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What Causes SIBO (Small Intestinal Bacterial Overgrowth) and Why It’s so Hard to Treat

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Reviewed by Vanessa Wong, MD

While bacteria are an essential part of a healthy small bowel and perform important functions, small intestinal bacterial overgrowth can lead to leaky gut and a number of other symptoms. Learn what puts you at risk for SIBO.

sibo info
SIBO (small intestinal bacterial overgrowth) is a complex issue. istock.com/frentusha

The normal small bowel, which connects the stomach to the large bowel, is approximately 20 feet long. Gut microbiome bacteria are normally present throughout the entire gastrointestinal tract, but in varied amounts. Relatively few bacteria normally live in the small bowel (less than 10,000 bacteria per milliliter of fluid) when compared with the large bowel, or colon (at least 1,000,000,000 bacteria per milliliter of fluid). And, the types of bacteria normally present in the small bowel are different from those in the colon.

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Why You Should Thank Your Small Bowel and the Beneficial Bacteria That Live There

The small bowel plays an important role in digesting food and absorbing nutrients. It is also an important part of the immune system, containing an impressive network of lymphoid cells (cells of the immune system that help fight infections and regulate the immune system).

Are you at risk for small intestinal bacterial overgrowth? Find out what the most common risk factors and symptoms are.#SIBO #SIBOsymptomps

The normal (beneficial) bacteria that are an essential part of the healthy small bowel also perform important functions. These beneficial microorganisms help protect against bad (i.e. pathogenic) bacteria and yeast that are ingested. They help the body absorb nutrients, and also produce several nutrients (such as short chain fatty acids) and vitamins like folate and vitamin K. These bacteria help maintain the normal muscular activity of the small bowel, which creates waves that move the contents of the intestine, like food, through the gut.    

What Is SIBO?

SIBO, small intestinal bacterial overgrowth, is defined as an increase in the number of bacteria, and/or changes in the types of bacteria present in the small bowel. In most patients, SIBO is not caused by a single type of bacteria, but is an overgrowth of the various types of bacteria that should normally be found in the colon (1). Less commonly, SIBO results from an increase in the otherwise normal bacteria of the small bowel. 

SIBO has been shown to negatively affect both the structure and function of the small bowel. It may significantly interfere with digestion of food and absorption of nutrients, primarily by damaging the cells lining the small bowel (the mucosa). Additionally, this damage to the small bowel mucosa can lead to leaky gut (when the intestinal barrier becomes permeable, allowing large protein molecules to escape into the bloodstream), which is known to have a number of potential complications including immune reactions that cause food allergies or sensitivities, generalized inflammation, and autoimmune diseases (2).

These pathogenic bacteria, whether too many or the wrong types, can lead to nutritional deficiencies on top of those due to poor digestion or malabsorption. In particular, the bacteria will take up certain B vitamins, such as vitamin B12, before our own cells have a chance to absorb these important nutrients. They may also consume some of the amino acids, or protein, that we’ve ingested, which can lead to both mild protein deficiency and an increase in ammonia production by certain bacteria. (We normally produce some ammonia daily from normal metabolism, but ammonia requires detoxification, so this may add to an already burdened detoxification system.) The bacteria may also decrease fat absorption through their effect on bile acids, leading to deficiencies in fat soluble vitamins like A and D.

What Causes SIBO?

The body has several different ways of preventing SIBO. These include gastric acid secretion (maintaining an acidic environment), waves of bowel wall muscular activity, immunoglobulins in the intestinal fluid, and a valve that normally allows the flow of contents into the large bowel but prevents them from refluxing back into the small bowel. (This is called the ileocecal valve because it’s located between the ileum, or terminal end of the small intestine, and the cecum, a pouch forming the first part of the large bowel.)

The cause of SIBO is usually complex, and likely affects more than one of the protective mechanisms listed above. A number of risk factors for SIBO have been identified, with some of the more common risk factors listed below.  For a more complete discussion of associated diseases and risk factors check out this study and this study.

Risk Factors for SIBO

  • Low stomach acid
  • Irritable bowel syndrome
  • Celiac disease (long-standing)
  • Crohn’s disease
  • Prior bowel surgery
  • Diabetes mellitus (type I and type II)
  • Multiple courses of antibiotics
  • Organ system dysfunction, such as liver cirrhosis, chronic pancreatitis, or renal failure

Moderate Alcohol Consumption and Oral Contraceptive Pills (OCPs) Also Increase the Risk for SIBO

Heavy alcohol use has long been recognized in association with SIBO (3). This study also found an association between SIBO and moderate alcohol consumption, defined as up to one drink per day for women and two drinks per day for men. Alcohol appears to have effects on several of the normal protective mechanisms, including causing injury to the small bowel mucosal cells, contributing to leaky gut, and decreasing the muscular contractions. Additionally, alcohol may “feed” a few specific types of bacteria contributing to overgrowth (4).

Overall there appears to be a moderate association between OCPs and inflammatory bowel disease (IBD) such as Crohn’s disease (5). Though no studies to date specifically correlate the use of OCPs with SIBO, given the known relationship between IBD and SIBO, it is likely that this association holds true for SIBO as well. However, once patients stop taking OCPs, this risk appears to reverse.

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How Do You Know If You Have SIBO?

The number of people with SIBO in the general population remains unknown. Some studies suggest that between 6 to 15% of healthy, asymptomatic people have SIBO, while up to 80% of people with irritable bowel syndrome (IBS) have SIBO (6). 

SIBO is largely under-diagnosed. This is because many people don’t seek medical care for their SIBO symptoms, and because many doctors aren’t aware of how common SIBO is.

Complicating this, the most commonly used tests (breath tests measuring levels of hydrogen and methane gas) still have fairly high rates of false negatives (meaning the test results come back as negative but you actually do have the disease) (7).

The most common symptoms of SIBO include:

  • Abdominal pain/discomfort
  • Bloating and abdominal distention
  • Diarrhea
  • Constipation (generally associated with methanogens as Chris discussed in his recent podcast)
  • Gas and belching
  • In more severe cases, there may be weight loss and symptoms related to vitamin deficiencies.

Is SIBO Contagious?

Unlike many other bacterial infections of the gastrointestinal tract, SIBO is not contagious, and there is no evidence that exposure to any single microorganism increases the risk for developing SIBO. SIBO occurs due to a complex interplay of many different factors and is not passed on between individuals. However, some evidence suggests that there is an association between Helicobacter pylori and methane production, suggesting that H. pylori plays a role in gut dysbiosis. (8)

Why SIBO Can Be Difficult to Treat

Antibiotics are often used to treat SIBO. However, studies show that despite treatment with antibiotics, recurrence develops in almost half of all patients within one year. One study comparing treatment with rifaximin (the most commonly used antibiotic for SIBO) and botanical antimicrobials showed slightly better outcomes with the botanical protocol, but still with successful treatment in close to only half of all patients after one course of treatment.

