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Belly Bloating and Tummy Issues? Maybe It’s SIBO

Do you suffer from belly bloat, gas after eating, or often feel like your belly is constantly distended? Maybe you feel tired after a meal and can’t seem to concentrate or remember the next thing on your “to-do” list. You have probably heard of irritable bowel syndrome (IBS) or other tummy-related food sensitivities and intolerances to certain foods, but have you heard of SIBO? It's pretty common, and the number of SIBO diagnoses are rising. Though it’s different than IBS and other similar issues, it has some overlapping symptoms. This article will explore what SIBO is and provide an overview of natural protocols to consider when trying to deal and heal from this uncomfortable tummy issue. 

SIBO stands forSmall Intestinal Bacterial Overgrowth. In a normal digestive tract, bacteria live and reproduce in the small intestines,  but they are not supposed to take over the entire system. When they do, the condition is called SIBO and it is a very uncomfortable condition, to say the least. 

Symptoms of SIBO

If you are suffering from SIBO, you might have some of the following signs and symptoms:

  • Brain fog
  • Unexplained gas and bloating
  • Bowel symptoms
  • Abdominal bloating
  • Belching
  • Abdominal pain
  • Constipation
  • Symptoms are worse after meals
  • Malabsorption of vitamins and minerals, especially vitamin B12, iron,  calcium, magnesium, and fat-soluble vitamins (Vitamin A, D, E, and K), omega 3 fats, coQ 10, as well as folate and beta-carotene
  • Weight loss
  • Fat in the stools that is not absorbed
  • Difficulty eating fatty foods
  • Osteoporosis (brittle bones)
  • Negative endoscopic tests and X-rays
  • Elevated D-lactate levels

Who is at Risk for SIBO?

Researchers now believe that  80% of people with irritable bowel syndrome (IBS) have SIBO. In another study, SIBO was found in about 15% of patients who had chronic pancreatitis (inflammation of the pancreas), and more prevalent in those who were taking pancreatic enzymes or proton pump inhibitors, diabetics, or those who drank alcohol. This is because SIBO can be the result of conditions that reduce naturally occurring stomach acids, which normally kill bacteria. 

Causes of SIBO

SIBO can be caused by a movement problem in the small intestine:

  • Any bowel obstruction can cause SIBO, putting you at higher risk for Crohn’s disease if the obstruction lasts long enough. 
  • Another  risk factor for developing SIBO is a slow bowel. Inhypothyroidism, there is slow bowel movement in the digestive tract, explaining why SIBO is common in patients with hypothyroidism. 

Another risk factor to developing SIBO ischronic stress often causing  too much bacteria to enter the small intestine.  Stress also impairs the motility of the GI tract and provokes blood sugar swings. Chronic stress increases levels of cortisol (the stress hormone), and causesblood sugar levels to fluctuate, resulting infrequent hunger andsnacking throughout the day. 

Diagnosis of SIBO

How is someone diagnosed with SIBO? Learning to recognize the telltale signs — pain in the abdomen, queasiness, fatigue, feelings of bloat, gas, diarrhea and constipation — is key. If you have these then it’s time to start a dialogue with your healthcare professional about possible SIBO. 

A SIBO diagnosis can be determined using a fasting glucose hydrogen breath test. When the bacteria are growing in greater numbers than usual, the amount of hydrogen gas that they give off will increase, simply because there are more of them. A lactulose breath test may also be performed for diagnosis. 

Accurate diagnosis requires identification of bacterial species growing inappropriately within the small intestine and symptom response to antibiotics, according to London doctors. More than 100,000 colony-forming units of bacteria per ml of fluid in the proximal jejunum is a definitive diagnosis of SIBO. 

Treatment Protocols for SIBO 

Conventional treatment may include a medication called Rifaximin, which is commonly prescribed for this condition. A usual dose will last 10 to 14 days. But because of the negative side effects of using medication and the havoc it could wreak on your gut microbes, it may be a good idea to seek out natural treatment options, such as: 

Herbs and Spices

Natural ingredients such as dill seed, red thyme oil, oregano oil, sage leaf, Artemisia absinthium, Stenoma Sesilifolia, coptis root, Pulsatilla chinensis, Brucea javanica, Picrasma excels bark, lemon balm leaf, ginger, Acacia catechu, Philodendron bark, Indian barberry root, yarrow, Hedyotis diffusa, rhubarb root, Chinese licorice root, berberine sulfate, and Chinese scullcap have been found to have a positive effect on the treatment of SIBO. 

Antimicrobial Foods

Foods such as grapefruit seed extract, oregano oil capsules, garlic, goldenseal, olive leaf extract and Pau d’arco when taken consistently have been found to be extremely powerful in the natural treatment of SIBO as well, according to many nutritionists. 


According to some scientific literature, probiotics have been shown to demonstrate similar results to antibiotics for treating SIBO. In one study of 40 patients done at the University of Foggia in Italy, patients received either Rifaximin or a probiotic. 

The probiotics were able to improve 5 out of 6 symptoms, and the researchers did not see a significant difference in the percentage of improved symptoms between the two groups, suggesting either therapy would be equally effective.

Probiotics have also been found to be effective in combating SIBO by Chinese researchers. In their study of 112 gastric cancer and 88 colorectal cancer patients, SIBO was seen in those who took proton pump inhibitor drugs. However, the probiotic was effective in combating SIBO and improved a lot of the GI cancer related symptoms. 

Dietary Treatment 

This could include a FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet, which involves cutting out certain foods, including dairy, sugar, starch, and wheat, among other things. Incorporating 1-2 tablespoonsMCT oil, ox bile supplements, and omega 3 supplementation may also be recommended dietary changes. 

What is the Big Goal of Treatment?

The goal of treatment should be to accomplish the following three things:

  1. Correct the underlying cause. If the cause is the use of proton inhibitor drugs, discontinuing the drugs might be the goal. If the cause is addressing hypothyroidism, then working on that is important. This is where a discussion with your healthcare provider is important.
  2. Getting back to overall health. It’s important to provide nutritional support, especially since vitamin and mineral deficiencies may have occurred. Looking for underlying vitamin and mineral deficiencies is paramount to the complete reversal of SIBO.
  3. Treat the overgrowth of bacteria.

Probiotic protocols often include the gradual increase ofprobiotics, which are designed to restore the balance of good and bad bacteria in the gut.

You can make a difference in your SIBO. Whatever natural remedies you seek out, make sure to implement them methodically and keep records so you can monitor improvement. Over time, progress should appear with these protocols and the appropriate lifestyle changes.

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