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What You Need To Know

SIBO stands for Small Intestinal Bacterial Overgrowth.

It is a condition characterised by an excessive growth of bacteria in the small intestine, where they shouldn't normally be present in large numbers. This overgrowth can lead to various digestive symptoms, such as bloating, abdominal pain, diarrhea, and malabsorption of nutrients.

Testing for Small Intestinal Bacterial Overgrowth (SIBO)

Testing involves a breath test. This non-invasive test measures the levels of hydrogen and methane gases produced by bacteria in the small intestine.

It helps to diagnose SIBO by identifying abnormal bacterial overgrowth in the small intestine. The breath test is usually performed after fasting and involves drinking a solution containing specific carbohydrates followed by breath samples at regular intervals. These samples are analysed to determine the presence and extent of SIBO.

Treatment for SIBO often involves a combination of dietary changes, antimicrobial therapy, and addressing underlying factors contributing to the overgrowth.


SIBO has a high rate of relapse, meaning that the condition may recur after successful treatment.

Several factors contribute to the relapse of SIBO, including:

  • Underlying Causes: If the underlying causes of SIBO are not addressed, such as impaired gut motility, structural abnormalities, or immune dysfunction, the overgrowth of bacteria in the small intestine may return.


  • Incomplete Treatment: Failure to completely eradicate the bacterial overgrowth during treatment can result in a relapse. This can happen if the prescribed antibiotics or antimicrobial agents do not effectively target the specific bacteria causing the overgrowth.


  • Diet and Lifestyle Factors: Poor dietary choices, such as a high intake of fermentable carbohydrates or a diet low in fibre, can contribute to the recurrence of SIBO. Lifestyle factors like chronic stress, inadequate sleep, and lack of physical activity can also impact gut health and increase the risk of relapse.


  • Underlying Health Conditions: Certain underlying health conditions, such as gastrointestinal disorders (e.g., Crohn's disease, celiac disease), immune system dysfunction, or hormonal imbalances, can predispose individuals to SIBO relapse.


To reduce the risk of SIBO relapse, it is essential to address the underlying causes, follow a customised treatment plan that includes appropriate antimicrobial therapy, and make dietary and lifestyle modifications.

Regular follow-up with your practitioner can help monitor progress, identify any relapse signs early on, and make necessary adjustments to the treatment approach.

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Underlying Factors To Consider

There are several underlying factors that can contribute to the development of Small Intestinal Bacterial Overgrowth (SIBO). Some common factors include:

  • Impaired gut motility: Conditions that slow down the movement of food through the digestive tract, such as intestinal obstructions or conditions like gastroparesis, can create an environment for bacterial overgrowth in the small intestine.


  • Structural abnormalities: Any anatomical or structural abnormalities in the gastrointestinal tract, such as strictures, diverticula, or surgical changes, can disrupt the normal flow of bacteria and promote SIBO.


  • Disrupted gut flora balance: Changes in the composition of the gut microbiota can allow certain bacteria to overgrow in the small intestine. This can occur due to factors like antibiotic use, low stomach acid, or a lack of beneficial bacteria.


  • Impaired immune function: Weakened immune function can reduce the body's ability to keep bacterial populations in check, allowing overgrowth in the small intestine.


  • Impaired digestive function: Insufficient production of digestive enzymes or a decrease in bile acids can impair the breakdown and absorption of nutrients, creating an environment where bacteria can thrive.


  • Altered gut motility: Conditions such as irritable bowel syndrome (IBS) or certain neurological disorders can disrupt the normal muscular contractions of the gut, leading to stagnant food and bacterial overgrowth.

  • SIBO and thyroid function: There is a connection between thyroid function and SIBO (Small Intestinal Bacterial Overgrowth). Thyroid hormones play a crucial role in regulating the function of the gastrointestinal tract, including gut motility and the secretion of digestive enzymes. When thyroid function is disrupted, it can lead to changes in gut motility and digestion, increasing the risk of SIBO.


  • Hypothyroidism, an under active thyroid condition, is commonly associated with SIBO. The slowed metabolism and reduced gut motility seen in hypothyroidism can contribute to bacterial overgrowth in the small intestine.


  • On the other hand, SIBO itself can also affect thyroid function. Bacterial overgrowth in the small intestine can lead to impaired nutrient absorption, including key nutrients needed for thyroid hormone production and conversion. This can potentially impact thyroid function and exacerbate existing thyroid conditions.


  • It is important to address both thyroid function and SIBO when managing these conditions. Optimising thyroid function through appropriate medication, diet, and lifestyle interventions, along with treating SIBO through targeted therapies and dietary modifications, can help improve overall gut health and thyroid function. Working with a healthcare professional experienced in functional medicine can provide personalised guidance and support in addressing both conditions effectively.



Identifying and addressing these underlying factors is an important part of managing SIBO and preventing its recurrence, which is very common.

A comprehensive approach that includes dietary modifications, lifestyle changes, and targeted treatments can help restore gut health and reduce the risk of SIBO.

SIBO and Nutritional Supplements

Supplements can be used as part of a comprehensive treatment plan for SIBO (Small Intestinal Bacterial Overgrowth).


However, it's important to note that individual needs may vary, and it's best to consult with a healthcare professional before starting any new supplements. Here are a few examples of supplements that are commonly used in SIBO treatment:

  • Digestive Support: Supplementing with betaine HCl and/or digestive enzymes can support the breakdown and absorption of nutrients, helping to improve digestion and alleviate symptoms associated with SIBO.


  • Herbal Antimicrobials: Herbal antimicrobial supplements, such as berberine, oregano oil, neem, or grapefruit seed extract, have shown effectiveness in reducing bacterial overgrowth in the small intestine. These should be used under the guidance of a knowledgeable practitioner.


  • Gut Healing Supplements: Supplements like glutamine, short chain fatty acids, DGL aloe vera, and zinc carnosine can help support gut healing and reduce intestinal inflammation, which can be beneficial in SIBO management.


  • Motility Agents: Certain supplements, such as prokinetics or motility agents like magnesium, ginger, or 5-HTP, can help improve gut motility and prevent bacterial overgrowth.


It's important to remember that addressing SIBO requires a comprehensive approach that includes dietary modifications, lifestyle changes, and potentially prescription medications. Working with us means that you are receiving a tailored treatment plan that suits your specific needs.

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