Have you been dealing with small intestinal bacterial overgrowth (SIBO) that just won’t go away, or irritable bowel syndrome (IBS) that doesn’t seem to get better? Well, you aren’t alone. It’s estimated that 60% of individuals with IBS also have SIBO, and SIBO affects 10% of the world’s population—that’s a huge number of individuals dealing with uncomfortable and frustrating symptoms without relief.
While many factors can contribute to IBS and SIBO, the function of the migrating motor complex (MMC) definitely plays a role. The MMC is basically a clean sweeper for your GI tract. It runs every 90-120 minutes, sweeping food stuff down to your large intestine. By sweeping food stuff down, it keeps the bacteria in the large intestine from working its way up to the small intestine to feast on our undigested food, which can cause all the gas, bloating, and pain we may feel from SIBO. While many things can cause our MMC to not work properly, including eating too often, stress, traumatic brain injuries, and connective tissue disorders, one emerging thought for those who can’t seem to shake it or improve their symptoms, is an autoimmune condition triggered by food poisoning.
Basically, when we get food poisoning, the pathogen we’ve ingested produces cytolethal distending toxin B (CdtB). To fight the food poisoning, our body produces antibodies to this toxin. Unfortunately, this toxin looks a lot like a protein on our MMC known as vinculin. Yep, that spells trouble, because not only does our body produce antibodies to the toxin, but it may also make antibodies to vinculin, thus attacking our MMC and creating an autoimmune condition. This means that instead of our MMC running 8-12 waves per day, it may only make 1-2 waves per day. Less waves means increased likelihood of bacteria creeping up into our small intestine and causing lots of digestive issues.
Since this is emerging research, studies are limited. However, the studies that have been conducted show a positive correlation between the presence of CdtB and anti-vinculin antibodies, and a positive diagnosis of SIBO and IBS.
So, what does that mean for those of us that can’t shake our SIBO and IBS symptoms? Whether you know you have the antibodies or not, here are a few tips to support your MMC:
Space meals/snacks out by at least 3-5 hours. The MMC only works when we’re in a fasted state, so if you find yourself snacking every few hours, try to space it out to at least 3 hours.
Skip calories and sweeteners in your drinks (even artificial sweeteners). Yep, even drinks can prevent the MMC from working, because the body detects nutrients, so focus on sipping on water throughout your day between meals.
Schedule time with a physical therapist who specializes in visceral work as well as working on internal scar tissue. This ensures organs are in proper tone and/or placement, as well as ensuring scar tissue isn’t getting in the way of your bowels moving smoothly.
Finding flow with stress. This is easier said than done, I know (and I feel ya). Whenever possible, eliminate or reduce stress by saying no or finding support from others. However, some stress can’t be reduced or eliminated, and most of us will always have some degree of stress in our life. I encourage you to reach out to a therapist or life coach for support and/or ways to navigate how we accept and/or perceive those stressors we can’t change.
And if you test positive for the antibodies?
Work with your practitioner on a maintenance program that is specific to your SIBO (there are three different types) or IBS diagnosis (four different types). Keeping the bacteria overgrowth at bay (and IBS symptoms) and supporting the MMC are key.
Work with your practitioner on an autoimmune protocol that reduces inflammation and symptoms, as well as fits your lifestyle and needs.
I’d love to hear from you. Are you dealing with SIBO or IBS you just can’t shake? If so, were these tips helpful? Please comment below or send me an email. Also, if you’d like support with your digestion and gut health, I’d love to help. Please send me an email and let’s work together!
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With love, Steph
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Pimentel, M., Morales, W., Rezaie, A., Marsh, E., Lembo, A., Mirocha, J., Leffler, D. A., &… Change, C. (2015). Development and validation of a biomarker for diarrhea-predominant irritable bowel syndrome in human subjects. PLoS One, 10(5): e0126438. doi: 10.1371/journal.pone.0126438.
Talley, N. J., Holtmann, G., Walker, M. M., Burns, G., Potter, M., Shah, A., Jones, M. &… Keely, S. (2019). Circulating anti-cytolethal distending toxin B and anti-vinculin antibodies as biomarkers in community and healthcare populations with functional dyspepsia and irritable bowel syndrome. Clinical and Translational Gastroenterology, 10(7): e00064. doi: 10.14309/ctg.0000000000000064.