Small Intestinal Bacterial Overgrowth

If you suffer from IBS you may have come across a condition called SIBO.

SIBO stands for Small Intestinal Bacterial Overgrowth and occurs when an elevated number of bacteria are found in the small intestine.

Since the small intestine is meant to contain a low number of bacteria, an overgrowth of organisms can lead to symptoms of IBS.

These are symptoms such as:

  • bloating
  • cramping
  • altered bowel patterns (constipation or diarrhoea)
  • heartburn
  • unpredictable food reactions


It has been estimated by some that up to 80% of those with IBS have SIBO.

Clues it may be SIBO

In addition to the symptoms of bloating, cramping, abdominal pain and constipation or diarrhea there are additional indicators that SIBO may be present.

  • You feel worse with prebiotics or probiotics.

  • Your bloating starts within 1 hour of eating.

  • Your symptoms started following a case of food poisoning or travellers diarrhoea.

  • The symptoms improved temporarily while on antibiotics for an unrelated problem.

  • Fibre worsens bowel movements.

  • You’re Coeliac yet continue to have symptoms whilst on a gluten-free diet.

Additional symptoms and conditions associated with SIBO

An increasing amount of food sensitivities

Impaired vitamin absorption

Maldigestion of fats

Histamine intolerance

Brain fog

Restless leg syndrome

Acne rosacea


Testing for SIBO

The small intestine is a particularly tricky place to get to.  However, one test we can use is the SIBO breath test.

The test is performed by drinking a sugar solution which acts as a food source for the bacteria in the digestive system.  When the bacteria come into contact with this sugar solution, fermentation takes place.

The gases produced during the fermentation process are then absorbed into general circulation, transferred into the lungs, and then exhaled.

Elevated levels of these gases found in breath samples can indicate the presence of SIBO which can then help guide your protocol.

These tests can be carried out in your own home with results typically back from the lab within 10 working days.


Road to Resolution

Once we have established the likelihood of an overgrowth of bacteria in the small intestine the approach is 3 fold

Lower the bacterial load in the small intestine

Support the healing of the gut lining

Address the underlying cause of the overgrowth

Underlying Causes of SIBO

Impaired Digestion
Microbiome dysfunction, chronic stress, sIgA deficiency,
poor bile flow, low stomach acid.

Altered Motility
Hypothyroidism, diabetes, chronic infection,
MMC damage, scleroderma, traumatic brain injury.

Opiates, proton pump inhibitors,
tricyclic antidepressants.

Impaired Flow Through the Intestines
Ileocecal valve dysfunction, endometriosis,
abdominal surgeries/adhesions, EDS.

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