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Could Reoccurring SIBO be Linked to Adhesions?

This year, The SIBO Symposium had a very fascinating presentation regarding adhesions and how they may be linked to reoccurring SIBO in some cases. A revisiting speaker to the symposium was Larry Wurn, LMT, co-founder of Clear Passage in Gainesville, Florida. He presented a very compelling lecture to a room filled with very interested practitioners. He started his presentation by stating that Clear Passage has been conducting research for manually decreasing adhesions for the past 25 years.

In 1984, Larry's wife, Belinda Wurn, PT (co founder), was diagnosed with cervical cancer and went through treatment resulting in a debilitating condition which adhered her pelvic area with its adjoining tissues causing what is know as "frozen pelvis". She was in so much pain. Surgery was not an option because the doctor informed them that adhesions would form once again after surgery. They began to research and investigate other ways to find Belinda some relief. They found that crosslinks attach collagen fibers to organs and to each other with a molecular bond which seemed like vulnerable areas, and thus, became the Wurns focus for their manual treatment for Belinda 1 .

Image from Larry Wurn, LMT, SIBO Symposium 2016 Presentation

They soon developed a model to remove adhesions manually crosslink by crosslink. Soon enough, she began to feel positive results. The Wurns developed their own technique and opened a clinic to treat others with chronic pain. Soon afterwards, they realized that they were opening blocked fallopian tubes as a result from their treatment which is known as The Wurn Technique, consisting of 200 manual techniques. If they could clear blocked fallopian tubes and improve the function of pelvic organs, it would seem very likely that clearing adhesions in the bowl and improve abdominal organ function could be possible. They eventually developed methods and expertise in treating recurring small bowel obstructions (SBO) – intestines blocked by adhesions 2. Over the years, they have treated intestinal adhesions in hundreds of patients. Within the past couple of years, they have started officially tracking and treating people with reoccurring SIBO with a specialized protocol which was set in place in collaboration with SIBO experts Dr. Allison Siebecker and Dr. Steven Sandberg-Lewis. Some of these results have been positive 4.

According to Digestive Surgery, 2001, surgery is a major cause of adhesion formation and the number one cause of small bowl obstruction 3. He states that the abdomen and pelvis are frequent sites for adhesions. These adhesions can decrease motility and slow or stop the transit for bowl evacuation.

Image from Larry Wurn, LMT, SIBO Symposium 2016 Presentation

Once these adhesions have been formed they remain in the body, grow and sometime spread to other structures 1. Bowel adhesions can be massive and encapsulate neighboring structures in powerful glue like bonds 1 .Fibroblasts are critical in supporting normal wound healing, involved in key processes such as breaking down the fibrin clot, creating new extra cellular matrix (ECM) and collagen structures to support the other cells associated with effective wound healing, as well as contracting the wound 3. Adhesions can squeeze the intestines from the outside, creating a build-up of bacteria (SIBO). These adhesions need to be cleared so that bacteria can leave the body 2.

Things to Keep in Mind

Larry Wurn indicated that adhesions begin to develop as the first step in healing from the following events:

1.Surgery (back, hip, abdominal, pelvic, etc)

2.Infection (ruptured appendix, etc)

3.Inflammation (SIBO, Endometriosis, Crohns, IBS, etc)

4.Trauma (falls, car accidents, abuse)

5.Radiation Therapy (post cancer treatments)

Some surgeries that cause adhesions:

C-section, Hysterectomy

Exploratory Surgeries ( Pain, infertility, etc.)


Bowl obstruction/ resection



SIBO Treatment at Clear Passage:

Bowel adhesions generally form as the first step in healing from surgery, infection, inflammation, trauma, endometriosis or radiation. SIBO can cause severe inflammation over time; that in itself can cause adhesions. If you have a history of any of these and are struggling with resolving your symptoms, you may have adhesions 2.

Clear Passage regularly screens for infections and uncontrolled inflammatory conditions before accepting applicants for therapy. They request recent CBC results and the patient's complete medical history. The patient's medical history is fully assessed for contraindication.

They do not treat SIBO patients unless they are on herbal antibiotics for 3 months before treatment or pharmaceutical antibiotics (rifaximin, neomycin) to begin 3 days before treatment. They take patients who are under the care of a referring physician.

They recommend starting Dr. Seibecker's Diet SCD + Low FODMAP before starting and during treatment.

See a captivating video that Larry presented featuring collagen fibers where adhesions can form. Click on Strolling Under the Skin.

I hope you find this information helpful.

Wishing you a wonderful symptom free day,

Sibo Warrior


Larry Wurn, LMT SIBO Symposium 2016 Presentation 1

PubMed US National Library of Medicine :Treating Small Bowel Obstruction with a Manual Physical Therapy: A Prospective Efficacy Study. 4

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