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— Small Intestinal Bacterial Overgrowth —

Small Intestinal Bacterial Overgrowth (SIBO)

People who struggle with IBS (irritable bowel syndrome) or celiac disease often also struggle with SIBO. In SIBO, bacteria that normally occupy the colon (large intestine) migrate up to the small intestines where they feed on the carbohydrates that we eat and multiply. This leads to inflammation, bloating, slow motility and many other symptoms all over your body.

Can you relate to any of these?

  • I am often so bloated I feel 5 months pregnant
  • My bowel movements jump back and forth between constipation and diarrhea
  • I’ve been given a diagnosis of Irritable Bowel Syndrome (IBS)
  • I wake up with a flat stomach that progressively bloats throughout the day
  • I often feel fatigued after eating
  • I struggle with fibromyalgia
  • My digestive issues went away while I took antibiotics
  • Food tends to sit heavy in my stomach 
  • I often have excess gas and belch a lot 
  • I’m tired of my digestion ruling my life
If you struggle with 2 or more of the above, consider SIBO.

Common SIBO Symptoms

  • Mood issues
  • Reaction to carbohydrate rich foods
  • Reaction to prebiotics or probiotics
  • Leaky gut (which can lead to other symptoms)
  • Fatigue
  • Heavy feeling in stomach
  • Stomach or intestinal pain
SIBO and IBS symptoms are often intertwined, but there are a few key differences to look for!

Common Causes of SIBO

  • Slow gut motility (genetics, diabetes, meds, diet…)
  • Ileocecal valve issues
  • Diverticuli that don’t clear out
  • Food poisoning
  • Adhesions or other anatomical abnormalities
  • Inadequate digestive juices (stomach acid esp)
  • Pancreatic insufficiency
  • Gallbladder removal: bile drip may not coincide with food appropriately

Did your digestive issues start after a bout of food poisoning or after a few rounds of antibiotics?

SIBO Testing

SIBO is typically either hydrogen dominant, methane dominant, or hydrogen sulfide dominant. To determine which bacteria or archaea is overgrown, a lactulose breath test is typically performed. 

You can make diet and lifestyle changes before SIBO testing if SIBO is suspected as they are low risk, but SIBO testing is always helpful for figuring out the best treatment protocol.

SIBO Treatment Basics

  • Reduce symptoms through diet (often low FODMAP, SCD/ low FODMAP, or AIP/low FODMAP (also consider oxalates, histamines, salicylates and other food chemicals/sensitivities)
  • Work to improve the migrating motor complex
  • Use natural antimicrobials or antibiotics to remove the overgrowth (can also use elemental diet)
  • Consider treating biofilms
  • Support digestion and detoxification (enzymes, betaine HCL with pepsin, charcoal, bentonite clay etc.)
  • Keep bowels moving well — address constipation
  • Repopulate the good bacteria in the gut (probiotics and prebiotics)
  • Heal the gut lining
  • Replenish nutrient deficiencies
  • Consider prokinetics

If you aren’t sure if SIBO or bacterial imbalance is your main issue, take the free digestive health quiz below to help you narrow down your root causes!

digestive health quiz
Leslie was such a massive help and light when I was miserable and honestly scared to eat because I would be in so much pain. Diet changes and the supplements she recommended helped me have hope I didn’t have to feel like this forever. It is amazing how few medical professionals and dietitians seem to know how to address SIBO. I was so thankful for your help!
– Jackie L.
In the past 9 years, I had been to 2 different regular doctors and 2 different GI doctors for my digestive issues. They diagnosed me with IBS and later SIBO and put me on a prescription medication, but I only got some relief. Thankfully the second GI doctor suggested I go to Leslie at Grace, Goals & Guts. She asked me lots of questions, took into consideration all my symptoms, and helped me figure out what the best course of action should be. I ended up finding out that I was sensitive to quite a few foods, plus have digestive distress when I have too many high FODMAP foods. With Leslie’s help, I have been able to change my diet and heal my gut. This didn’t happen overnight, but it has been life changing. Through it all Leslie was so patient and great at listening to my issues, symptoms and struggles. I have recommended several people to her and will continue to do so!
– Cindy J.

I need help figuring out a plan for my digestive issues.

Not sure if we’d be a good fit…