If you’re struggling with chronic bloating, unpredictable digestion, or persistent abdominal discomfort, we understand your situation. Many people experience these symptoms for years before discovering the underlying cause:

SIBO, or Small Intestinal Bacterial Overgrowth. SIBO is a condition that’s gaining more attention in the world of digestive health, and for good reason; it can explain a wide range of frustrating gut symptoms that don’t seem to go away with standard treatments.

But what exactly is SIBO? Why does it happen, and how can you recognize the signs? In this guide, we’ll break down the basics of SIBO, explore its causes, and help you understand the symptoms so you can take the next step toward better gut health.

What is SIBO?

SIBO stands for Small Intestinal Bacterial Overgrowth. It’s a condition where there are too many bacteria, often the wrong kinds, in the small intestine. Normally, the small intestine has fewer bacteria as compared to the large intestine. When this balance is disrupted, bacteria that should stay in the colon start to multiply in the small intestine, leading to a host of digestive problems.

Why is SIBO a Problem?

The small intestine is the organ for nutrient absorption. When bacteria overgrow here, they start to ferment the food you eat before your body can absorb it. This fermentation process produces gas, disrupts digestion, and can even damage the lining of your gut. Over time, SIBO can lead to nutrient deficiencies, weight changes, and chronic inflammation.

How Does the Digestive System Normally Work?

To understand SIBO, it helps to know a bit about how your digestive system is supposed to function:

Stomach: Breaks down food with acid and enzymes, killing most bacteria.
Small intestine: Absorbs nutrients. It has some bacteria, but not many.
Large intestine (colon): Home to trillions of bacteria that help ferment undigested food.

A healthy gut keeps bacteria in the right place. The small intestine uses muscle contractions (the migrating motor complex) to sweep bacteria down into the colon. Stomach acid, bile, and enzymes also help keep bacterial populations in check.

What Causes SIBO?

SIBO doesn’t happen randomly. There are several reasons why bacteria might overgrow in the small intestine:

Impaired Gut Motility

The small intestine relies on rhythmic muscle contractions to move food and bacteria along. If this process slows down, bacteria can linger and multiply.

Common causes of slow motility:

Previous food poisoning (which can damage gut nerves)
Diabetes (affecting nerve function)
Hypothyroidism
Scleroderma and other connective tissue diseases

Structural Abnormalities

Physical changes in the gut can create pockets where bacteria thrive.

Adhesions: Scar tissue from surgery or infection
Diverticula: Small pouches in the intestinal wall
Strictures or blockages: From Crohn’s disease or radiation

Low Stomach Acid

Stomach acid acts as a barrier to bacteria. Low acid (from aging, medications, or H. pylori infection) allows more bacteria to survive and reach the small intestine.

Medications

Certain drugs can increase SIBO risk:

Proton pump inhibitors (PPIs)
Opioids (which slow gut motility)
Antibiotics (which disrupt normal gut flora)

Underlying Health Conditions

Irritable Bowel Syndrome (IBS): Up to 80% of IBS patients may have SIBO.
Celiac disease
Chronic pancreatitis
Liver cirrhosis

Immune System Issues

A weakened immune system can make it harder for your body to control bacterial populations in the gut.

Types of SIBO

Not all SIBO is the same. The type of gas produced by the overgrown bacteria can influence your symptoms:

Hydrogen-dominant SIBO: Bacteria produce hydrogen gas, often leading to diarrhea.
Methane-dominant SIBO (also called IMO): Archaea (a different type of microbe) produce methane, which is more likely to cause constipation.
Hydrogen sulfide SIBO: Produces hydrogen sulfide gas, which can cause foul-smelling gas and a mix of symptoms.

Understanding your SIBO type can help guide treatment and dietary choices.

SIBO Symptoms: What to Watch For

SIBO can be sneaky, with symptoms that overlap with other digestive disorders. Here are the most common signs:

Digestive Symptoms

Bloating: Often severe and worse after meals. Many people describe looking “six months pregnant” by the end of the day.
Excessive gas: Both burping and flatulence, sometimes with a foul odor.
Abdominal pain or discomfort: Cramping, especially after eating.
Diarrhea, constipation, or both: SIBO can cause either, depending on the type of bacteria involved.
Nausea
Unintentional weight loss or gain
Feeling full quickly (early satiety)

Nutrient Deficiencies

Because SIBO interferes with nutrient absorption, you might develop deficiencies in:

Vitamin B12: Leading to fatigue, brain fog, and nerve issues.
Iron: Causing anemia and weakness.
Fat-soluble vitamins (A, D, E, K): Leading to a range of symptoms from poor vision to bone loss.

Non-Digestive Symptoms

Fatigue: Chronic tiredness is common.
Brain fog: Trouble concentrating or remembering things.
Skin issues: Rashes, acne, or eczema.
Joint pain or inflammation
Mood changes: Anxiety or depression.

If you notice these symptoms persisting for weeks or months, it’s worth discussing SIBO with your healthcare provider.

How Is SIBO Diagnosed?

Diagnosing SIBO can be challenging, but several tools are available:

Breath Testing

The most common test is the hydrogen and methane breath test. After drinking a sugar solution (usually lactulose or glucose), you’ll breathe into a series of tubes over a few hours. If bacteria in your small intestine ferment the sugar, they produce hydrogen or methane, which is measured in your breath.

Hydrogen SIBO: Often linked to diarrhea
Methane SIBO (IMO): More likely to cause constipation

Small Intestine Aspirate

This is a more invasive test where a sample of fluid is taken from the small intestine and cultured for bacteria. It’s rarely used outside of research or complex cases.

Blood and Stool Tests

These can help rule out other causes and check for nutrient deficiencies or inflammation.

Symptom Assessment

A thorough history and symptom review are essential. SIBO often mimics IBS, so a careful evaluation is key.

