SIBO, or small intestine bacterial overgrowth, is a common digestive disorder that can cause various symptoms. While there is no one-size-fits-all approach to treating SIBO naturally, there are many ways to improve your symptoms. Some of the most popular natural treatments for SIBO include dietary changes, probiotics, and herbal remedies.
What is SIBO?
SIBO is a disease that affects the small intestine. The small intestine becomes infected when the bacterial population increases. Other areas of the gut may also contain these bacteria in small amounts and are regularly eliminated from the body. Pain and diarrhea result from this. The bacteria can also cause malnutrition, robbing the body of nutrients.
Causes of SIBO
Surgery or disease can cause the condition by slowing the movement of food and waste products through the digestive tract, producing a breeding habitat for germs.
SIBO typically begins when you don’t move food properly through your small intestine. A large number of bacteria grow and stay around too long. An imbalance can develop if the “good” bacteria that help you digest food cannot keep up with the “bad” germs. In addition to diarrhea, excessive bacteria may lead to malnutrition and weight loss.
A diagnosis could be made using a medical examination and a laboratory investigation of pus or discharge.
Underlying Conditions
Any number of underlying medical conditions can contribute to the development of SIBO. Conditions such as diabetes, Crohn’s disease, or celiac disease can affect your gut’s environment and promote bacterial overgrowth.
Dietary Factors
One significant influence on SIBO arises from dietary factors. Your diet can either promote or help prevent bacterial overgrowth. Certain foods may feed harmful bacteria, exacerbating your symptoms. Key dietary considerations include:
- High sugar intake
- Refined carbohydrates
- Processed foods
Perceiving these dietary influences is vital for managing your symptoms and supporting gut health.
A diagnosis could be made using a medical examination and a laboratory investigation of pus or discharge.
SIBO Symptoms
SIBO is classified into three types: hydrogen-dominant, methane-dominant, and sulfur-dominant. These types refer to the primary type of gas produced by unwanted bacteria in your small intestine.
Hydrogen dominant SIBO is most associated with diarrhea, while methane prevalent is linked to constipation.
Hydrogen Sulfide (H2S) is a third form of gas commonly present among patients with SIBO. This type cannot be detected with a breath test. However, it is diagnosed by the presence of sulfur-like, rotten egg-smelling gas or belching.
Here are six of the most notable symptoms caused by these gases, usually hydrogen and methane:
- Bloating – feeling full and uncomfortable, especially 1-2 hours after eating carbohydrate-rich meals (sugars are a type of carbohydrate).
- Abdominal pain – associated with bloating. Abdominal pain can be caused by gases building up in the small intestine, stretching the intestinal walls. People may be unable to perform daily tasks due to this pain, which can be crippling.
- Excessive belching – When gas builds up in the small intestine, it must be expelled! Although belching is normal after eating and drinking, especially fizzy beverages, SIBO can cause excessive belching that can be embarrassing and uncomfortable.
- Reflux – Long-term use of proton pump inhibitors for reflux symptoms is believed to be one of the causes of SIBO. Bacteria enter the small intestine through the stomach when these medications make it less acidic. Belching can cause patients to belch acid out of the stomach into their gullet, mimicking reflux symptoms like heartburn.
- Flatulence/wind – Wind can be very smelly when patients suffer from SIBO. SIBO patients may experience difficulties going out, leading to relationship problems.
- Constipation or diarrhea – commonly seen as symptoms of irritable bowel syndrome (IBS), both can be symptoms of SIBO. It is less clear what causes this symptom than the others, but many practitioners believe that at least some people with IBS may also have SIBO.
Diagnosing SIBO
After experiencing symptoms that may indicate SIBO, such as bloating and abdominal discomfort, the next step is to seek a proper diagnosis. This may involve a detailed discussion of your medical history, diet, and lifestyle, alongside specific testing to confirm the presence of small intestinal bacterial overgrowth. Early and accurate diagnosis is crucial for effective treatment and, ultimately, your well-being.
Testing Methods
To diagnose SIBO, healthcare professionals typically utilize breath tests, which measure hydrogen and methane levels in your breath after ingesting a sugar solution. These gases are produced by bacteria in the small intestine, and elevated levels can signal an overgrowth. Stool tests and small bowel aspirate procedures can also be employed, but breath tests are the most common and non-invasive options.
