This morning I got to thinking about some of my favorite papers of the past, and decided to pick one to write about today.
In the spring of 2010, around the same time I saw Dr. Jeremy Nicholson present his findings – that the urine of children on the autism spectrum contains metabolites different from their typical peers, confirming the existence of an altered bacterial microbiome[i] – I read a paper[ii] in the journal, Nutrition, that also rocked my world. (I mentioned this once before, in one of my SCD posts.) It confirmed that everything I was doing as a nutritionist for my clients with the symptoms of SIBO (small intestine bacterial overgrowth) and/or IBS (and actually, IBD as well), everything I had done for my own son, everything I had observed and learned to be effective, was spot on. Science had finally caught up with me.
The paper pointed out that the available laboratory testing for SIBO is inadequate and unreliable. (This is still the case, 8 years later, by the way.) Therefore, the best way to determine its presence is to treat for it and if the person gets better, that’s what they had.
What then did these authors suggest as therapeutic approaches? “In light of the potential mechanisms by which SIBO might cause symptoms, therapeutic approaches theoretically include reducing the bacterial load and/or changing the functional properties of the microbiota.”
Everything we’ve learned since – for example, all the recent work on the importance of prebiotics in the diet – continues to support the above as the best treatment options available at this time.
[i] Yap, IKS, Angley, M, Veselkov, KA, Holmes, E, London, JC, Nicholson, JK. Urinary metabolic phenytyping differentiates children with autism, fromtheir unaffected siblings and age-matched controls. Journal of Proteome Research. 2010. 4;9(6):2996-3004.
[ii] Gibson PR, Barrett JS, The concept of small intestinal bacterial overgrowth in relation to functional gastrointestinal disorders. Nutrition (2010), doi:10.1016/j.nut.2010.01.005