The Pill Can Be One Of The Causes Behind Small Intestinal Bacterial Overgrowth or SIBO.
Welcome back I’m Dr Hagmeyer and today is video #4 in our series titled, “Is The Pill Wrecking Your Gut Health”
Last week I did a video on Birth control pills and Leaky gut, I talked about testing for leaky gut, I explained some of the different leaky gut markers we look at in blood, I showed you several examples of test results from patients who have leaky gut and why most 30, 60, 90 day leaky gut “programs” are not are not enough to truly correct a leaky gut and so just a quick reminder if you are just tuning in,
In this video series titled “Is the Pill wrecking your gut?”, I have shown you how
- The pill causes Gut inflammation,
- I have shown you how the pill causes Intestinal permeability or Leaky gut,
- I have showed you how the pill changes and affects the levels of healthy gut flora and the diversity leading to Gut Dysbiosis.
In today’s video, I want to talk about the connection between The Pill and its affect on Gastro intestinal motility and how this ultimately leads to bacterial overgrowth and other symptoms associated with IBS/SIBO- such as Bloating, Constipation, Gas, and or diarrhea.
Last week I had a young woman in her 20’s email me a question about SIBO. She had recently started taking “The pill” because her doctor felt “The pill would help regulate her cycle” and manage her symptoms better, within about 4 week of taking the pill, she found herself stooped over in pain, constant sensation of being bloated feeling generally sick. Now, not every woman experiences symptoms as severe as these when starting the pill but these symptoms make sense!
Studies show Estrogen slows down intestinal contractility resulting in slower transit time
Studies show Estrogen slows down intestinal contractility resulting in slower transit time and slower transit time allows bacteria to accumulate…. In this study, it was found that 32 % of 1,657 women who started taking oral contraceptive pills (OCPs) discontinued them within six months; 46 % stopped taking the pill due to side effects.
How Estrogen From The Pill Causes SIBO
Here’s why this is important and the How it relates to SIBO. Estrogen like the kind found in the pill does several very important things and if you have IBS/SIBO or some other kind of GI disorder, then you will want to follow along here….
Estrogen relaxes smooth muscle contraction and slows down gastric emptying and like I mentioned earlier this can create the perfect environment for the development of SIBO.
If food is sitting in the stomach and or sitting in the intestines for too long, this can make a nice environment for bacteria to set up shop. Think about a dam that gets backed up? If water can’t circulate it stagnates
Now…Let me explain a few more things.
If you look at this picture, you will see that muscle (specifically, Smooth muscle) lines the sphincter between the esophagus and the stomach. This sphincter is called the LES or (Lower Esophageal Sphincter),
The smooth muscles ALSO lines ANOTHER sphincter that separates the LARGE intestines and SMALL intestines-This sphincter is called the IC valve or the ileocecal valve. The IC valve Plays a huge role in IBS and SIBO
When We Slow Down Or Relax The Muscles of GI Motility….
Now, here is why this is important and why I show you this illustration. When we slow down or relax the muscles that affect the Motility of the intestines or the emptying of stomach contents, We can develop a bacterial or fungal overgrowth or excessive colonization (of these bacteria and fungus) in the stomach in the upper part of the small intestines or the lower part of the small intestines.
If you are woman who experiences acid reflux after taking the pill or worsening of your acid reflux after taking the pill- I would start thinking about the effects of “The pill” as it relates to relaxing the LES (lower esophageal sphincter)
Now…Just a side note- if you are a woman who experienced acid reflux with any of your pregnancies, this is most likely the culprit. The estrogen from pregnancy was causing the relaxation of this sphincter.
One point to keep in mind and this is very important. SIBO (Bacterial overgrowth in the Small Intestines) is a secondary condition that develops in the setting of slowed intestinal motility or slowed stomach/gastric emptying- Both of which can be and are caused by “The Pill” this is the very definition of SIBO!
“SIBO is Secondary Condition DUE to Slowed Intestinal Motility and or Slowed Stomach Emptying.”
Every day I have a person who calls and says “I have SIBO and I started a low FODMAP diet and I have taken Rifaximin and I’m not any better.” or I felt better but know I’m worse. Of course you are not better!-
You have a motility disorder as the primary CAUSE and the overgrowth of bacteria/infection is the RESULT-SIBO is a result it’s a symptom not the problem!
I believe many doctors who treat patients with SIBO, are falling into the same rabbit hole and doing the same thing from a treatment perspective.
Once you and your doctor understands this and start thinking about SIBO as a symptom, your chance of successful treatment for SIBO will increase dramatically! It comes back to asking the question “WHY” ……Why do I have SIBO…- What caused it? What are the other factors behind the progression of it.
Let me explain a few other things that I think are so important. While there can be many reasons for SIBO, the Ileocecal valve is one of the main players in the development of bacterial overgrowth.
If this is a topic of interest to you, you can watch my video “Why most SIBO treatments fail” and watch the 2 part video I did not that long ago)
OK…what else about the Pill and SIBO…. I just talked about how The Pill relaxes the LES sphincter- well the pill also relaxes another sphincter called the Ileocecal valve High levels of Estrogen like the ones found in the pill for many woman cause bloating and this bloating in and of itself ALSO keeps the Ileo-cecal valve open.
