Sibo and Hemorrhoids: The Connection

HemorrhoidsSmall intestinal bacterial overgrowth or SIBO is misunderstood. As the name suggests, people suffer from this disease when there is too much bacterial fauna in the small intestine.

Is SIBO caused by good bacteria or bad bacteria?

There is a lot of debate on this topic. However, according to Dr. Mark Pimentel of Cedars-Sinai Medical Center of Los Angeles, CA, who is one of the pioneers in researching Irritable Bowel Syndrome (IBS) and SIBO, people suffer from SIBO when bacteria from the colon colonize the small intestine. [1] Hence it is not caused by either good or bad bacteria in the traditional sense; rather it is caused by bacteria that do not belong in the small intestine.

So how do the bacteria spill over from the large intestine to the small intestine? It is caused by a backflow of stool from the colon into the small intestine. This can be triggered by the following:

  • The ileocecal valve acts as a doorway between the small intestine and the large intestine. It stays closed most of the time and opens shortly to allow the residue from the small intestine to move into the large intestine. [2] If there is any weakness in the ileocecal valve, then the fecal matter may move into the small intestine, causing it to be colonized by the bacterial fauna that belongs in the colon. [3]
  • If you suffer from severe constipation, it will put a lot of pressure on the ileocecal valve and may damage it in the process, leading to SIBO. Chronic sufferers of constipation should look at investigating the causes of constipation and try resolving it naturally.

Hence, it is pretty apparent that there is a strong link between constipation and SIBO. It is no secret that hemorrhoids can be caused by constipation as well! [4] By inference, one can assume that there is a strong link between SIBO and hemorrhoids. But is that it or is there an even deeper link? Let’s take a look at the evidence.

SIBO and Hemorrhoids

The following demonstrates how deeply inter-twined SIBO and hemorrhoids actually are!


As stated earlier, constipation weakens the ileocecal valve, causing the bacterial overgrowth in the small intestine. This in turn means that there are less of the beneficial gut bacteria in the colon. This is exacerbated if you have taken antibiotics for any reason, as they completely wipe out the colon bacteria. When this happens, you will be severely constipated, even if you consume a lot of fiber. This is because it is a common misconception that your stool is primarily made up of fiber. It is not! It is primarily made up of gut bacteria.

Fiber consists of plant polysaccharides that cannot be digested by saliva, stomach acids and pancreatic enzymes. If your colon does not have the requisite amount of gut bacteria, these polysaccharides go undigested, which is then transformed into hard clumps that is even harder to pass through. As you must know already, this is just a ready recipe for hemorrhoids.


Non-alcoholic fatty liver disease (NAFLD) is very common in people who are significantly overweight. There is also a very strong correlation between people who suffer from NAFLD and SIBO. [5]

People who are obese also tend to be sedentary. This means that they get little or no physical exercise. A sedentary lifestyle makes the blood flow irregular, weakening blood vessels throughout the body. If one’s blood vessels are weak and not flexible, it puts the person more likely to suffer from hemorrhoids as well!

Modern Diets:

No, we are not talking about the various fad diets like the Paleo diet or the Atkins diet. Thanks to our busy lifestyles and diminishing real incomes, many people either do not have the money or the time to eat healthy foods. Most of the processed foods available in the supermarket consists of fats, protein and starch, most of which are digested before it even reaches the colon.

The lack of fiber in colon leads to the gut bacteria being starved, leading to imbalance and constipation in the process. As established already, this will lead to SIBO and hemorrhoids.

Colon Cleanse:

This is one procedure that seems to have captured the imagination of people across the globe, especially in the typical “first world” countries. In this procedure, a mixture which primarily consists of coffee is shot into the colon. Coffee is known to be a diuretic and a laxative. The unnatural introduction of an inordinate amount of coffe initiates an involuntary peristaltic reaction, which empties the colon. Along with the fecal matter, all of the gut bacteria are eliminated by this process as well!

Hence, colon cleansing has almost the same effect as taking too many antibiotics or surviving on a diet of processed foods. It eliminates the gut bacteria from the colon, causing constipation, which as we have already stated causes SIBO and hemorrhoids.

Home Remedies to Treat SIBO and Hemorrhoids

We have only properly understood SIBO as a disease over the last few years. Hence treatments for SIBO are few and far between. However, people who suffer from hemorrhoids due to SIBO needs to treat both conditions for long-lasting relief. Following are some home remedies that can possibly help overcome both conditions.

Peppermint Oil:

Research has shown that enteric-coated peppermint oil (ECPO) can help people suffering from irritable bowel symptom (IBS). There have been cases where people suffering from SIBO where the disease manifested as a typical symptoms of IBS. Even such patients showed remarkable improvement after ECPO was administered to them. [6] However, further research and tests are required before ECPO can be hailed as a definitive cure.

Although chances are that people reading this article would already know what hemorrhoids look and feel like. To define it in a nutshell, hemorrhoids are inflamed blood vessels in and around the anus when they are exposed to more pressure than they can typically deal with. Mixing peppermint essential oil with equal parts of carrier oil (such as coconut oil or olive oil) can relieve the symptoms because of the following.

  • The menthol in peppermint essential oil has natural anti-inflammatory properties. A topical application of the same will help the inflamed blood vessels shrink to their natural size.
  • Peppermint essential oil also has strong anti-microbial properties. Hemorrhoids can rupture, leading to some bleeding and the sufferer may also become vulnerable to secondary infections. Regular application of peppermint essential oil on the ruptured hemorrhoids can certainly stave off such infections.

Dietary and Lifestyle Modifications:

As stated earlier, obesity leads to SIBO and hemorrhoids. It is true that no one really chooses to be obese and at times genetic factors or certain glandular abnormalities may lead to severe weight gain. [7][8][9] However, if people are disciplined enough, they can probably make their weight more manageable. Managing obesity reduces the chances of NAFLD, which would in turn reduce the chances of suffering from SIBO or hemorrhoids.

Following are some useful tips.

  • Make at least thirty minutes per day for light exercise. It can be as simple as joining a Pilates, spinning or a yoga class, or simply taking the dog out for two mile hike. Also skipping the elevator or the escalator and taking the stairs whenever possible will help tremendously!
  • Incorporate more fiber in your diet. You can start your day with a high fiber cereal. Also incorporating a healthy salad with lots of fresh leafy greens will go a long way!
  • Vagus nerve Stimulation: Stimulating vagus nerves increase MMC waves that push the food through our intestines. Such action prevents purification and dehydration of stools in the intestines thereby avoiding constipation and thus hemorrhoids. Vagus nerve can be stimulated with deep breathing techniques. Sit comfortably devoid of any distractions. Breathe in for the count of 4, hold your breath for a count of 4 and then release slowly for the count of 6-8. If this is not possible you will soon be able to with little trying. Do this for 10 minutes daily and you will witness burping, passing of gas and induction of calm that all help in digestion.

Please note that the dietary and lifestyle modifications are preventative measures only and can only limit the incidence of SIBO and hemorrhoids. If you are already suffering from these ailments, then you need to treat them while making these lifestyle changes, so that they do not recur in the future!

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