Have you heard of SIFO?

This stands for Small Intestinal Fungal Overgrowth.

Many of the symptoms are also symptoms of IBS (Irritable Bowel Syndrome):

• Bloating
• Abdominal Pain
• Diarrhea

… these are the 3 most common, and even the most common I have seen within my practice.

So how does this get diagnosed?

The gold standard for diagnosing SIFO is through aspiration from the 3rd or 4th portion of the duodenum, which is the first part of our small intestine. And this is done through an endoscopy.

But the problem is… this is not available to everyone, and a lot of GI physicians do not perform it.

What would be the next steps in diagnosing then?

After a thorough history, and after we have ruled out some bigger diagnoses, I like to consider SIBO as a diagnosis too (because the symptoms are just so similar). 

Up to 70% of IBS patients are estimated to have Small Intestinal Bacterial Overgrowth. Here’s the thing: yeast and bacteria can co- exist together. 

Typically ways we can tell if someone is experiencing SIFO alongside SIBO, is when they are not tolerating treatment for the SIBO very well, or they do not respond well at all to the elemental diet (which is a wonderful treatment for SIBO).

Another way to identify SIFO is through performing an Organic Acids Test, I personally like the ones from Great Plains Lab or Vibrant America. This test is done through urine examination and measures the metabolites in our urine, it is useful in even identifying mold and bacteria!

Patients with SIFO tend to be deficient in these nutrients, which can be another sign:

• Magnesium
• B6
• Iron
• Essential Fatty Acids
• Vitamin A
• Folate

An iron deficiency is even known to predispose to a candida infection.

What are some other risk factors for SIFO?

• Unnecessary antibiotics
• Scar tissue from previous GI issues
• NSAIDS
• Stress inhibiting our autonomic nervous system
• Dysmotility
• Pancreatic enzyme or HCL deficiency

Many patients with SIFO also have celiac or gluten sensitivity, as the Hwp1 is similar to the gliadin protein, so there is cross reactivity between them resulting in an issue with gluten.

Mast cell activation is another common occurrence with SIFO, because candida colonization affects the mucous membrane barrier. Mast cells are our body’s defense and line almost everywhere in our body, including the GI tract. 

Treatment involves working with a qualified practitioner who can work through SIBO & SIFO, as well as provide guidance for low histamine diet (if needed) and mast cell stabilization.

It’s not enough to just treat the overgrowth, but to identify the root cause as to why this occurred in the first place. Only then can we prevent relapse and allow the gut to thrive!

Looking for help in your gut health journey? I offer free discovery calls to hear about your case and see if we would be a good fit.

Happiness & health,

Dr. Steph

Free discovery call: https://drstephaniepeacock.as.me/schedule.php 

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