In this episode, we detail the role of vitamin B1 (thiamine) in supporting gastrointestinal function, highlighting intestinal motility through vitamin B1's involvement in acetyl-CoA and acetylcholine synthesis. We discuss thiamine insufficiency as well as how small intestinal bacterial overgrowth (SIBO) can further affect thiamine availability. We further detail host defense mechanisms—including gastric acid, pancreatic enzymes, and gastrointestinal motility—that work in concert to regulate microbial balance in the small intestine.

Topics:

1. Introduction

- Focus on SIBO, intestinal motility, and vitamin B1 (thiamine)

2. Small Intestine and Microbial Regulation

- Low bacterial load under healthy conditions

- Protective mechanisms: gastric acid, enzymes, motility…

3. Overview of SIBO Subtypes

- H₂-SIBO, hydrogen-producing bacteria

- IMO, methane-producing archaea

- H₂S-SIBO, hydrogen sulfide-producing bacteria

- Subtypes can coexist, share underlying factors

4. Host Factors in Microbial Regulation

- Gastric acid, motility, pancreatic enzymes, bile acids, and immune surveillance

5. Gastric Acid and Parietal Cells

- Hydrochloric acid and intrinsic factor

- Acid environment supports digestion and microbial regulation

- Protein denaturation and pepsin activation

6. Chief Cells and Enzyme Function

- Pepsinogen and gastric lipase

- Pepsinogen activated by acidic pH

7. Hypochlorhydria and Downstream Effects

8. Pancreatic Enzymes in the Small Intestine

9. Intestinal Motility and the Enteric Nervous System (ENS)

- Coordinated smooth muscle contractions

- Myenteric and submucosal plexuses

10. Intestinal Wall Anatomy

- Epithelium and lamina propria

- Submucosa contains the submucosal plexus

- Myenteric plexus located between muscle layers

11. Vitamin B1 (Thiamine) and Gastrointestinal Function

- Acetylcholine synthesized from choline and acetyl-CoA

- Acetyl-CoA formation, thiamine availability

- Acetylcholine signaling

12. SIBO and Nutrient Availability

- Bacterial overgrowth can affect nutrient absorption

- Thiaminases

13. Conclusion

- Root cause approach, multi-factorial

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