Interpreting Results
For an accurate interpretation of your test results, it’s necessary to understand the normal ranges for hydrogen and methane production. Elevated levels may indicate SIBO, but it’s important to consider your symptoms and clinical context since false positives can occur. Your healthcare provider will integrate these findings with your overall health status before drawing conclusions.
Results from breath tests are generally quantified in parts per million (PPM), with a rise in hydrogen or methane levels indicating potential SIBO. Typically, a significant increase within 90 minutes after sugar ingestion suggests an overgrowth of bacteria in the small intestine. Note that while positive test results are indicative, your symptoms and a comprehensive evaluation by your healthcare provider are critical in confirming the diagnosis and deciding on the appropriate treatment pathway.
Treatment Options for SIBO
Dietary modifications and medication are among the treatments available for SIBO.
Low-FODMAP foods are included in the diet for a temporary period to decrease bacterial overgrowth in SIBO patients. It usually lasts 2 to 6 weeks.
Which foods should you avoid?
There has been clinical evidence that a low-FODMAP diet can have beneficial effects on treating irritable bowel syndrome (IBS) and associated symptoms. Many people with IBS also have SIBO. You can improve your digestive health by reducing or eliminating foods high in these carbs.
A gradual elimination diet is required to treat SIBO. The goal is to reduce inflammation throughout the digestive tract and minimize bacterial overgrowth in your small intestine.
By eliminating sugar alone, you may be able to improve your symptoms. People with digestive disorders often adhere to low-FODMAP diets, which include carbs that are hard to digest and ferment.
When eliminating FODMAPs from your SIBO diet, focus on the following main categories:
- Fructose, simple sugars commonly found in fruits and some vegetables, honey, and agave nectar
- Lactose, a sugar molecule in dairy products
- Fructans, a sugar compound found in gluten products, fruits, some vegetables (wheat, garlic, onion, asparagus, leeks, artichokes, broccoli, cabbage), and prebiotics
- Galactans, a compound found in some legumes, cabbage, brussels sprouts, soy
- Polyols, a sugar alcohol often used as a sweetener (sorbitol, isomalt, lactitol, maltitol, xylitol, and erythritol, commonly found in sugar-free gum, mints, and some medications)
Which SIBO diet is best for you?
Here are the top five SIBO diet protocols:
- LOW FODMAP DIET– This diet limits a particular group of carbs known as FODMAPs, short for Fermentable Oligosaccharides (fructans and oligosaccharides), Disaccharides (lactose), Monosaccharides (fructose), and Polyols (sorbitol and mannitol). It is possible to suffer from gas and bloating from these foods because some carbohydrates are resistant to digestion. Symptoms such as loose stools, diarrhea, and abdominal cramping are caused by the osmotic effect of carbohydrates in some foods.
- SPECIFIC CARBOHYDRATE DIET (SCD)—is a restrictive, grain-free diet plan designed to help people with conditions such as Crohn’s disease, ulcerative colitis, celiac disease, diverticulitis, cystic fibrosis, and chronic diarrhea. It is thought that by eating just quickly digestible carbs, there will be no undigested carbohydrates to produce a chain reaction of intestinal discomfort.
- SIBO SPECIFIC FOOD PLAN—The SIBO Specific Food Plan was designed by leading SIBO expert Dr. Allison Siebecker, and is one of the few diets explicitly formulated for SIBO. SCD and low FODMAP diets are combined in this diet plan, which restricts a wide range of carbohydrates.
- BI-PHASIC DIET—The SIBO Bi-Phasic Diet designed by Dr. Nirala Jacobi, is a modified version of Dr. Siebecker’s SIBO Specific Food Plan. The protocol utilizes a 2-phase approach:
- Phase one (4 – 6 weeks) involves reducing trigger foods and repairing the gut lining and digestive system. This phase includes a very restrictive diet plan in addition to digestive support nutrients and probiotics.
- In phase two (4 – 6 weeks), the overgrowth will be removed as your gut naturally goes back into homeostasis. Despite being based on a low-fiber diet, this diet is slightly less restrictive. This phase also involves antimicrobial herbs and prokinetic supplements.
- ELEMENTAL DIET—The Elemental Diet has the highest restriction and is the only diet considered a primary treatment strategy for SIBO. The diet requires that medical food and beverages be consumed exclusively for two to three weeks. Nutrients are essential for survival when they are predigested and in their simplest form.