These finding suggests that treatment of the overgrowth alone is not enough for most people. An additional piece of successful treatment must include addressing the underlying cause, or predisposing factor.

Though there are many identified associations between SIBO and other diseases as described above, abnormalities in gut motility are recognized as one of the most common associations. One study published this month demonstrated that patients with SIBO do have significant delays in small bowel transit time (the amount of time it takes something to move through the small bowel). This finding suggests that patients with SIBO, who do not recover after a standard course of antibiotics, or botanical antimicrobial protocol (which we prefer), may benefit from the addition of a prokinetic agent, which increases the muscular contractions of the small bowel. Octreotide and low dose naltrexone are two such options that are being investigated, and may help treat some cases of SIBO that don’t respond to antimicrobials alone. Other options may include prucalopride and low-dose erythromycin, as well as lubiprostone. (9)

As research into SIBO continues, we are increasingly understanding the complexity of this disease, and how treatment must be tailored to each individual to maximize success.

If you need support in dealing with SIBO, consider working with the California Center for Functional Medicine. CCFM offers a membership-based health transformation service that excels at helping people with chronic conditions make the changes necessary to reclaim their health. Find out more about what CCFM has to offer.
Amy Nett

About Amy:  Amy Nett, MD, graduated from Georgetown University School of Medicine in 2007.  She subsequently completed a year of internal medicine training at Santa Barbara Cottage Hospital, followed by five years of specialty training in radiology at Stanford University Hospital, with additional subspecialty training in pediatric radiology.

Along the course of her medical training and working through her own personal health issues, she found her passion for Functional Medicine. She works with patients through a Functional Medicine approach, working to identify and treat the root causes of illness. She uses nutritional therapy, herbal medicine, supplements, stress management, detoxification and lifestyle changes to restore proper function and improve health.

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1,226 Comments

Join the conversation

  1. Will treating SIBO with pro-biotics eliminate the constant nausea that I am experiencing?

  2. I was recently diagnosed with SIBO after experiencing months of nausea, bloating, flatulence, constipation and lack of appetite. My GI specialist says it probably was caused by my recent diagnosis of type 2 diabetes.I also have suffered from GERD (reflux), gastroparesis, Non-alcoholic Sreatal hepatits (fatty liver), hiatal hernia, etc. etc. etc. so I was already slightly nauseated even though I am being treated with domperidone-through a study at Temple University since this medication i not available in America). My GI specialist is prescribing pro-biotics. I have also read somewhere that peppermint oil and certain anti-biotics can help. My main question is will this get rid of the continuous nausea? I can only eat 1 or 2 meals a day, have lost about 12 pounds and am avoiding carbs, and fats.

    • What about Iberogast a pro kinetic. It helps with movement of food through the digestive system. I take it and it helps me not keep that full feeling for hours after meals.

      • I’d like to hear more about Iberogast. I’ve never even heard of it. So what is it doing for you in addition to keeping you feeling full hours after meals. That alone would be great but I’m thinking you are taking it for other benefits. Am I right? Tell us all more.

        • I tried Iberogast when I was no longer able to get a prescription for my gastroparesis. I did not find it helpful. I am going to give the florastor, peppermint oi and oregano oil a try before adding in anything else. Thanks for your suggestion.

        • We tried ibergast with our 3 year old. It seemed to aggravate her symptoms. I think she has a yeast issue too, and ibergast has alcohol in it.

        • I was taking Atrantil For SIBO symptoms and its recommended to take a pro kinetic with SIBO Treatment or with gastroparesis. I feel a lot better I actually feel hunger now. You can take it theee times a day or just in the evening before bed.

    • Probiotics probably will not get rid of your nausea. Probiotics are to put back the good bacteria in your intestines. Please do not take any anti-biotics because that is probably one contributing factor to your IBS. The more natural you eat and start doing everything the healthy, natural way, the better you will feel. My best friend was diagnosed with IBS and has all the issues that you are listing but she does not have diabetes. I have diabetes but do not have IBS. I have been cleansing, detoxing, doing colonics and trying to eat healthy as well as taking all kinds of probiotics, healthy immune system medications, etc. I feel good and I lowered my blood sugar count (via the doctor’s testing). I quit drinking soda’s and trying to exercise more. I cut out all sugar and am working on cutting out all meat. Read, search the internet for related articles and get yourself back the health you deserve. You do not need to be sick and hurting all the time. I have read almost everything there is on Candida, Thyroid, Intestines, healthy eating, juicing, green smoothies, etc and you should do the same and get your health back.

      • Hello,
        I have stomach issues as well. They were waaay worse than they are now. I went Paleo diet and even removed some of the approved foods such as nuts,coffee,night shades,ect. I had constant diahrea,stomach pains and burning plus complete fatigue. Went to the Dr. and had elevated CRP Level and elevetaed CBC on more than one ocasion. Antibiotics made me very sick with severe diahrea and a yeast infection every time. I knew i had to do something. So thats when i went paleo and took out anti immflamatory foods. I take a 50 billion pro biotic capsule made by Garden OF Life for women they also make one for men to. I get more probiotics in the foods i eat and i study eastern remedies such as roots and herbs, ect. Known for healing properties. I have made much improvement with no specialist. I do have an appmnt coming up with a specialist and am anxious to see how or if the way i changed things have effected my CRP and my CBC level.

    • Hello Andrea Smith. I also experienced almost all your symptoms except diabetes,you can check Bonnie’s advise on Lugol iodine solution to solve the sibo for more than 70% ,just avoid foods that trigger sibo and GERD within the 3weeks of taking lugol.

  3. Hi,

    I have been tested positive for SIBO through a breathing test a few months ago after months of suffering post food poisoning.

    I have gone through 2 rounds of 2 weeks of Xifaxan and just finished my 2nd round 4 days ago. I started doing Sibo Specific Diet immediately, but my stomach hasn’t been feeling too comfortable. So I ordered Herbal Antibiotics (Metagenics Candibactin-AR with Metagenics Candibactin-BR) on my own, and started taking them today along with MotilPro for prokinetics. If anyone can help answer my questions below, I’d really appreciate!

    1. Can I eat fruits raw during first 2 weeks of Sibo Specific Diet or do I have to cook everything?

    2. Can I start herbal antibiotics 4 days after the end of Xifaxan treatment?

    3. Can I stick to Sibo Specific Diet during herbal antibiotics treatment or should I eat food that feeds bacteria?

    4. Can I take prokinetics while doing herbal antibiotics?

    Any help would be appreciated!

    Thank you!

  4. Hi,
    Question for the group.

    For those of you that have had SIBO return, were you on a strict low FODMAP diet, staying away from wheat, corn, basically all carbs?

    I have been eating 95 % Meat, Vegetables, & Fruit only and on occasion I will stray only slightly, but in very small quantities.

    Did you feel that it came back all at once, or did you feel it slowly but surely returning?

