Now You Can Stop The Symptoms of SIBO - Even If You’re Confused And Feel Hopeless About Recovering Your Health

1. Relying on Antibiotics Alone 

Maybe your doctor gave you a course of Xifaxan (Rifaximin), or if your insurance company didn't cooperate, a dose of tetracycline or Flagyl (metronidazole)or Ciprofloxacin (fluoroquinolones).

You took it with high hopes. Finally, some relief.
But 2-4 months later, the bloating came right back, along with all of the other symptoms typical of SIBO.

It is truly devastating. You can feel it coming back and you don't want to admit it. You silently beg to yourself "please, please don't let it be back."

Now what do you do? Keep taking antibiotics every time it comes back?

Xifaxan is the most popular antibiotic for SIBO. It has been shown in clinical research to reduce bacterial overgrowth by as much as 71%! But it does not address the underlying cause. None of the antibiotics do.

Lots of people think that just taking the meds will cure them and that is just not the case.

You can treat the bacteria over and over again, but until you figure out why it is overgrowing in your small intestine in the first place, it will keep coming back.

2. Taking Probiotics

If you're anything like most of the people that I work with, you've been told by your GI doctor to take probiotics for SIBO. The most popular with conventional medicine doctors are VSL#3 and Align.

Probiotics for SIBO are quite controversial. If you ask a handful of functional medicine practitioners, you are likely to get completely different answers. Probiotics with SIBO? Yes, no, maybe.....

Studies show that probiotics can improve symptoms of SIBO and even reduce bacterial overgrowth. The reason why they are controversial is because they help some, make some worse and don't do anything for others. There are many reasons for this discrepancy-dosage, strain, timing.

But typically, probiotics alone will not be enough to get rid of SIBO for good.

3. Taking Supplements for SIBO

There are many supplements and various remedies that are currently popular. Maybe you have tried magnesium, high fiber, low fiber, and/or strong antibacterial herbs like oregano oil. How about flaxseed and peppermint?

You hear about a supplement or a new remedy and get excited, this is the one! Only to have your hopes dashed when it doesn’t work.
No matter what the supplement is, you try it and it doesn’t live up to your expectations or worse, your symptoms become even more unmanageable.

I made the same mistake. I tried 20 plus different supplements over the years-thinking that there was one remedy that would solve all of my problems. The truth is, it takes more than just supplements to heal from SIBO.

4. Thinking Diet Will Cure Your SIBO

You heard from a friend or maybe even a nutritionist who told you that the low FODMAPs diet would help relieve your symptoms. In fact, research shows that following the low FODMAPs diet can improve your bloating, abdominal pain, gas and diarrhea and/or constipation by 70%.

You really want to do it the right way, so you strictly cut out all of the high FODMAP foods. It’s been 6 months and you find yourself stuck. You can't get off of the low FODMAPs diet. You keep restricting more and more foods to feel better. Then you enter into a vicious cycle. Interestingly, the more foods you restrict, the more difficult it is to digest a wider variety of foods.

You must be missing something else. And you are.

Diet alone will not cure your SIBO.

Probiotics and supplements alone will not cure your SIBO.

Antibiotics alone will not cure your SIBO.

You may need a combination of all of these. They must be well timed based on your individual needs and above all, you’ve got to find the underlying cause. 

Here are some tips to help manage your symptoms while you get started on your SIBO journey:

1. Find out what type of SIBO you actually have.

Currently, there are three types of SIBO: hydrogen dominant, methane dominant (now known as intestinal methanogen overgrowth (IMO) and sulfide dominant.

The breath test is the most non-invasive measurement to determine which type you have. Your conventionally trained doctor may not feel that these tests are accurate. However, in 2017-17 doctors/scientists got together and published a consensus statement suggesting that breath testing is the method of choice to diagnose SIBO.

Why does testing matter?

Well, methane dominance is typically associated with constipation while hydrogen dominance is associated with diarrhea. But not always. I have had clients with extreme constipation but had hydrogen predominant SIBO. In these cases, the constipation was not caused by the SIBO, but something else.

This leads us to another point, the different types of SIBO are treated differently and you can't always know which type you have based on symptoms alone.

Sometimes testing isn’t feasible for various reasons and the practitioner reading the test needs to be experienced in interpreting the results. But knowing what you are dealing with right off the bat can be very helpful in the long run.

2. Create a Custom SIBO Diet for You

There are multiple SIBO diets out there. Here are a few that you may be familiar with:

• Cedars-Sinai Low Fermentation Diet
• Fast Tract Diet
• FODMAPS diet
• SCD/GAPS diet

Don't get confused by all of the choices. These diets are guides, not absolutes. Everyone responds differently and that is normal. Finding the approach that will stop feeding your particular SIBO bugs will provide huge symptom relief.

Which diet is best for you? You have to experiment.

Once you find a diet that you want to start with, stick with it for about 4-6 weeks. During that time, it is very important that you keep a food diary listing the foods that you eat and any symptoms that may occur. The purpose of a food diary is for you to establish an awareness of what foods have a tendency to increase your symptoms.
This is how you create your own, customized diet. Diet can make a huge difference in symptoms reduction, but it alone does not cure SIBO.

3. Find and Address Your Underlying Cause(s).

This is a biggie. It can take time and effort to figure out why you developed SIBO in the first place. There are many different underlying causes and most of my clients have more than one. Here is a list of some of the most common underlying causes. Can you relate to any of these?

• Low stomach acid, lack of enzymes and/or bile acid
• Slowed motility
• Irritable Bowel Syndrome (IBS)
• Post-infectious SIBO
• Dysbiosis
• Certain medications - recurrent antibiotics, acid suppressing drugs, drugs that suppress the immune system, steroids, levothyroxine
• Hypothyroidism

These are just a few of the underlying conditions that can cause SIBO. In addition, there are some conditions that you wouldn’t expect are correlated with SIBO, like interstitial cystitis, restless leg syndrome and rosacea.

Research in this area is continuously being published as more and more scientists are becoming aware of this condition. Keeping up with the new information is important. It is very difficult for clients to try to manage this condition on their own without the guidance of a practitioner that is familiar with SIBO.

P.S. - My name is Darla and I have a PhD in Nutrition, I’m a Registered Dietitian and Certified Functional Medicine practitioner.

I suffered with IBS for 25 years and then developed SIBO after the birth of my second child. After seeing numerous doctors over many years, I was told that nothing was wrong with me. I had to sort through all of the research to finally determine that it was SIBO that was causing so much pain and bloating. I trained in functional medicine from the Kalish Institute in 2015. I created the Gut Professor, www.gutprofessor.com, an online nutrition consulting business so that I could help other people struggling with SIBO. I work as a university professor and also worked with an integrative physician in a face to face clinic for 3 years, focusing on SIBO, gastrointestinal problems and autoimmune disorders.

Outside of work, I love to cook, make and teach others about properly fermented foods, read, take walks, and spend time with my family-including the four-legged variety.

I can help you in your journey to heal from SIBO. I’ve been there myself. I know how you are feeling and what you’re going through. My training in functional medicine and my experience with the integrative physician has given me knowledge of both the pharmaceutical and naturopathic treatments. I can be a part of your healthcare team, to help guide you in meeting your health goals. You don’t have to just exist, you can learn to live again.