Small intestinal bacterial overgrowth (SIBO) is a complex condition that can cause many symptoms. In this article, we’ll explain how to treat SIBO naturally by identifying and addressing the potential root causes.
What is SIBO?
Small intestinal bacterial overgrowth, or SIBO, occurs when too many bacteria end up in the small intestine instead of the colon. When too many bacteria start to colonize in the small intestine, you can experience unpleasant symptoms such as:
- skin conditions (acne, eczema, rashes)
- diarrhea or constipation
- gas and/or bloating
- heartburn and/or reflux
- abdominal pain
- weight gain
- food sensitivities
SIBO is also associated with many different health conditions, like irritable bowel syndrome, acne
, and hypothyroidism
Testing for SIBO
The main test to diagnose SIBO is a breath test. For this test, you drink a specific syrup and then provide breath samples at various time intervals. If the levels of gas are higher than the provided threshold, this may indicate a SIBO diagnosis.
A stool test can also be helpful in looking at the microbiome of the large intestine. This stool sample tells us if there are other issues in the gut like candida overgrowth, dysbiosis (an imbalance of good to bad bacteria), or parasites.
Treating SIBO Naturally
Unfortunately, individuals with SIBO may go undiagnosed for years as conventional medicine often ignores or discredits this diagnosis. When SIBO is recognized, the most common treatment is a prescribed antibiotic called rifaximin. This antibiotic is fairly effective with about 50 percent of patients experiencing a normalization of a repeat breath test (1
). However, while this treatment may initially remove overgrowth, relapse is common in over 40 percent of cases (2
). By identifying and treating the root causes of SIBO, you can more effectively remove overgrowth and reduce recurrence of this condition.
Here are a few interventions we may recommend to treat SIBO naturally.
A low-FODMAP diet is a short-term elimination diet designed for individuals with digestive conditions like SIBO. The premise of a low-FODMAP diet is to temporarily eliminate foods high in FODMAPs that may worsen your GI symptoms. Common foods high in FODMAPs include wheat, dairy (lactose), garlic, onions, and more. The low-FODMAP diet can provide fast relief from digestive symptoms, so we often start with this intervention while implementing other methods to treat SIBO from the root cause. You can purchase our low-FODMAP food plan here
Remove Bacterial Overgrowth
The first step of treating SIBO naturally aims to reduce bacterial overgrowth and remove pathogens (the bad bugs) with targeted supplements, like antimicrobials. We often recommend our Microbiome Balance
supplement which offers a blend of botanicals known to remove overgrowth without killing off the good bacteria in the process. In this step, we may also recommend “starving” the bad bugs by limiting foods that typically promote their survival like added sugar, refined grains, and alcohol.
Replace Digestive Enzymes and Stomach Acid
SIBO is common in individuals with acid reflux (3
). Many researchers believe this may be due to chronic use of acid reflux medication that can cause low or inadequate amounts of stomach acid (5
). Replacing stomach acid with supplements and other necessary factors required for digestion (like digestive enzymes) may help prevent recurrent bacterial overgrowth. Our Root Digestive Enzymes
contain betaine HCl to support proper stomach acidity and digestive enzymes for optimal digestion.
Hypothyroidism occurs when your thyroid gland does not make enough thyroid hormones to meet your body’s demand. Unfortunately, a deficiency of thyroid hormones causes slower gut motility and increases the risk of developing SIBO. Overgrowth is common in patients with hypothyroidism and one study found over 50 percent of the subjects with hypothyroidism also had SIBO compared to just 5 percent of healthy controls (6
). Read more about SIBO and hypothyroidism
Repair the Gut
SIBO can cause damage to the intestinal wall, a condition commonly referred to as a “leaky gut.” Treating a leaky gut may reduce food sensitivities, lower inflammation, and correct bacterial imbalances. For this step, we may recommend our Gut Health Rebalance
powder which offers healing nutrients, like glutamine and aloe vera extract, to support and soothe the intestinal wall.
Reintroduce Healthy Bacteria
While it may seem counterintuitive, probiotics are also a useful intervention to treat SIBO if introduced correctly (8
). We usually recommend our SIBO probiotic
which contains three different strains of spore-based probiotics for optimal results. In this step, you may include fermented foods into your diet, like raw sauerkraut, kimchi, and kombucha which naturally contain probiotics as well. Read more about using our SIBO Probiotic
Balance Your Lifestyle
In functional medicine, we recognize the importance of treating the body as a whole instead of isolated systems. For this reason, we recommend healthy lifestyle adjustments in all of our treatment programs, including ones that address SIBO. Optimal sleep, stress management, and physical activity all play an important role in encouraging the body to find balance. We help you implement lifestyle interventions and may recommend supplements, like magnesium
or adaptogens, that can help you relax and rebalance your life.
SIBO occurs when too many bacteria reside in the small intestine and causes undesirable side effects. Treating SIBO naturally involves identifying and addressing the root causes of this condition to ensure effective treatment and reduce the risk of recurrence.