    Thanks

    • Just starting Fodmap diet, but SIBO is back, I am sure. And as someone else noted their symptoms , “I have terrible leg pain (cramps in calves) and sharp pains in my hands, and very heavy feeling throughout my body as well as sharp stabbing pain in my stomach. I even notice a very strong ammonia smell that is very embarrassing. Another weird thing is that my hair becomes very dry and snarly, fingernails brittle.” I have all the same ones. What works?

  5. Hi, these SIBO symptoms keep coming back on me. I’ve tried absolutely everything and absolutely nothing I’ve done helps. I’m missing my ileocecal valve and it’s the gatekeeper from the colon to the small bowel and this is why it keeps recurring. The only thing left I think is to have an ileostomy. I have Crohn’s and had c-diff colitis 12 times. Any suggestions, anyone?

    • I too am missing my cecum valve. I had an appendectomy and small bowel resection (part of my cecum) I have terrible leg pain (cramps in calves) and sharp pains in my hands, and very heavy feeling throughout my body as well as sharp stabbing pain in my stomach. I even notice a very strong ammonia smell that is very embarrassing. Another weird thing is that my hair becomes very dry and snarly, fingernails brittle. Veins become very blue and easy bruising. Bloated and gassy 🙁 My doctor prescribed Amox-Clav 875 mg. I take 10 days worth and the pain seems to go away for a few months. Hair and nails get healthier. I have refilled my script 3 times and am on my last refill for the year. Will I have to take antibiotics the rest of my life? I never want surgery again! Appendectomy caused a sbo and ended with an NG tube and open abdominal surgery to remove a titanium surgical staple that strangled my small bowel.

  6. Hi, I would like to share my condition ten years ago when I suffered from IBS/SIBO and eventually how I got rid of it. It wasn’t diagnosed that time with proper tests. Some of the doctors suggested that I was suffering from IBS while I find my symptoms related more to SIBO than to IBS. My problem worsened when I started taking antibiotics on doctors prescription as the disease was misdiagnosed. There were times when the meals that were taken an hour before came out as whole without containing any bile with it. After reading about the disease over the internet, I started the course of Rifaximin tablets and Pro-biotic capsules on Doctor’s prescription. Though they helped slightly more but never cured the disease. The most important activities that cured the disease were the change in my dietary habits( switching from fast/processed food to homemade one), change in sedentary lifestyle( from less active to more active), the intake of natural sources of vitamins, particularly from cod liver oil and Himalaya LIV52 rather than from medicines, and the change in the environment. In short, I had to change myself in order to get rid of the disease. It took me an year so before coming back to normal. I believe the disease is mostly psychosomatic( physical illness caused by mental conflict or stress) and thus living a more healthy and satisfying lifestyle, both physically and mentally, can cure the disease.

    • Thank you for sharing! That makes sense to clean out the liver if anyone has gut problems.. I just ordered LIV52

    • RB is there anyway of contacting you via email or phone I’ve been struggling with digestive issues for 5 years had my gallbladder removed a year and a half ago when they couldn’t figure anything out, I just had a colonoscopy and upper scope done 6 weeks ago and now been in the most pain I’ve ever been, but my theory on that is that I cleaned myself out for the prep and now the bad bacteria has over taken the good. Let me know if we can talk.
      Thank you,
      Chad

      • Yes sure Chad. You can contact me over my email [email protected]. Your theory on Good bacteria/ Bad bacteria is correct. Also in order to maintain the good/bad bacteria proportion, one takes vitamins essential for digestion from outside sources but as soon as one leaves those medicines the symptoms return because the body isn’t producing any vitamins. But when I took liver tonic for almost half a year( not continuously) and shifted my focus from disease to more important works, I found those symptoms getting reduced. The intake of liver tonics, along with physical activities, reduced the stress and strengthened the liver, helping make an acidic and appropriate environment for digestion, in turn keeping the bad bacteria below the small bowel. Your problem also, seems to me, is mostly liver related. So you may also start some good Ayurvedic liver tonic on doctor’s prescription. One good thing about these ayurvedic medicines is that they don’t have serious side-effects in general. They helped me so there’s a chance they can help you.
        Good Luck
        RB

  7. Last year I was diagnosed with SIBO by a Hydrogen lactose test. I was subsequently treated, with success, with Rifaximin.
    My symptoms returned not too long ago whereupon my GI Nurse Practitioner at the VA placed me on a FODMAP diet. It works with strict adherence, but any deviation results in the same symptoms. Am I treating the symptoms? When I asked about another regimen of Rifaximin she declined saying that won’t help in spite of articles that I have read stating otherwise. There was a triggering event event that l believe was associated with the re-emergence of my symptoms – high sugar intake at one sitting. I’m the one that pushed for Rifaximin in the first place because it wasn’t on the VA formulary. Now I’m questioning whether the VA is more concerned about costs and just treating symptoms. I have gone to great lengths to clean up my diet/lifestyle and willing to buy from a trusted Canadian Pharmacy.
    Am I wrong in thinking another shot with Rifaximin, along with a FODMAP approach, might eradicate SIBO. I hate my current situation of not knowing.

    • You’re not wrong. My GI Dr. had said that if I had SIBO (which I don’t unfortunately, still have no idea what’s wrong with me) she would recommend Rifaximin but that some people need it yearly. It sounds like it’s more of an issue with the VA, I would ask why they don’t want you to do it again if it worked the first time. Hope that helps!

    • Try Enteragam. It’s a lot cheaper and easy to get. Tell them to send it to foundation care pharmacy and you should pay no more than $59 for a box

      • I agree Enteragam & also low fodmap diet helps but that did not cure mine. For some reason, trying the herbal methods upset my stomach & caused worse malabsorption (and leg cramps), so I’m on rifaxamin now. Fingers crossed it works.

    • If you are unable to get the prescription there are alternative methods that I have used because I couldn’t get the prescription (too expensive and not covered). I have used Oreganol, Biocydin, Candibactin and garlic. Not all at once but I pulse through them one bottle at a time. I also get colonics which really help me move out the dead bacteria and reduce pain symptoms.

    • I ordered mine from a Canadian pharmacy since my insurance wouldn’t pay until I took a bunch of other drugs first. Otherwise it was going to over $1000 out of pocket if I purchased in the US. From the Canadian pharmacy it was $160 for 100 tablets. I noticed the price in rupees (it’s made in India) was about $33.

      I’ve only been on it for a week & am still bloated but my acid reflux is gone. Fingers crossed for successful treatment.