High levels of Estrogen (like the ones found in the pill) for many woman cause bloating and this bloating in and of itself ALSO keeps the Ileo-cecal valve open.
Now let me explain a few more things about the Ileocecal valve and why if it stays open- it can be a problem…
So here again is a picture showing you where the IC valve is located. You will notice that it is between your large and small intestines and in the lower right quadrant of your abdomen. In fact, if you notice that area being an area of tenderness or pain- (And) you also have bloating, frequent gas, Constipation or Diarrhea there is a good chance that you have a problem with your IC valve being stuck open.
Think of the Ileocecal Valve like a Trap Door.
Think of the Ileocecal valve like a trap door- (normally it is closed) but it opens to allow food to pass from the small intestines into the large intestines and then it closes. But when it stays open or develops high pressure because of constipation, bloating or because we have slowed intestinal motility or because we have slowed gastric emptying (all things the pill can do)…. Bacteria will colonize in the small intestines where they don’t belong. (Ileocecal Valve Release Technique)
If you are taking “The Pill” Estrogen Replacement therapy, using a hormonal IUD, Patch or ring or in the past have had fertility shots (anything that has high levels of synthetic estrogen’s) this can affect gastric motility, gastric emptying, dysbiosis, leading to the symptoms of constipation, bloating, diarrhea, acid reflux, and SIBO
Alright….Stay with me here….There is another problem with the pill that I want you to be aware of and this is the connection to something called the Migrating Motor Complex.
This migrating motor complex is also a very important player in IBS and SIBO.
The Migrating Motor Complex is like sweeper. It’s a neurological mechanism which causes muscular contractions in the intestines.
The nerve cells in the intestines as well as the smooth muscle in the intestines have receptors for estradiol- specifically Beta Estradiol receptors. What this means is that when estradiol (estrogen) attaches to these receptors- it slows it down motility. If you remember from a past video I did, I talked about the importance of these rhythmic and muscular contractions.
These contractions sweep food, bacteria, debri and toxins down and out of the intestines preventing that colonization and bacterial overgrowth we have been talking about.
In some individuals, these synthetic hormones… not only slow down motility and gastric emptying, they also slow down the function of that migrating motor complex which we talked about. So those are three main ways that Estrogen can be traced back to SIBO and IBS.
This is an exciting areas of research and I am sure as time goes on, researches will understand this mechanism in even greater detail. I think there is still…. so much we don’t understand, but I believe that for now, I believe it’s safe to say, (based on what current research shows us), that we have a mechanism by which “The pill and other forms of unnatural hormones can certainly cause or exacerbate IBS and SIBO……
7 Important Points to Remember About Today’s Video
Point #1 Synthetic estrogens (found in The Pill, IUD’s, fertility shots, ERT/HRT have been shown to slow down gastric emptying, relax the IleoCecal valve and relax the Lower Esophageal Sphincter- Check out a video that shows you how to self massage the IC valve
Point #2 when these sphincters (Lower esophageal and IleoCecal sphincter) relax, this can be a ROOT CAUSE…in setting the stage for SIBO, IBS, Bloating reflux and other motility disorders.
Point #3– If you are woman who is suffering with IBS symptoms and you have been working with a functional medicine doctor and you feel your doctor is just missing something. Your doctor may need to shift his/her attention to correcting your hormones or addressing medications that might be hindering your gut motility and gastric emptying,
Point #4 Remember…..SIBO is a secondary problem due to motility issues or slow stomach emptying. It is a SYMPTOM not a Cause. If your doctor tells you that you have SIBO, you should ask him/her what caused it-and your very next question should be what we are doing to address the cause of the SIBO.
Point #5 Taking antibiotics for SIBO is like giving kids antibiotics for ear infections. DON’T ACCEPT AN ANTIBOTIC AS THE ANSWER TO YOUR PROBLEM.
Point #6 While, I didn’t talk too much about this, even the “so called” low dose birth control pills still have about 20 TIMES more estrogen than a woman naturally produces on her own. This creates that Estrogen dominant state that many woman with hormonal imbalances are often struggling with.
Point #7 if you are a woman who is taking the pill in order to regulate your cycle or because you have menopausal symptoms-there are many natural ways to correct and address your hormone imbalances.
You may want to consider addressing the root cause of why you have a hormone imbalance in the first place and work on correcting those problems very often, not only will this improve your Hormonal imbalances, it may also improve your IBS, SIBO and gut health.
I know taking the pill sounds like the easy way out- when it comes to regulating a cycle and dealing with many post hormonal symptoms-but as we can see “The pill” just complicates the integrity of a woman’s gastrointestinal system and compromises the health of gut which we know, extends far beyond just the symptoms of IBS.
So there you go, Hope you enjoyed today’s video on Birth control pills and gastrointestinal motility. I hope that you learned a few new things and most importantly, I hope that you will stay tuned in to this video series. In my next video, I will talk about “The pills affect on the gallbladder”
Also Don’t forget, for those of you who are struggling with GI symptoms and you are in need of recommendations on what to do about your heath-Visit my website and in the upper corner you will see a tab that says start here- when you complete a health questionnaire, within about 10-15 minutes, I will email you several recommendations or steps you can take to start improving your health.
See you next time!