The Elemental Diet is beneficial in two ways: first, they can rest and heal because large food particles are not being broken down in the gut; second, the overgrowth of bacteria will cease because all carbohydrates are absorbed almost instantly, depriving it of its primary source of nourishment.
SIBO diets should be tailored to each individual based on their lifestyle, eating habits, motivation level, and history.
The SIBO diet may treat symptoms but not the underlying causes, although it is considered an effective treatment. We should not ignore traditional treatment methods.
Supplements ideal for SIBO are:
How to treat SIBO Naturally?
SIBO is treated with selective holistic antibiotics, dietary changes, and probiotics. It is crucial to treat SIBO in three stages: fix the underlying cause, provide nutritional support, and treat the overgrowth.
Using low-FODMAP foods on the SIBO diet helps reduce bacterial growth. Usually, the treatment lasts between two and six weeks. Most importantly, getting your gut bacteria back in balance would be best, which should ease your symptoms and help your body absorb more nutrients from your food.
There is no one-size-fits-all approach—each patient must be treated uniquely based on their symptoms and lifestyle choices.
-
- The first recommendation to overcome SIBO is to consume smaller food portions during meals. Spread your meals in 5–6 smaller amounts throughout the day rather than three larger meals. You can digest your food quicker when you eat smaller meals, which is crucial to overcoming SIBO. Overeating significantly contributes to SIBO, which causes food to sit in the stomach for a long time and reduces gastric juice production. SIBO is primarily driven by low stomach acid production since stomach acid kills bacteria in the upper GI tract.
- Starting probiotic supplements and eating probiotic-rich foods right away will help eliminate SIBO. The probiotic foods are as follows: Yogurt, Kefir, Sauerkraut, Tempeh, Kimchi, Miso, Kombucha, Pickles, Traditional buttermilk, Natto, and some types of cheese such as Gouda, mozzarella, cottage cheese, and cheddar.
- Essential oils are also helpful for people with SIBO symptoms and dietary changes and supplements. Several gastrointestinal symptoms, including IBS, were reported to be relieved by peppermint oil in a case report published in the Alternative Medicine Review. Essential oils such as oregano oil, tarragon oil, frankincense oil, clove oil, and others may also be beneficial when treating SIBO symptoms.
- Lifestyle changes include the SIBO diet and eating smaller meals 3 to 5 hours apart. It is also ideal to chew food thoroughly since digestion begins in the mouth. Drinking lots of water during the day keeps us hydrated.
- During the healing process, yoga, tai chi, barre, regular exercise, and acupuncture can reduce stress levels while keeping you motivated to stay on track with the SIBO diet.
- For patients who don’t respond well to Rifaximin, herbal remedies may be as effective as three courses of antibiotic treatment. Besides helping to eradicate bad gut bacteria, herbal antibiotics can provide many additional health benefits for your digestive system.
Most of the herbs used for SIBO are:
-
-
Berberine
- Phellodendron (not to be confused with the household plant Philodendron)
- Coptis Chinensis
- Goldenseal
- Oregon grape root
- Barberry
-
Polyphenols
- Pomegranate husk
- Propolis
- Cloves
- Oregano leaf
-
Volatile oils
- Oregano oil
- Thyme oil
- Clove oil
- Peppermint oil
-
- Add medium-chain triglycerides to your diet – Without using digestive enzymes, these fats are absorbed directly. Coconut oil is recommended for people with bacterial overgrowth or malabsorption.
There are many ways to treat SIBO naturally. Diet, supplements, and herbs can all help treat this condition. If you are suffering from SIBO, it is essential to consult a functional medicine professional to find the right treatment plan.
There are many options available, and each person’s situation is unique. There is hope for those who suffer from this condition, and natural treatments can be very effective.
Conclusion
So, understanding SIBO—its symptoms, causes, and available treatment options—is important for managing your digestive health effectively. By recognizing the signs and understanding potential triggers, you can take proactive steps toward diagnosis and treatment. Whether through dietary changes, antibiotics, or other therapeutic measures, addressing SIBO can significantly improve your well-being. Always consult with a healthcare professional to tailor a treatment plan that best suits your needs and ensures a healthier gut.