  8. Hay everybody my name is raz im from israel i want to share with you all my story or journey but first of all I want to apologize on my English it’s it not my basic language I’m from Israel anyway it started 4 yrs ago I started to feel very sick and I didn’t thought it could be worse than that and it was in one split second in a dentist appointment one injection that straw the camel back and change my life for much worser from fatigue it went to brain fog tinnitus itching hearing loss and much much more the first thing that we normally do is run to doctors office and from there is a tons of tests blood mri CT colonoscopy endoscopy and much more with all the docs from any department like proof of neurological and internal prof that recognize autoimmune and gastrointestinal prof and more but nothing has found for 1.5 yrs all the while I thought that I have cancer or that I will never made to go out of it never it’s only had worse after this time I decided to find someone how help me alternative way and found one special that it’s live in u.’s and he is well known and he change the way I’m thinking about health and he’s way basically was to stay away from animal food be vegan and take a lot of supplement after you have done a lot of test that shows you a lot of things like candida digestion heavy metals early cancer signs inflammation and so forth off record I had all them in some degree I decide to go in this way full force and don’t look right or left with a lot of motivation and the next 2 yrs was very slight improvement but other great deals of symptom also arise much worse digestive and bladder and immune like neck pain back knees well slowly I’ve got to a point were I react to every food that I’ve ate and go down from 84kg to 53kg can’t even walk literally on death door blood test started to show that my body started to be very week and still nothing found in conventional medicine I realise that my symptoms was increasing by food and I understood that the basic of all I have is from the digestive system so I left my atl doc and search someone that help me meanwhile I’ve started to read a lot of books that is written on autoimmune heavy metal’s digestive parasites cleansing intestinal cystitis and bladder symptoms candida h.pylori (that I have also) and supplements and I found one thing that connect all of them … food… I startedon’t to try thing nothing has work and I know that I need help from someone and found some British guy after one conversation with him I like his ideas and sign him to help me I was hopeless I don’t care it cost me a lot started to learn from him and he just show me the right direction for thing and slowly things clear up and fog is disappear in 6 months I’m 8kg more my blood test is much better after I stuck with no improvement I tweak by myself with things that I’ve learn that isn’t working before and now they do because I’ve need to take from him the basic without the basic (food) it’s never work and stages of new food so it’s literally a formula and yes I’m proud to say I know the formula and yes I want to help other the most important thing is that it’s very big thing I can feel the power of been health again it can reverse anything autoimmune gut infection is chrons maybe even cancer belive me I never thought that I could say that I will get out of it I even almost sell my taxi in desperation and sickness but I wanted to beemail health again not just to live with very low grade life quality anyway plz contact me for forther question

    • Hi Raz, so much in common with your symptoms but one especially, bladder issues. I learned thru reading others comments that my pain was due to oxylates in my diet. I could not handle SIBO symptoms, the aching back, legs, feet… AND BLADDER.

      • Have not been diagnosed with SIBO; DX’d with IBS approximately 4 – 5 yrs ago. Have severe bladder problems & have seen 5 different Dr’s. I began searching for an answer to my symptoms & have arrived at SIBO. Now to go back to the Dr. I am still paying off Dr bills as I do not have insurance Still am thankful to have found this site and you wonderful sharing people !

    • Hi, I have a young friend (27 yrs) who has come to the conclusion that he has SIBO. It has been something he has dealt with since he was a teenager, but in the last 2 months it has gotten very very serious. He can’t work or even leave the house its so bad. I know he is trying to get better and seeing specialists, but nothing seems to help. Is there anyone I can introduce him to that might be able to give him options he hasn’t encountered yet?
      Thank you,
      Paul

      • There are at-home tests u can take, or he can go see a parasitologist. His rectum or stool would need to be examined for the presence of any parasite or overgrowth, and the appropriate antibiotic prescribed to kill it. I have been dealing with a parasite that keeps coming back, but I see a Dr that identifies it and provides me the appropriate medication. This stuff will nuke everything in his system – both good and bad – so its not always the wisest choice, but if he is in such a bad way, it may be necessary.

      • Hi Paul,
        I am posting what I posted for Leonardo above but I think this will help. You need a natural medicine doctor MD who believes in holistic treatment and does conventional medicine as well so they can also run the proper tests.

        Usually I don’t read these blogs but fortunately this will help. I have been sufferring from SIBO, yeast infection and 5 other stomach infections that resulted in a lot of joint pains and I could not eat and I was afraid to eat for some time. I was wondering what was going to happen. I am doing well now and I will tell you what I did for treatment. There are a handful of doctors who practice integrative medicine which is doctors MD with knowledge and acceptance of holistic treatment methods as well and they have a whole bunch of new tests to find out what is wrong since modern medicine is sometimes not knowledgeable for some reason. Do not trust naturopaths and websites since they are trying to sell their stuff and don’t know what they are doing. One of the best in the east coast is Dr. Mark Hyman and his center http://www.ultrawellnesscenter.com/home/ and of the best doctors in the US for integrative medicine that I took help of is Dr. Joseph Sciabbarrasi in LA. You can call his chamber and set up an appt with him he is more available. There is another doctor that I also see he is even better but it is harder to get appointments. Send me an email and I will send you his info but you need treatment urgently so it will be a good way to start right away with Dr. Sciabbarrassi and then also see the other Dr. They use all sorts of natural remedies and supplements that I have never heard of along with conventional medicines. Best of both worlds. Google integrative medicine to find more practitioners around your area but in my knowledge these people I mentioned are the best. Hope this helps.
        https://www.yelp.com/biz/joseph-sciabbarrasi-md-los-angeles

    • Hi Raz. Would love to hear more. I am working on a research program with a nutritionist. Please email me. Thanks

  9. Are parasites such as e-histolytica under the SIBO umbrella? I tested positive recently and am looking into appropriate courses of action to kill it.

    • I have been sick for the past 13 years, very debilitating miserable life. Since I was in my early 20’s I have been diagnose with candida, IBS, positive h-pylory, frequent colon and intestinal polyps and frequent gastritis and stomach ulcers, fibromialgya, chronic fatigue, PMS, pelvic tumors, fibroids, endometriosis, and now my Holistic doctor sent me to get SIBO breath test and full GI Panel for parasites, candida and bacteria. I am waiting to hear back which I am pretty sure they will come back positive, The lab that I was referred to is in Scottsdale Az. http://www.parasitetesting.com , I’ve heard great things about their treatments as well for getting rid of bacteria, parasites and candida. all natural and all info is on that website. All the regular doctors treat you with antibiotics which they dint seem to work because kills good bacteria in your gut so is a cycle thing. They treat the symptoms but not the root cause. But i was told by my holistic doctor it does fall on the same umbrella, reason; parasite/bacteria/candida causes. all under the same boat.!! i am looking forward on starting that treatment soon. I will post updates that hopefully will help most of here suffering from terrible symptoms especially chronic .

      • Thanks for sharing RS, and I feel your pain to a certain extent. Let us know how the treatment goes; as far as I can tell the options out there are limited so if this place in AZ is legit then the word needs to get out to help people in our similar situation. My Dr keeps prescribing the same antibiotic cocktail every time and while it has immediate success, the parasite keeps coming back a year later and the cycle repeats itself.

