Biofilm SIBO relapse refers to the pattern where overgrowth returns after treatment, and as Kieran puts it: "It's frustrating when you've tried about 3 different herbal protocols, used the best biofilm agents and even kept on top of your motility, But until you've addressed why an overgrowth can even happen."
Why Does SIBO Keep Coming Back After Biofilm Agents and Antimicrobials?
Be me:
have SIBO for most of my teenage years put together the strongest round of antimicrobials + biofilm agents Feel better for a month It comes back... realise my stomach acid was always low, hence the overgrowth in the first place realise because of this my bile flow was poor also, making overgrowth even more likely address both of these and do another more gentle round felt immensely better since, now eat pretty much whatever without a worry
I see this happen over and over again with clients, most have already tried antimicrobials by the time they begin working with me,
It's because microbes aren't what are causing your issue but the environment that allows them to overgrow is.
It's frustrating when you've tried about 3 different herbal protocols, used the best biofilm agents and even kept on top of your motility,
But until you've addressed why an overgrowth can even happen.
Why you're body cannot undergo homeostasis of the microbiome.
Unfortunately you're destined for relapse,
I see most commonly:
- Low stomach acid or inappropriate timing/regulation
- Poor bile quality causing both disrupted motility and bacterial overgrowths
- Methylation, Low vitamin D and Zinc leading to less secretion of your bodies own antimicrobials
- Chronic disruption of basic processes such as the MMC and circadian rhythm leading to no co-ordination of the "dance" that is the work of the gut.
But also I'm seeing more and more people nuking their microbiome with stronger and stronger herbals, more biofilm agents and more firepower,
And what that leads to is more resistant bacteria/microbes.
Ones that are better at hiding, and for these people even restoring the bodies natural capacity is rarely enough,
At this point we focus on the bacteria/microbes virulence factors also,
Focusing on lowering their defences and then striking whilst their guard is down.
Some things like quercetin, apigenin, propolis, limonene and baicelein i've seen be increasingly helpful on this front,
But the end point remains the same. The ways of "just take antimicrobials and biofilm agents" is nearly impossible to get away with in this day and age.
We need full scale environmental manipulation and advanced natural strategies.
What Actually Causes Overgrowth Before Bacteria Even Get Involved?
No gut issues ever start with bacteria, but they always start with:
- Low stomach acid which should normally nuetralise 99.9% of harmful bacteria you swallow
- Poor bile flow again leading to less antimicrobial pressure in the small intestine, also promotes biofilm formation
- Too much oxygen in the gut lining, whether this is damage through NSAID's, Alcohol, Stress or other toxins it leads to more harmful oxygen loving bacteria growing
- On a similar note a damaged gut lining from above things leads to less antimicrobial peptide production, your body literally loses it's compounds that balance the microbiome
- Slow motility is usually a combination of above factors, and it leads to slower transit time and more bacterial fermentation
- Again connecting to the above notes more damage to the gut lining = more damage to the mucus lining = less protection against bacterial toxins = more damage to the gut lining.
Everyone loves to blame bacteria, but rarely anyone looks at why they even had the chance to overgrow in the first place,
You can actually find which of these were the key players in your issues through very specific yet simple timeline and symptom mapping.
I've spent the last 6 months actively seeking out the hardest cases of SIBO and gut issues I could find,
Those who had tried antimicrobials, biofilm agents even supporting stomach acid and bile.
I've been compiling what I've seen work, and training GutFix AI to act appropriately in helping people identify strong levers for action.
Which Levers Matter Most: Stomach Acid, Bile Flow or Gut Lining?
You'll waste time doing literally anything in the body without working on the gut first,
It is the grand multiplier. So on this note what are the biggest levers we can pull without becoming neurotic about each strain of bacteria within our gut?
Prevent endotoxin production, don't just bind endotoxin infinitely. Seriously this is the biggest thing that gets ignored or slept on, you only have high amounts of endotoxin producing bacteria because your gut allows for it,
Here are the factors that allow for SIBO, therefore high endotoxin, therefore high systemic inflammation and also the inability to drink OJ.
Stomach acid is 99% of the job, nuetralises many pathogenic bacteria, literally required for bile flow and all in all is needed to keep the small intestine clean and prevent massive dumps of endotoxin.
Bile flow, forget taking a million and one antimicrobials bile will break biofilms, rupture bacterial cell membranes all as a secondary function whilst it digests any fat you eat. I really like bitters for this, but stomach acid is needed as a prerequisite.
Gut and Mucus lining. Okay let's say you have more endotoxin than normal, usually nothing to be too worried about, your gut lining and mucus lining break down endotoxin and nuetralise it and physically buffer it from your system,
A strong gut lining means endotoxin is a non issue, combined with reducing the bacterial overgrowths too.
Your gut lining is also one of the most powerful antimicrobials your body has, secreting antimicrobial peptides which when combined with bile and stomach acid are more than sufficient,
Instead of chasing a million and one supplements. Focus on the big three.
Stomach acid. Bile. Gut lining.
From there everything keeps itself regular, homeostasis applies to the gut too.
How Do You Know Which Type of Overgrowth You Have?
Intense bloating or gas.
Looking at it statistically this is likely a direct result of the above, considering bile and acid create an environment where an overgrowth is very unlikely we should address the first two before killing bacteria to lower relapse rates,
Now we've got environmental factors out of the way determning type of overgrowth can give us hints as to which tools can be most helpful.
Constipation is often methane dominant SIBO, now some specifics I like for this are quercetin and potentially red yeast rice paired with Coq10 for offsetting potential depletion,
Diarhhoea is often symptomatic of hydrogen or hydrogen sulfide, you can tell easily by the sulfurous rotten egg type smell. Oregano oil and pepto bistmol or bismuth subsalicylate and or subgallate stand out for this too,
But the overall commanility is both H2S and Methane feed off hydrogen, so removing the overgrowth as a whole is more effective than any one specific targetted intervention.
Now for this I actually am not adverse to short term rifaximin paired with s boulardii and potentially seeking health histamin X and entersogel spaced for die off,
A purely herbal route may depend on the type but including binders biofilm agents and most important anti virulence factors to reduce antimicrobial resistance such as quercetin, limonene and apigenin for example can make treatments drastically more effective.
