• 2017 SIBO Symposium, all presentations

    Original Date: June 3-4, 2017

    Small intestine bacterial overgrowth (SIBO) is a chronic bacterial colonization of the small intestine. These bacteria normally live in the gastrointestinal tract, however, in SIBO they have overgrown in a location not meant for so many bacteria. The bacteria interfere with our normal digestion and absorption of food and are associated with damage to the lining or membrane of the small intestine. These mechanisms in turn lead to myriad other disorders—gastrointestinal, systemic, and neurological.

    The 4th Annual SIBO Symposium features the nation’s leading experts on the topic to present an evidence-based educational program on managing small intestine bacterial overgrowth. For more information, visit www.sibosymposium.com

    Presentations include:
    • SIBO Overview
    • Risk Factors and Environmental Toxins
    • Methane and Autoimmunity
    • Low-Dose Naltrexone and Low-Dose Erythromycin
    • Managing Treatment Failures in SIBO, IBS and IBD
    • Overview of Nutritional Therapies
    • Elemental Diet Protocol
    • Expert Panel
    • NUNM Research Update
    • Methylation, Genomics, and SIBO

    12.25 CEUs (including 3.5 pharmacy and 8.75 general) for NDs approved by OBNM

    10.25 Category B credits approved by the California Board of Chiropractic Examiners
  • This course requires an enrollment key
    Cost: US$ 55.00
    SIBO Overview

    Presenter: Mark Pimentel, MD
    Original Date: June 3, 2017

    The mechanisms for SIBO are more complex in 2017. There is now evidence that food poisoning is a cause of SIBO and that most of IBS is SIBO. The way food poisoning may be contributing to SIBO is through the development of autoimmunity. In this lecture, the development and measurement of autoimmunity in these subjects are described.

    In addition, methane is unique in SIBO in that it contributes to constipation. Methane gas itself slows transit in the gut. By manipulating methane, constipation can be improved. Interestingly, methane is produced by an organism called M. smithii. This organism has unique properties and new treatments are being developed to help patients based on these. In this lecture, we discuss some pharmaceuticals including rifaximin, neomycin, and lovastatin.


    1.5 CEUs (including 0.5 pharmacy and 1.0 general) approved by OBNM

    1.0 Category B credits approved by the California Board of Chiropractic Examiners
  • Risk Factors and Environmental Toxins

    Presenter: Melanie Keller, ND
    Original Date: June 3, 2017

    A thorough review of risk factors, including exposure to environmental toxins, clinically relevant in SIBO and associated conditions. Since the use of Agent Orange (Dioxin, DTT) in Vietnam the scientific and public communities have come to understand that environmental chemicals can cause physiologic disruption by acting as a xenoestrogen or endocrine disrupting chemical (EDC). The PUBMED literature confirms that exposure to Dioxin (DDT, TCDD, etc.) is directly linked to endometriosis in women and diabetes in men. Reuters noted a 3-fold increase in IBD in Northern California since 1996. And in Canada there has been a 10-fold increase in Ulcerative Colitis in children.

    The introduction of genetically modified organisms able tolerate higher concentrations of glyphosate (Round Up™), a potent pesticide, has made oral exposure ubiquitous and has epigenetic potential to trigger autoimmunity. A 2014 publication entitled “Glyphosate affects the spontaneous motoric activity of intestine at very low doses - in vitro study” [Pestic Biochem Physiol.] demonstrates the effects of EDC’s on the gastrointestinal tract. Scientific treatment of SIBO and associated conditions should include consideration of xenoestrogen’s influence on mitochondrial dysfunction and autoimmunity.


    1.0 general CEUs approved by OBNM

    1.0 Category B credits approved by the California Board of Chiropractic Examiners
  • Methane and Autoimmunity

    Presenter: Mark Pimentel, MD
    Original Date: June 3, 2017

    The mechanisms for SIBO are more complex in 2017. There is now evidence that food poisoning is a cause of SIBO and that most of IBS is SIBO. The way food poisoning may be contributing to SIBO is through the development of autoimmunity. In this lecture, the development and measurement of autoimmunity in these subjects are described.

    In addition, methane is unique in SIBO in that it contributes to constipation. Methane gas itself slows transit in the gut. By manipulating methane, constipation can be improved. Interestingly, methane is produced by an organism called M. smithii. This organism has unique properties and new treatments are being developed to help patients based on these. In this lecture, we discuss some pharmaceuticals including rifaximin, neomycin, and lovastatin.


    1.5 CEUs (including 0.5 pharmacy and 1.0 general) approved by OBNM

    1.0 Category B credits approved by the California Board of Chiropractic Examiners
  • Low-Dose Naltrexone and Low-Dose Erythromycin

    Presenter: Natalie Gustafson, PharmD
    Original Date: June 3, 2017

    Traditional naltrexone has been used to help patients struggling with addiction to opiates or alcohol. However, for decades we have recognized that at lower dosages, aptly named Low Dose Naltrexone (LDN), we see an entirely different effect on the body. LDN has been shown to have a significant impact on improving gut function in various conditions from Crohn’s Disease to SIBO. Understanding its mechanisms of action and literature can help practitioners ascertain which SIBO patients might benefit from LDN as part of their treatment protocol.

    Similarly, Low Dose Erythromycin (LDE) has become part of many SIBO management programs. Erythromycin has been used in gastroparesis caused by diabetes mellitus for many years, but as an antibiotic can had deleterious effects. This presentation covers the benefits of using lower dosing and its role in SIBO management, as well as when to use LDE, LDN or both.