      • Hi RS, I can relate to your story. Have had many the sam DX as yourself over past 20+ yrs.. but. 3 yrs ago was DX with chronic Lyme Disease. My current holistic Dr. believes all these other co-conditions where able to take root because Lyme was never detected and treated. Testing for LYME is much like Sibo tho, very inaccurate with many false negatives. It is important to find a well versed Dr. that can evalute your WHOLE health and past history. While, we have done several rounds of antibiotics to treat my Lyme, he believes treatment wont be successful until we address all these other co-conditions. Im not implying you have Lyme, but given our simular history maybe worth looking into. As Lyme is allowed to go without treatment it reeks havoc on the entire body, from gut, immune, nervous system, & hormones which greatly effect menstrual cycles. This had been a life long journey for me, and im not healed yet but i am getting answers now & knowledge is power 🙂
        Hope you too will continue to get the help and answers you seek and deserve & good luck with your new protocol ~ wishing you all better health in days to follow.

        • Hi T,

          I also suffer from a severe case of Lyme disease which has changed my immune system. I was lucky and was diagnosed within a year we think of the tick bite. However I suffer from major inflammation and gut issues.
          Please contact me if you are interested in sharing
          Thanks,
          Laurie

          • Hi Laurie, I, too suffer from Lyme and SIBO/gut inflammation…Just wondering how you are doing now? I’ve been having a very hard time with the abdominal distention, in particular – it’s very severe, worse at night – but present 24/7…

    • Hey Dan! Me too! There doesn’t seem to be a lot of info out there. What have you found out? I am taking a whole bunch of natural “killers”, but I am skeptical it will work from everything I read. I have found some interesting alternative treatments. One of which is using a RA drug for the Histo. Very frustrating.

      • What alternative treatments have u found? I try my best to stay away from inflammatory foods like sugars and gluten as well as my food allergies (cow’s milk, peanuts), get sufficient exercise and sleep, and supplement with things such as berberine, allicin, and one/two probiotics every day with the hope of my body just eliminating the parasite naturally. It seems to be improving my overall condition but not taking fully eliminating it, which is why I keep resorting to the antibiotics. Pretty desperate for any other ideas tho.

        • Dan, have a read on Atrantil that is meant for Sibo. Also if you can, try avoid antibiotics. Drs dish antibiotics out for anything and everything to ‘mask’ a problem that doesn’t eliminate an issue. Check out naturalhealth365 a great website with all sorts of insightful info (including warnings on certain antibiotics causing permanent nerve damage).

          • Has anyone tried some of these black walnut/wormwood compounds that are supposed to be a natural parasite killer? Looks like there are capsules and liquid eye-dropper types on amazon, I may give them a shot if anyone thinks they work?

            • Hi, I have used the Dr. Hilda Clark parasite cleanse which is herbal with wormwood cloves and double strength black walnut hull tincture. Was tested before and after and it works great. It is recommended you do this once a year for maintenance.

              • I just purchased the black walnut tincture. What is a good dosage that people have used with this? One, two, three times per day and how many drops? I realize it will be what I can tolerate but what have others started out with? I am using it alongside Candibactin, biocydin and oreganol and have been pulsing through those for about 4 months and wanted to add the black walnut to get at any lingering strains of this bacteria. I am feeling much better but know theres a little bit still hanging on because I still get some random bloating and pain. Thanks

              • That’s great info thanks. I finished a cycle of paromycin and tindamax recently that Dr Cahill (a well-known parasitologist in NYC) prescribed me and not sure it killed everything. I am gona get re-tested soon and when in his office, plan on asking him his thoughts on this alternative. It cant hurt to try.

            • It helped me but then I may have gone a little bit overboard. I was taking the recommended dose of 2 dropperfuls, 3x a day. I did that but it only kept the Candida at bay and then if I ate anything with sugar, I could feel it coming back. So, I took 4 dropperfuls 2-3 times a day and felt it sort of come back so I upped the amount to 6 dropperfuls 2-3 times a day. By that time I finished off my bottle and had to get more fast but did not get the same brand at my local health food store but by that time I think I pretty much got rid of the Candida or at least do not feel the effects of it like the pain and pressure when I urinate. I was also taking Chlorophyl at the same “overdose” amount to be sure my liver stayed clean while I was getting rid of these toxins.

            • Hi Linda

              I have used black Walnut worm wood for parasite cleanse and is is very effective combine with bentonite clay a detoxing agenthe and physillum husk to push the parasite and toxins out of the body.
              All can be found on amazon.

  10. One more question: Anyone have an explanation for why one might wakeup with SIBO-related nausea and have it last a chunk of the day but then have it completely disappear by evening?

  11. I may be repeating myself BUT what sort of experience has anyone had treating methane-dominant SIBO with Flagyl? I’m halfway through a 14-day course. Also, has anyone ever gotten a good explanation for why nausea might become THE most pernicious symptom, especially in year three of Spring recurrence of symptoms? The nausea began in April 2015 while going another round with Rifaximin (which had been “effective” in Sept 2014, but then recurrence six months later.)

    • In doing just a small bit of research it looks as thought the antibiotic Flagyl has nausea as a side-effect. It is non of my business what kind of doctor you have treating this but I myself would look for a Naturopathic doctor and get a natural cure to my SIBO. I would do endless research on it myself and see what I can do to alleviate the suffering from this horrible disease. I would do nothing but natural, holistic cures. Antibiotics continue to cause problems within the intestinal area and if it were me I would discontinue all use of antibiotics and seek only natural cures. First of all, a Gluten-free diet would probably alleviate most of your symptoms and do this as a lifestyle change not a temporary diet. Americans are suffering from over-thinking the cure. If we rely on the same cures our ancestors had and stay away from processed foods, stay with natural, organic eating then we will all live healthier, better quality of life.

  12. Hi,
    I am allergic to Betaine and any kind of Vinegar. What other supplements are out there that can raise stomach acid naturally?
    Btw, I have SIBO(confirmed by the breath test). Mine is the Methane type.
    Thank you so much,

      • I was told to try Milk of Magnesia and after taking 2 nights my symptoms are 90 % better! I have tried everything so was so surprised ☺️

    • Try bitters with out alcohol.

      or the best I have ever come across is Dr. Shades Liposomal bitters. 45 dollars a bottle but I Think it’s worth it. Just keep taking bitters.

  13. I’ve had SIBO for several years but just discovered Atrantil. It’s wonderful. I suggest you check it out. Herbal developed by an MD.

