ALL ABOUT SIBO
This blog post has been a long time coming! I have been chatting about SIBO on my Instagram for a few weeks but I wanted to write out a whole post to give all the details.
It is estimated that up to 20% of healthy individuals have SIBO and yet I don’t think many people even know what it is! It is also estimated that up to 84% of people diagnosed with “IBS” have SIBO. That is roughly 36 million Americans! So yes, this is huge problem that needs to be discussed.
What is SIBO?
To put it simply, SIBO is when you have bacteria in your small intestine. SIBO stands for small intestinal bacterial overgrowth. We want to have a diverse variety of bacteria in our colon/large intestine but the small intestine should be sterile. When there is bacteria in there it can lead to a host of symptoms and issues.
What are the symptoms of SIBO?
You could have symptoms that aren’t even related to your gut and have SIBO so even if there aren’t obvious digestive issues it could still be an issue.
Some symptoms could include: gas, bloating (especially in the lower stomach, around the bellybutton), constipation, abdominal pain, diarrhea, brain fog, fatigue, skin issues (acne, rashes, eczema, etc…), nutrient deficiencies, diagnoses of IBS, food intolerances, chronic diseases such as diabetes, fibromyalgia, autoimmune diseases, fat malabsorption, leaky gut, large intestine imbalances
How do you get SIBO?
There can be many ways you get SIBO including: eating a high sugar diet, growing up on the Standard American Diet ( Hi, it’s me!, you’re not alone if this is you!), stress, low motility, food poisoning, bowel obstructions, hidden infections (like unknown oral infections), having large intestine dysbiosis and certain medications just to name a few.
How is SIBO diagnosed?
The gold standard for SIBO testing is through a breath test. There is a common misconception (even in the functional healthcare world) that stool testing can identify SIBO. This is not true. Stool testing gives a picture of your large intestine/colon. I do think this testing is beneficial and I have personally done it myself but it is NOT testing for SIBO. Some practitioners will do a stool test and then treat their patients for SIBO when they haven’t truly tested.
To treat SIBO you have to know what type it is. The two predominant types are methane and hydrogen. The test involves drinking a lactulose solution and then breathing into tubes every 20 minutes or so over a span of 3 hours. This measures the gasses produced in your system to determine what type of SIBO you have.
You could have methane, hydrogen or a combination of both.
Note: If you have methane then it is likely you also have hydrogen as the methane molecules can disguise the hydrogen.
If you see a practitioner who does a stool testing and calls it SIBO this isn’t accurate. It doesn’t mean that a large intestine protocol isn’t warranted, it just means you need to separately test for SIBO to truly know if you have it and how to treat it. Treatment for the two isn’t the same.
How do you treat SIBO?
There are 3 main ways to treat SIBO:
Prescriptions: There are a few prescriptions you can use to treat SIBO but they are expensive, typically not covered by insurance and could cause more damage to your gut.
Herbal protocols: These are popular and effective but they do take longer than pharmaceuticals
Elemental Diet: There is also a diet you can do called the elemental diet and it is where you drink a solution for 2 weeks and don’t eat anything else. This is an effective method but for obvious reasons, it’s hard to do. Drinking this substance bypasses the small intestine so you essentially starve the bacteria there.
The important thing to realize is that you need to treat the SIBO with targeted supplements but you also need to treat your whole body.
You need to determine how you got SIBO in the first place and treat the body as a whole so you don’t keep getting the SIBO back over and over again.
Other things to look at/heal: stress, stomach acid, large intestine dysbiosis, parasites, hidden infections, nervous system regulation, enzyme production, eating habits, diet and more.
My SIBO Story
I became passionate about sharing about SIBO as I was just diagnosed this year and I believe I have been suffering from this for 15+ years at least.
Growing up, the earliest I can remember is around age 15 or so, I would bloat after every meal. every.single.day. I would wake up with a perfectly flat stomach but right after eating it would bloat to look 6 months pregnant. I have suffered with this for all of these years. Back then I didn’t know any better. I just thought it was a weird thing my body did. It didn’t cause me any pain or digestive issues and it went away every night so I just assumed it was an annoying cosmetic thing I would deal with. If I had had other signs/symptoms I likely would’ve gotten checked out but truly it seemed like just an annoying thing so I didn’t know any better back then.
As I got more into functional healing (around 2017 or so) I tried all the trendy diets- Whole 30, gluten free, dairy free, etc…. And nothing helped. To make a long story short, I have been educating myself on gut health for several years and in 2021 I joined Taylor Dukes first Get Your Gut Right program. I did stool testing and learned I had major gut dysbiosis. I was breastfeeding at the time so I couldn’t heal as it’s not safe to do while pregnant or breastfeeding. In the Fall of 2022 I finally was able to do the protocol after breastfeeding. I got some relief but not full relief and that’s when I started researching SIBO more and suspected I had it.
In January of 2023 I tested and sure enough I have methane SIBO. As I write this I am 10 days into my herbal protocol. I also did some oral testing at the end of 2022 and learned I had a possible hidden infection in a spot where one of my wisdom teeth was taken out when I was 14. Come to find out, the spot where the infection is in tooth # 32 and that is the tooth on the meridian linked to my small intestine! How wild. Our body is so interconnected. Next month I will be going through a procedure with my biological dentist to clean the area. I don’t think the infection caused my SIBO but I think it could prevent full healing from happening and it definitely contributed in some way to it even if it wasn’t a direct cause.
I will be sure to include updates as I go through this healing journey!
Special Considerations
If you have SIBO there are some things to keep in mind.
Probiotics, prebiotics and fermented foods can make things worse. SIBO means you have bacteria where it shouldn’t be. Taking in pre and probiotics in supplements or foods can make things worse because you’re just feeding that bacteria. Wait until you have cleared your SIBO before repopulating your gut with the good or else you can make bloating much worse.
FODMAP diets are not a cure. Some people get relief when they go on this diet but it is not a root cause way to heal.
Certain foods can make you feel worse- things like salads and uncooked veggies. Digestive enzymes, HCL and Ox bile can be so hugely supportive while healing SIBO so you can absorb and break down food.
Do not start a protocol if you aren’t detoxing well. You should be having at least 1 bowel movement a day, at a minimum, before starting a protocol. The last thing you want to do is start killing bacteria but having nowhere for it to go.
I do not recommend doing any protocol while pregnant or breastfeeding.
Where do I learn more?
I know this can be a lot of info! Please feel free to reach out if you have any questions about this. It’s hard to put it all in one blog post! I’m happy to help direct you.
I recommend the following resources:
Amy Meyers Website Amy Meyers is a SIBO expert. Download her free Guide to SIBO Ebook. It has so much info!
Read Super Gut by William Davis. This is one of the best books I’ve read. He takes a deep dive into SIBO and includes his own protocol at the end.
Read Taylor Dukes' SIBO article.
Follow @thesibonutritionist on Instagram. She has lots of info. I bought her course myself.
Follow @kristen.greene.nd on Instagram. She also provides lots of free information as well!
Feel free to shoot me a message to chat about any of this stuff! I know it can be a lot to learn and I’m here to help.