    1.0 pharmacy CEUs approved by OBNM
  • Managing Treatment Failures in SIBO, IBS and IBD

    Presenter: Melanie Keller, ND
    Original Date: June 3, 2017

    SIBO has been found in association with Irritable Bowel Syndrome, Ulcerative Colitis, Crohn’s, Depression, Endometriosis, Rheumatoid Arthritis, Thyroid Disease, and other conditions however very few believe that SIBO is the cause or that treating SIBO will correct the associated dysfunction or disease. It is possible to shift how to treat the complexities of SIBO, IBS and IBD (even those who have failed biologics) and direct treatment to addressing the ubiquitous endocrine disrupting chemicals and address the cause.


    1.5 general CEUs approvedby OBNM

    1.5 Category B credits approved by the California Board of Chiropractic Examiners
  • Overview of Nutritional Therapies

    Presenter: Kate Scarlata, RDN
    Original Date: June 4, 2017

    There is no evidence based nutritional therapy specific for SIBO. Many online nutrition “solutions” provide contradictory information leaving patients experiencing SIBO to be confused. This presentation reviews current nutritional therapies prescribed for SIBO, along with the pros and cons of each.

    The low FODMAP diet is an evidence based nutritional therapy that can mitigate symptoms of IBS. IBS symptoms often mimic those seen in SIBO. In fact, SIBO was confirmed in 60 percent of IBS sufferers with predominant symptoms of diarrhea. A significant amount of data has now demonstrated the effectiveness of the low FODMAP diet in managing IBS, especially for bloating and pain, two key symptoms experienced with SIBO.

    The emergence of nutritional interventions for complex GI disorders continues to evolve with the understanding of diet and gut microbial interactions. Food may elicit GI symptoms via osmotic, chemical, neuroendocrine, and prebiotic pathways or through changes via the microbiota due to impact on bile acid, pH, and fermentative end products (metabolites, short chain fatty acids and gas.) Gut barrier function, nature of gut flora, intestinal resection, gut inflammation, or disruption of the enterohepatic circulation, impairs normal digestion and requires a modified nutrition plan. The nutritional goal for those with SIBO is provide the most varied and least restrictive diet for symptom management to maintain quality of life, adequacy of nutrient intake and health of the gut microbiome.


    1.5 general CEUs approved by OBNM

    1.5 Category B credits approved by the California Board of Chiropractic Examiners
  • Elemental Diet Protocol

    Presenter: Lela Altman, ND, MSA, LAc
    Original Date: June 4, 2017

    An elemental diet is a meal replacement plan that uses a mixture of all essential and nonessential amino acids, fat, simple sugars, electrolytes, trace minerals and vitamins. Components of this mixture are already in their simplest forms so they can be easily assimilated. Because bacteria derive their fuels by breaking down long chains of sugars, the elemental diet is used to treat SIBO by providing adequate nutrition for the patient while starving bacteria. This presentation introduces elemental diets and provide information on how and when to use an elemental diet clinically. This presentation includes a discussion on indications and contraindications, as well as how to transition off of an elemental diet. A brief overview of current research and a couple of short cases demonstrating the use of elemental diets is also included.


    1.5 general CEUs approved by OBNM

    1.5 Category B credits approved by the California Board of Chiropractic Examiners
  • This course requires an enrollment key
    Cost: US$ 20.00
    Expert Panel

    Presenter: Kate Scarlata, RDN, Lela Altman, ND, MSA, LAc, Melanie Keller, ND
    Original Date: June 4, 2017

    Presenters respond to questions from the audience regarding nutritional therapies, elemental diets, or any of the content from Saturday covered by Dr. Keller, and more importantly in healing. A mixture of data, clinical experiences and outcomes and case examples are covered.


    0.5 general CEUs approved by OBNM

    0.5 Category B credits approved by the California Board of Chiropractic Examiners
  • This course requires an enrollment key
    Cost: US$ 30.00
    NUNM Research Update

    Presenter: Laurie Menk Otto, ND, MPH
    Original Date: June 4, 2017

    SIBO is a functional bowel disorder that remains controversial from a diagnostic perspective. The invasiveness of gold-standard diagnostic methods creates a need to develop alternative diagnostic methods that are accurate. Over the past 2 years, the National University of Natural Medicine has been conducting a clinical case-control study to investigate differential biomarker patterns for SIBO that improve diagnostic sensitivity. Specifically, physician-diagnosed SIBO cases (target n=50) and asymptomatic controls (target n=50) were tested for breath hydrogen and methane per manufacturer testing recommendations, and results were compared between groups. Additional biomarkers of gut inflammation, food intolerances via IgG testing, autoimmune cross-reactivity via IgG testing and microbiome differences were measured and compared between groups. Factor analyses will be performed in order to determine if more than 2 distinct testing patterns are apparent. Initial lessons from breath testing, including internal estimates of sensitivity and specificity are shared in this presentation.

    0.75 general CEUs approved by OBNM

    0.75 Category B credits approved by the California Board of Chiropractic Examiners
  • Methylation, Genomics, and SIBO

    Presenter: Paul Anderson, NMD
    Original Date: June 4, 2017

    The world of clinical genomics and nutrigenomics specifically has become an incredibly fast growing and high learning curve area of integrative medicine. Genomics as they affect GI health and SIBO specifically are still in their infancy but are impactful in the pathologies involved and healing from them.

    Dr. Anderson uses his knowledge of clinical genomics to propose ways in which ones genes and the epigenetic factors stressing them factor in to SIBO as a pathology and more importantly in healing. A mixture of data, clinical experiences and outcomes and case examples are covered.


    1.5 pharmacy CEUs approvedby OBNM

    1.5 Category B credits approved by the California Board of Chiropractic Examiners