, optimizing digestive function, right? We want to build that resiliency so you’re stronger when the next thing does come your way because it will, right? We’re all navigating all kinds of stuff all the time. So we really want to work to build resilience overall. SIBO is just the downstream result of other things happening upstream, and it’s not your primary issue.

So if you feel like you’ve tried multiple SIBO protocols, you’re not broken and you’re not stuck. There’s a lot more that we can do and dig into. We just have to shift the perspective from how do I kill off these bacteria to how do I repair my digestive function? So the environment is not conducive to allowing heavy bacterial overgrowth to even take place in the first place. So I hope that that feels super, super supportive for you. Big hugs each and every one of you, and I’ll see you next week. Okay. Bye everyone.

Hannah Aylward (54:18.296)

Thanks for joining me for this episode of the Nutrient Dense podcast. If you found this episode valuable, don’t forget to subscribe, leave a review, share with a friend, and come back next week for a new episode. See you then.