  14. Hi, I just finished 30 days straight of rifaximin for hydrogen SIBO – I have had IBS-D for 30 years and 3 years ago it became severe after a hysterectomy and I am thinking over use of diflucan for yeast infections. Anyways, I cured myself by starving out the bacteria for 2months straight but became anorexic weighing in at 106lbs that was nov 2013 to jan 2014. then I began to eat again with no issues. but now after eating tons of carbs I started to get more and more “d” every morning and bloating so tested positive for hydrogen. I didn’t feel awful but was worried I might go back to 2013 so treated it. Now 30 days after I am in worse pain then before. I can’t eat anything or even drink water without an IBS attack coming on. It has been a week off and I have missed 2 days of work due to ibs attacks. I seem to be hyper sensitive to all foods again!!! WHY is this happening??? why hasn’t anyone mentioned this might occur?? I have been told pancreas? but I am on pancreatic prescription enzymes! Please help as I am in tears and severely anxious thinking I am going back to 2013 again where I can’t eat anything without severe “D” and ibs spasms sooo severe I almost pass out!!!

    • Barb – are you taking any probiotics or natural supplements? Maybe try Liquid Chlorophyll for the pain, although if the pain is that severe you should probably see a doctor or qualified nutrition

    • Barb,
      I was in a position where I also was suffering extremely regular IBS attacks which were very painful. I fixed my problem by going onto a ketogenic paleo diet. I consulted a book by Robb Wolf called “The Paleo Solution”. It brought things under control for me and now I’m trying to sort out my underlying gut bacteria problem.

      • Hi
        I was told to stay away from any pork because it does not digest easily also limit beef products.

    • Try Colustrum from getthetea.com. It’s a miracle worker. My friend is taking it for her IBS. I got it for myself but do not have IBS so I gave to her. I research lots of things and have found so many cures for so many things but my problem is Candida. Can’t seem to rid myself. I just manage to keep it at bay. I went back to using something that I am sure would cure it if I could stay with the diet. I am about to start a 7 day fast and cleanse. If you have not done a colonic cleanse, then you do not know what you are missing. I did this about 20 years ago and did great. Changed my life but then went off the health wagon and have been suffering weight gain, thyroid problems, Candida to the max so now I am doing lots of research and studying. One good thing is that we are living in a time where new cures are coming about everyday and one day it will be our turn for “the cure”. I’m telling you though that I believe in this Colustrum, it is going to do wonders for IBS. I will continue to come back to this site and see what everyone is doing cause if we stick together and let each other know what works for us then we are bound to figure it out even if the doctors don’t. There is something I read about that seems to help and that is Allicin C which is on the same website getthetea.com but can also be found on Amazon cheaper. Be careful you get the same formulation as on getthetea.com because it seems to be the best. It’s made from garlic or using garlic or some how garlic is involved and the good thing is that you will not suffer from the smell of garlic either breath or from body odor. I will get this but want to deplete the other Candida cleanse that I have first.

      • Hi Linda – which candida cleanse are you using? I am also similar to you, initially thought it was a candida/sibo problem, now believe it’s a candida/hypothyroid problem with adrenal fatigue linked in. Everything stems from the gut so it’s key to get that right. I have on rotation (apparently its good to change it up every 3/4 days) Interfase Plus, Elle Belle ultimate candida cleanse and prescript-assist. I have just run out of prescript-assist but I would order again. My immune system has always been very weak so frustratingly I find if I take more than one capsule at a time I will feel the “die-off”. I haven’t heard of Colustrum, I also just read about Atrantil (although that’s more related to sibo). I agree, I think we can all help eachother more than doctors can help us.

        • I’m using CCWS Candida Cleanse. The website is http://www.candidacurecenter.com. The candida cure stuff is good but I did not see it through. The good thing about it is that you do not have to follow an organic or vegetarian diet because it tells you to eat a fatty diet so that the pills will adhere to the fat and go to work where the candida is growing. This candida is a big issue with me and I have had quite a time and lots of suffering with it. I am currently doing a cleanse along with a fast and colonic irrigation. I am sticking with this for 7 days with lots of prayer and waiting to see positive results. I have done so much praying on this candida issue and my hypothyroid and trust the LORD will lead me through a successful cleanse.

      • Linda – do you mean Colostrum? Did you try it at all or only give it to your friend? Only they say it helps Candida? (along with many other benefits)

        • I took it a time or two but for some reason I could not remember to take it at night. You are supposed to take first thing in the morning and then again at night at bedtime. I remember the morning but didn’t do the night. I did it on random days so of course could tell no difference but it’s because I didn’t take it consecutively so basically I didn’t take it. I will post again when my friend sees results either way. I know it is going to help her. I actually didn’t know it help Candida. I will be ordering more after my cleanse.

        • Yes, I misspelled Colostrum. Thank you for correcting me because I don’t want anyone to err because of my misspelling. I only gave this to my friend and she took it for about two weeks and stopped. She was determined to get her pain under control before tackling the IBS which I think she feels she must live with. I think she got better in a short period and figures she has it under control and I did see a great difference in her health while she was taking the Colostrum and wanted her to continue. With you telling me it helps with Candida, I will get that stuff out and try for myself. Why is it that all of us suffering these issues with Candida and IBS, SIBO and it seems no one cares enough to find the cure. There are horrible, painful issues here but no one has the time to find a cure. Makes me feel so insignificant!! None of us seem to be getting the REAL cure.

        • It seems that Candida is one of those issues that keeps rearing its ugly head. I wonder if I will ever get rid of it completely. I did a 7 day fast and cleanse a couple of weeks ago. I only took in the cleanse items which was natural pills to assist the cleanse and then mixed psyllium husk seeds and bentonite clay with a small portion of juice to be able to tolerate the mixture. I did drink some coconut juice (all 100% organic), apple juice (which was suggested in instructions for cleanse) which was also 100% organic. I was not focused on getting rid of candida but if it happened then all the better. About the 4th or 5th day I noticed some die-off effects of candida. I noticed also in urinating that I could see some cloudy mass that I identified as fungus and this from my urine. I experienced this about 20 years ago but then was not sure it was the candida but apparently that is exactly what it is. A couple more days on the cleanse and experienced even stronger die-off effects but I knew it was the candida die-off. Sure enough I am feeling much better and rarely have any of the candida flare-ups (at least so far). I know it is not gone but with me if I can get rid of a small portion then I am happy. I will continue fighting this battle until I find the sure fire cure. I am at war with my candida.

          • Linda, Something you may or may not know. Candida is a commensal yeast that lives synergistically w/ other bacteria in our bodies if it doesn’t get out of control. I spent years at war w/ candida. I took the Diflucan and a year on Nystatin. I also was very rigid on the Candida diet for 2 years. I can tell you from several nutrition courses I have taken and from my own frustrating experience, your candida issue is the canary in your gut telling you-you have a much bigger issue to address first. You will not win the war if you do not address WHY the candida is so prolific in the first place. Have you done an extensive stool test to look for parasites? That is where I would start. I had Blasto and too high of H-pylori. Follow up shows I won that war. Now I have Entamoeba Histolytica, which is a nasty lil critter. Hard to detect and hard to kill. My yeast levels are still very high as well, probably bc of the E.Histo and possible other co-infections. The more you stick w/ the gut protocols and clean low carb diet, the closer you get to health…I hope!! I still don’t have all the answers and am open to new suggestions.

