Is lactose intolerance really SIBO?

Evidence is growing demonstrating that intolerance to lactose is really just yet another manifestation of SIBO, small intestinal bacterial overgrowth.

In a small Australian study, for instance, of 10 elderly people with lactose intolerance, 90% had SIBO (by lactulose H2 breath testing); eradication of SIBO reversed lactose intolerance in all initially SIBO-positive participants. Likewise, in an Italian study, lactose intolerance was associated with SIBO; eradication of SIBO resulted in most people being freed from lactose (as well as fructose and sorbitol) intolerance.

It is part of the disruption of the digestive process that the microorganisms of SIBO inflict: intolerance to lactose and other sugars, fat malabsorption that causes fat to pass through undigested, intolerance to nightshades and FODMAPs, excessive histamine production, bile acid beconjugation (breakdown into their components) that increases LDL cholesterol/LDL particle number. You can appreciate that the cause of intolerances to foods suffered by millions of people is not due to the food; it is due to the disruption of digestion caused by SIBO. Why else, for instance, would someone develop intolerance to tomatoes or cheese at age 40 or 50? It’s not genetic, it’s not the food; it’s the change in microbial composition and location of SIBO.

The solution therefore only begins with elimination of the foods that cause symptoms, but that alone does not address the cause. The real solution is to confirm the presence of SIBO, then eradicate it. In the Undoctored Inner Circle, we take a three-step approach:

Correct the factors that caused SIBO in the first place—e.g., acid-suppressing medications, avoid herbicide/pesticide residues in food, manage hypochlorhydria, etc.
A two-week course of herbal antibiotics such as FC Cidal and Dysbiocide coupled with efforts to disrupt the intestinal biofilm such as N-acetyl cysteine
Efforts to prevent SIBO recurrence such as a high-potency, multi-species probiotic, fermented foods, prebiotic fibers, and the unique upper gastrointestinal tract probiotic properties of L reuteri yogurt 

I am shocked at the incredible prevalence of SIBO, especially now that we have the consumer AIRE device that detects breath hydrogen indicative of upper gastrointestinal bacterial overgrowth. Study after study has also revealed the presence of SIBO in 10-40% of “normal” controls without symptoms. And ignoring SIBO is unwise, as it has long-term consequences that range from fibromyalgia to coronary disease to diverticular disease and colorectal cancer.

If you therefore have lactose intolerance or any other food intolerances, or even if you are just concerned about the possibility of having silent SIBO, join our frequent discussions on this important health topic in the Undoctored Inner Circle.

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