SIBO, IBS and You

Posted in: Digestion    

Is your digestion anything less than a smooth sailing system? Food accepted kindly by your body with appreciation, and waste removed comfortably and predictably like a well oiled machine? Effortless digestion is a reality for many people and is a worthy goal. Unfortunately, uncomfortable or downright painful digestion is the norm for too many people, and since we eat 3-7 times each day that makes me sad.


For those of you who dread eating and have been diagnosed with IBS (irritable bowel syndrome) fear not! You may or may not have SIBO, and whether you have it or do not your IBS is totally treatable.

What is SIBO?

Small Intestine Bacterial Overgrowth (SIBO) is a chronic overgrowth of bacteria in the wrong part of the digestive tract. The large intestine is where probiotic bacteria thrive and support the health of the body, but when they take over stretches of the small intestine they can interfere with normal digestive processes such as nutrient absorption. Symptoms may be mild or severe depending on the degree of overgrowth, and the damage that can be done to the lining of the small intestine.


SIBO is the leading cause of IBS.


Symptoms of SIBO

Abdominal discomfort or pain

Anemia that is non-responsive to iron supplementation

Autoimmune conditions

Belching and burping (often chronic)


Brain symptoms (including autism)





Food allergies or sensitivities



Joint pain

Mood changes (namely depression)


Respiratory symptoms (including asthma)

Skin reactions from eczema to rashes

Steatorrhea (fatty stool)

Vitamin B12 deficiency



SIBO is tested through a simple, non-invasive breath test.   After 1-2 days of starving the bacteria through a modified diet a breath sample is taken upon rising in the morning to set a baseline. After drinking a solution of lactulose, a sugar that is non-digestible by humans but a birthday party for bacteria, breath samples are taken every 20 minutes for 3 hours (I know…it’s your whole morning but well worth it!). The fermentation of the lactulose by bacteria creates gases that enter the blood stream and are released through the breath. By tracking the release of gases a map of bacterial growth along the small and large intestines is created.



There are a few stages to the treatment of SIBO and restoring the small intestine to health.


For some people a Preparation phase may be useful. Your ND will work with you to determine the best way forward for you.


For others we dive right in to the Eradication Phase to kill off as much of the unwanted population as possible. This can be done with specific (and safe!) prescription antibiotics taken over two weeks. Click here to read an article I wrote for Sage Clinic on antibiotics for SIBO. Eradication can also be achieved through herbal antibiotics just as effectively although it takes longer at about six to eight weeks.


After the eradication phase you should feel at least 90% better! How great is that?! In stubborn cases retesting and retreating may be necessary before moving forwards.


Then comes the Maintenance Phase in which the underlying issues that led to SIBO in the first place are addressed and the system is “reprogrammed”. This is the time for a specific SIBO preventative diet and an additional prescription or herbal support. The maintenance phase can last several weeks to several months depending on the individual.