            • I would like to know more about how you discovered the parasites? Where did you get this stool test done? When the test is done, does it list what the stool contains? I have started doing some things to get rid of the Candida that seems to be working. In the past, I would just take something to get rid of the Candida without thinking about how the body would rid the stuff once it died. I read somewhere that in taking medications to rid the body of bacteria or fungus, etc, you also needed to cleanse the liver to be sure the liver wasn’t being taxed too heavily with all the toxins it was having to deal with. So, recently I read that Fresh Green Black Walnut Wormwood Complex was good for getting rid of Candida and I started taking it along with Chlorophyll for cleansing the liver. I took it for about a week and finally saw results. I now am not having any of the pain from the Candida and even after having something sweet still do not having any of the effects of the overgrowth. After this I decided to take another recommended product for getting rid of the Candida while also taking a cleanse for the Liver. For whatever reason, I am having success with the Candida and I am feeling very grateful for all the information out there and not from experts but from all those suffering with the same things I have suffered. By sharing information with each other, we can gain knowledge and helping ourselves as well as helping others with the information.

    • Seriously, try the Gluten-free diet. It could be the cure to all of your ailments. It will have to be a lifestyle change in order to stay healthy. Stay away from antibiotics. Search out natural, holistic cures. Instead of antibiotics, take probiotics and check out prebiotics from health food stores. Probiotcs will help replace and restore the “good” bacteria in the gut whereas antibiotics kill bacteria in the intestines. Stop using Western Medicine and seek out the healthy alternative…..find a Holistic doctor or Naturopath and stay away from the MD’s. Start doing your own research on the web and do not rely on anyone else to do your thinking for you. You must take your own health in your hands because no one cares about you like you do. Search and search and search some more for answers to your health problems. You will be glad you did.

      • Gluten Free is not enough, most of the food is packed with starches which translates to high carbs which translates to sugar. Candida and SIBO feed on carbs.

        • Gluten free isn’t necessarily enough but it can be a good place to start. Reducing (or ideally cutting out) sugar and gluten is beneficial for starving off bacteria because bacteria feed on this. It can be difficult at the beginning but it only takes 2 weeks for the body to adapt and for you to notice a change. It won’t necessarily solve the issue entirely but it will contribute to a better internal environment to solve the problem, either way it’s a good way to detox the body. Once you start I find it helps to almost visualise the bacteria in the gut “starving” and dying off in numbers due to the lack of feeding them. Garlic and other natural herbs are a very beneficial. On another note I would recommend looking into Atrantil.

          • Actually, Alan Ebringer’s research says it’s starch, not carbs that are the problem. Look up the no-starch diet. Said to produce miraculous results for IBS and other autoimmune / reactive arthritis type complaints such as ankylosing spondylitis. I guess it may also help SIBO if it is caused by pathogenic bacteria like proteus and klebsiella

    • Hi Barb,
      I am posting what I posted for Leonardo above but I think this will help. You need a natural medicine doctor MD who believes in holistic treatment and does conventional medicine as well so they can also run the proper tests.

      Usually I don’t read these blogs but fortunately this will help. I have been sufferring from SIBO, yeast infection and 5 other stomach infections that resulted in a lot of joint pains and I could not eat and I was afraid to eat for some time. I was wondering what was going to happen. I am doing well now and I will tell you what I did for treatment. There are a handful of doctors who practice integrative medicine which is doctors MD with knowledge and acceptance of holistic treatment methods as well and they have a whole bunch of new tests to find out what is wrong since modern medicine is sometimes not knowledgeable for some reason. Do not trust naturopaths and websites since they are trying to sell their stuff and don’t know what they are doing. One of the best in the east coast is Dr. Mark Hyman and his center http://www.ultrawellnesscenter.com/home/ and of the best doctors in the US for integrative medicine that I took help of is Dr. Joseph Sciabbarrasi in LA. You can call his chamber and set up an appt with him he is more available. There is another doctor that I also see he is even better but it is harder to get appointments. Send me an email and I will send you his info but you need treatment urgently so it will be a good way to start right away with Dr. Sciabbarrassi and then also see the other Dr. They use all sorts of natural remedies and supplements that I have never heard of along with conventional medicines. Best of both worlds. Google integrative medicine to find more practitioners around your area but in my knowledge these people I mentioned are the best. Hope this helps.
      https://www.yelp.com/biz/joseph-sciabbarrasi-md-los-angeles

  15. When reviewing a SCD it says no corn or wheat of any kind, however when it comes to alcohol bourbon is allowed which is a made from corn and wheat furthermore tequila is not allowed can someone explain this? Also, onions and garlic are OK but why is onion powder and garlic powder not OK to consume? One more thing with corn, is popcorn allowed on a specific carb diet?

    • Onion powder and garlic powder could have a starch added to it for caking purposes in the bottle. I believe the distillation process in alcohol may change the properties but I don’t know exactly, maybe the moderator will answer that one. And corn, I know for me, I avoid it all together. I think for many people doing the SCD they have digestive issues and popcorn is hard to digest or could activate their Irritable bowel or Crones disease.

  16. If SIBO is caused by moderate to heavy alcohol use, and then is treated with antibiotics, if one reduce the amount of alcohol greatly, will the small intestine repair itself over time?

  17. Has anyone tried diatomaceous earth for their SIBO condition? I have been reading a lot about it lately and watching youtube videos of testimonials.

    • Hi Elka, I was reading the same things. For some time I was looking at trying that or Bentonite clay. My SIBO is more lots of stools daily and I found that it increased my frequency so I stopped. Then I spoke to my colon therapist and she said that if you do a “cleanse” with these types of products you have be very careful and do it with supervision by a colon therapist or integrative doctor who understands the process and possible complications. So I am not saying its good or bad. I Just chose not to continue because I can’t pay for that supervision and I didn;t like the immediate effects I had.

      • I decided to give the diatomaceous earth a try for at least a week. I’m on my 2nd day — and actually feel better than before I started. I am just taking a teaspoon a day in liquid. I’ll try to remember to update here after a week.

        • Wow, so it’s been a week since I have started the diatomaceous earth daily for my IBS – SIBO. I started a week ago with 1 teaspoon a day in my coffee and by the fourth day upped that to a Tablespoon a day. Well — today I feel better than I have in over 5 years. Seriously — this is amazing. I will continue the DE and update after a month or so.

            • I went back down to 1 teaspoon a day. 1 Tablespoon was too much. I am feeling much better. I am feeling lighter and cleaned out. Sleeping better, and a lot more energy. Constipation gone. I’ll update in a couple of weeks.