Managing SIBO: Functional Medicine Approach

A functional medicine approach to SIBO focuses on addressing the root cause, not just the symptoms. Here’s how to manage SIBO for lasting relief:

Targeted Treatment

Antibiotics

The standard medical treatment for SIBO is a course of non-absorbable antibiotics (like rifaximin). These target bacteria in the gut without affecting the rest of the body. For methane SIBO, a combination of rifaximin and neomycin may be used.

Herbal Antimicrobials

Some people prefer herbal options, such as oregano oil, berberine, neem, or garlic extract. These can be effective but should be used under professional guidance.

Diet for SIBO

Diet plays an important role in managing symptoms and supporting healing.

Low-FODMAP Diet

FODMAPs are fermentable carbohydrates that feed bacteria. A low-FODMAP diet can reduce symptoms by limiting these foods. Common high-FODMAP foods include:

Wheat, rye, and barley
Onions and garlic
Beans and lentils
Certain fruits (apples, pears, cherries)
Dairy (for those who are lactose intolerant)

Elemental Diet

In severe cases, an elemental diet (a liquid formula of pre-digested nutrients) can starve bacteria and reset the gut. This is usually a short-term, medically supervised approach.

Gradual Food Reintroduction

After treatment, foods are slowly reintroduced to identify triggers and support a diverse, resilient microbiome.

Supporting Gut Motility

Improving gut movement is key to preventing SIBO recurrence.

Prokinetics: Medications or supplements (like ginger, low-dose naltrexone, or prucalopride) that stimulate gut motility.
Meal spacing: Allow 4–5 hours between meals to let the migrating motor complex do its job.
Stress management: Chronic stress can slow digestion—mindfulness, yoga, and deep breathing can help.

Addressing Underlying Causes

Treat low stomach acid: If needed, with betaine HCl or apple cider vinegar (under supervision).
Correct nutrient deficiencies: B12, iron, and fat-soluble vitamins.
Manage chronic conditions: Diabetes, hypothyroidism, or autoimmune diseases.

Restoring the Gut Microbiome

After SIBO treatment, it’s important to rebuild a healthy gut ecosystem.

Probiotics: Some strains (like Lactobacillus plantarum or Saccharomyces boulardii) may help, but timing and type matter; work with a professional.
Prebiotics: Gradually reintroduce prebiotic fibers to feed beneficial bacteria.
Fermented foods: Yogurt, kefir, sauerkraut, and kimchi can help restore balance.

Preventing SIBO Recurrence

SIBO has a high recurrence rate, so prevention is key.

Maintain Gut Motility

Continue prokinetics if recommended.
Stay active; regular movement supports digestion.
Avoid unnecessary snacking; allow time between meals.

Support Stomach Acid and Digestion

Avoid long-term use of acid-suppressing medications unless necessary.
Chew food thoroughly and eat slowly.

Address Structural Issues

If you have adhesions or anatomical problems, consult with a gastroenterologist or surgeon.

Manage Stress

Chronic stress can disrupt gut function. Practice regular stress-reduction techniques.

Regular Follow-Up

Work with your healthcare provider for ongoing monitoring and support.

SIBO and the Gut Microbiome

SIBO is a sign that your gut microbiome is out of balance. The small intestine should have relatively few bacteria, while the large intestine is home to trillions. When this balance is disrupted, it can affect not just digestion, but also immunity, mood, and overall health.

The Role of the Microbiome

Digestion: Bacteria help break down food and produce vitamins.
Immune function: 70% of your immune system lies in your gut.
Barrier function: Healthy bacteria protect the gut lining from pathogens.

SIBO and Leaky Gut

SIBO can contribute to leaky gut (increased intestinal permeability), allowing toxins and bacteria to enter the bloodstream and trigger inflammation.

SIBO and Systemic Symptoms

Beyond digestive issues, SIBO can cause:

Fatigue
Brain fog
Skin problems
Joint pain

This is why a holistic, functional medicine approach is so important.

Conclusion

SIBO is a complex but manageable condition. By understanding the causes, recognizing the symptoms, and taking a functional medicine approach, you can address the root issues and restore your gut health. Remember, healing takes time and patience, but with the right support and strategies, you can reclaim your comfort, energy, and quality of life.

Key Takeaways

SIBO is caused by bacterial overgrowth in the small intestine, leading to bloating, gas, and digestive discomfort.
Common causes include slow gut motility, structural issues, low stomach acid, and certain medications.
Diagnosis involves breath testing and a thorough symptom review.
Treatment includes antibiotics or herbal antimicrobials, dietary changes, and addressing root causes.
Prevention focuses on supporting gut motility, healthy digestion, and stress management.
A functional medicine approach offers personalized, root-cause solutions for lasting relief.

Ready to take control of your digestive health? If you suspect SIBO or struggle with chronic digestive symptoms, reach out to Conscious Medicine for expert, compassionate care. Our team specializes in providing functional medicine solutions for better gut health, SIBO, and complex digestive issues.

Frequently Asked Questions

Can SIBO Go Away on Its Own?

It’s rare for SIBO to resolve without treatment, especially if underlying causes persist. Professional intervention is usually needed.

Is SIBO Contagious?

No, SIBO is not contagious. It’s a result of internal imbalances, not an infection you can catch from others.

Can SIBO Cause Weight Gain or Loss?

Both are possible. Some people lose weight due to malabsorption, while others gain weight due to inflammation and changes in metabolism.

How Long Does SIBO Treatment Take?

Treatment typically lasts 2–6 weeks, but full recovery (including gut healing and prevention) can take several months.

Can Diet Alone Cure SIBO?

Diet can help manage symptoms, but most people need targeted antimicrobial treatment to fully resolve SIBO.

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