SIBO Causes Body Pain and Inflammation

This is the second post in a series about small intestine bacterial overgrowth. Read the first post.

You may think that if you have zero digestive complaints, then you couldn’t possibly have SIBO. It is true that this condition often accompanies irritable bowel symptoms like bloating, constipation, gas, or diarrhea. However, it is possible to have few or no digestive complaints, yet still have problematic small intestine bacterial overgrowth. It turns out that SIBO can cause inflammation and pain in other parts of your body. Classic examples include high cholesterol, fibromyalgia, autoimmune diseases, interstitial cystitis (IC), and rosacea.

Dr Laura Paris, functional medicine, monterey, acupuncture, GI map, SIBO breath test

Systemic inflammation

In a nutshell, here’s how SIBO can cause inflammation or pain in other parts of your body:

Ideally your small intestine should be fairly low in bacterial populations, and the good ones are called aerobic, gram-positive bacteria, such as lactobacillus. On the other hand, your small intestine should not have many anaerobic, gram-negative bacteria. These bacteria have a cell wall that contains an endotoxin called Lipopolysaccharide (LPS). If these gram-negative bacteria overpopulate your small intestine, then they secrete their LPS there, which has detrimental effects both in your small intestine and your whole body.

Too much LPS can damage your small intestine lining, and make it more permeable or “leaky.” Then, the LPS toxins pass through your gut lining into your bloodstream, and wreak inflammatory havoc throughout your body. LPS toxins trigger strong immune and pain reactions. They are associated with these inflammatory conditions:

So, in all cases of autoimmune diseases and/or any of the above conditions, you may want to investigate if SIBO is a contributing factor. And certainly if you have any hallmark digestive complaints (bloating, constipation, diarrhea, IBS, belching, or gas) plus an inflammatory condition of any type,  you may want to test for SIBO.

Nutrient deficiencies

SIBO causes malabsorption, and consequent deficiency of many nutrients. If your small intestine lining is inflamed, as in the case of SIBO, it makes sense that your digestion and absorption of vitamins and minerals is suboptimal. Research shows that SIBO can cause deficiencies of these nutrients:

  • Vitamin A
  • Vitamin D
  • Iron
  • Vitamin B12

You can measure these levels with a blood test. If you are low in one or more of these, keep in mind that SIBO can be part of the picture. You may not acheive optimal status until your bacterial overgrowth is knocked down and your small intestine lining becomes healthy.

More about iron and SIBO

Bacteria require iron in order to produce their sticky, gluey biofilms that they hide in. (Plaque is an example of bacterial biofilm formation in the mouth.) SIBO-type bacteria use a lot of your iron, which can cause anemia. So if you have low iron, despite taking iron supplements or eating high-iron foods regularly, then you can suspect SIBO. Also, SIBO is associated with poor thyroid function, and low iron levels may be the culprit as your thyroid requires iron to function.

Food intolerances

SIBO causes leaky gut, which means undigested proteins pass between your intestinal cells into your bloodstream. Then, your immune system can easily tag these food proteins as invaders and create antibodies against them, resulting in an inflammatory cascade. If you have food intolerances, especially a lot of them, then you can assume you have some degree of leaky gut. It’s not always caused by bacterial overgrowth in your small intestine, however this can be on your radar when investigating the cause of multiple food sensitivities.

Often, when you clear up SIBO and heal up your gut lining, you can tolerate foods you couldn’t tolerate before. Leaky gut and food intolerance are often part of a SIBO picture.


Hopefully, this gives you a sense of the ways SIBO can cause widespread problems, especially inflammation, pain, and malabsorption. In the next post I describe how to determine if you have SIBO, and how to treat it.

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4 Comments

  1. I just finished treatment of SIBO with Xifaxin and m feeling better. I also had empathic E. Coli and was treated with another antibiotic as well. My Calprotectin level was 1190 and normal should be under 50. I had a colonoscopy last week and have no Crohns or UC. I am feeling better,, but still have terrible bloating and cramps. I had a resection of my cecum, ascending colon and first part of my small intestine including my illegal valve which is no doubt the cause of my SIBO. I am wondering why my Calprotectin was so high. My gastro says it wasn’t because of the SIBO. What’s your opinion? I am waiting for results from biopsies for microscopic colitis, but do not think I have that.

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