SIBO is definitely linked to leaky gut and autoimmune conditions including:
- Celiac disease
- Sjögren’s syndrome
- Rheumatoid arthritis
- Ankylosing spondylitis
- Type one diabetes and more
How is SIBO linked to leaky gut and autoimmune conditions?
SIBO is an inflammatory process which can damage the lining of your small intestine. This damage not only impacts efficient digestion of fats, carbohydrates and proteins but can also cause the intestine to become leaky. Leaky gut is where your small intestine becomes more porous or permeable (leaky) to proteins, bacteria, viruses, toxins and incompletely digested food particles. Normally these particles are fully contained in the intestine.
But when leaky gut occurs, the particles go beyond your small intestine and come into contact with your immune system whose job is to identify, hunt down and destroy them. Unfortunately, the same immune response can trigger various autoimmune conditions in people who are genetically predisposed to them.
This mechanism is called “molecular mimicry.” Foreign proteins or other antigens resemble some of our body’s own proteins, thus when they elicit an immune response, the reaction also targets our proteins.
What about SIBO being a cause?
The most common test for leaky gut is the lactulose/mannitol small intestinal permeability test. Intestinal permeability (IP) is the medical term for leaky gut.
Using the test, this study evaluated 34 subjects suspected of having SIBO and 34 asymptomatic (no symptoms) controls. The subjects with SIBO exhibited increased IP. Increased IP has also been observed in people with a variety of SIBO-related conditions including fibromyalgia, celiac disease, IBS, another IBS study, post infectious IBS and Crohn’s disease.
While these studies don’t prove SIBO is the cause of leaky gut, the close association of SIBO with leaky gut and the types of damage caused by SIBO convince me that SIBO likely plays a causative role.