      • I’ve used the Bentonite clay along with Physillum husk seed which is great. I used this 20 years ago and am starting tomorrow on another fast and cleanse using this. I’m sure a doctor would tell you that you need to be supervised so they can get more money out of you but there is no need to be supervised. The Bentonite clay draws out toxins from your body and the physillium husk seed scrubs the tough hardened lining of the intestine to get the junk out that keeps your body from absorbing nutritious food and supplements. The clay draws out toxins and the husk scrubs and cleans the junk out along with anything else in the intestines. I would not hesitate to use these products. You also need to use a very good Probiotic at the same time to implant good bacteria in the intestines. I’m starting the Sonne’s cleanse that contains all the stuff you need for a reasonable price (Amazon) with instructions as to what to take when. The Candida cure is at candidacurecenter.com. The orders come from some place I cannot spell but I believe it was said it was in Thailand and takes as much as two weeks to receive once you order. Don’t be afraid cause it’s perfectly legit and I have ordered. It is also guaranteed with 60-day money back guarantee. someone has a website with negative review or warning about this and said if you didn’t believe it was a scam then just ask for your money back and they will run and hid. So, out of curiosity I did ask for my money back and they refunded it. I felt like a heel lying about how it didn’t work for me but I am going to reorder and let them know I continued to use the product and it did work. I’m going to get healthy once and for all. I’m tired of being sick and tired and not feeling good. I freed myself of the hold those soft drinks had on me and now ready to cleanse this tired old body. I want to cleanse at least once a year at least. It talks about fasting and cleansing in the Bible or at least fasting cause the thing about cleansing didn’t make it in the scriptures where Jesus talks about using a gourd to well (you don’t want to hear about that).

  18. Help the natural way.

    I have candida problem but noticed a different kind of digestive disturbance that started about a year or so ago. It got really bad after starting gelatin/bone broth. Within a few weeks my stomach or small intestine started pounding with what felt like flu symptoms at night.

    I seemed to be ok once I stopped bone broth. I knew that oregano oil was suppose to have an effect on bacteria so I thought that I would try it against the sibo. I took a few drops of oregano oil under my tongue twice a day for 3 or 4 days. I started doing bone broth again and after a few days the pounding began again. This time I took a few drops of oo and the pounding stopped within a short period of time. The process may have repeated another time, can’t remember. Anyway I have been eating 4 or 5 ounces of jelled bone broth for couple months now every morning with no trouble at all.

    As a side note I buy 100% oo and cut it myself with 30% or so coconut oil.

  19. I have had ibs-d prominent for 20 years and then in 2005 had a bowel resection for diverticulosis. Now my quality of life is suffering. I have been everywhere, to teaching hospitals and also Cedars Sinai where Dr. Pimental originated the SIBO theory. I have used Rifaximan but it doesn’t last. Cipro seems to set me straight after a four day dose but the doctors don’t like giving antibiotics. I have gas, bloating, stomach pain, intestinal pain and diarrhea every day. I used loperamide daily. Lately though it seems to be a two edged sword, I need that to go out but then it stops up the gas. I am very down about the entire situation but hearing you all have makes me feel less alone. I know it is hereditary because one of my children and one grandchild also have it. I wonder if an SSRI will help. I do have anxiety but this doesn’t seem related. SIBO doesn’t care what I eat although I know sugars and going off the FODMAP diet make it worse. I hope someone finds a way to help us soon. With modern medicine you’d think they could.

    • Anxiety IS related to gastro issues. Google anxiety, gut and you’ll find some studies/articles on this. It stands to reason if you are not digesting well or have reduced nutrient intake because of SIBO you’ll begin to feel the effects of lacking nutrients such as depression, etc. The majority of the serotonin receptors exist in your gut.
      This article may explain one aspect of gut biome health and our moods: http://www.caltech.edu/news/microbes-help-produce-serotonin-gut-46495

      • Hi Sallie, you sound as I used to feel with anxiety and many other issues. What are you currently eating? What has helped my SIBO exponentially (I’m free of all symptoms) is by NOT eating any grains, including gluten-free grains like rice, or pseudo grains (quinoa, millet, amaranth) at all. None. The SIBO bacterias are feeding on the sugars that grains convert to in the gut. The Specific Carbohydrate Diet and refraining from only certain FODMAPs like onions (or me) along with two courses of Xifaxan/Rifamaxin and some supportive supplements like B complex, Vit A, D, C, zinc, magnesium, rhodiola for adrenals and colostrum to heal mucosal lining have done the trick so far. I’m not saying I’m totally healed of all my maladies yet, as not a whole lot of time has passed, but boy do I feel better withe he SIBO and my other digestive complaints. The caveat? If I return to eating grains the SIBO will more than likely return. It’s the way it is for those of us who are prone to SIBO. At least for now until things really get under control, as Ihope they will for us all. However, I’ve learned a new way of cooking and eating. I’ve looked at it as a new adventure in culinary delights (attitude is everything for those of us who are chronically ill) and all my illnesses are greatly improving (IBS, SIBO, Reflux and heartburn, fibromyalgia and its myriad miserable manifestations, and the best… my Barrett’s Esophagus (precancer of the esophagus, GERD being the primary risk factor for contracting it) is no longer present according to my last endoscopy!) Do give the SCD a try. What can it hurt?

    • Just from the symptoms you spoke of gas, bloating, diarrhea it sounds like you need a Gluten-free diet. Stay away from antibiotics which only cause more problems. You need more “good” bacteria in the intestines but antibiotics kill that off with each pill you take. Take a good probiotic and switch every month or so to a different brand with different bacteria. This will help you more than you can believe but also check out doing a gluten-free diet. Not only will you be able to rid yourself of those awful symptoms but you could cure yourself of the SIBO.

    • Please be careful with Cipro and related drugs. I now have a dual problem. I have had IBS -D for years post getting a parasite in Morocco. 4 doctors told me it was IBS, and basically there was nothing I could do. Then, I got a UTI for the first time and was prescribed Cipro. After the 3rd pill, I developed tingling in my left hand and occasionally my left arm and foot. I hasn’t gone away and now I’m trying to treat that with glutathione IVs from a naturopath specializing in detox. I told her about the IBS, and she suggested I may have SIBO. I have yet to do the test, but will soon. Anyway, don’t take Cipro- you may be lucky and not have nerve issues, but you don’t need another issue to deal with.

      • Julie
        So sorry to hear all you are going through. I too have issues and they don’t seem to have any answers.
        I have read posts about Fossil Powder being helpful for digestive issues and am in day 2 of trying to detox by taking it slowly hoping this will help. Go to Amazon and view testimonials.

  20. I most likely gave SIBO.
    I have done many diets.
    Now I manage with lowish fodmap, gluten free mag citrate for constipation, making sure I get enough soluable fiber ( gluten free pasta, etc) to deal with diarrhea and just started b-12 shots. I juice my greens ( not too much because of thyroid and don’t eat raw stuff except for carrots and peppers. I make sure to mix cooked greens with white rice or gluten free pasta.

    I would love to get rid of SIBO but for now after trying the protocols and failing this is working for me. Everyone is different.
    It is managing it