Why Diet Alone Is Not Enough to Treat SIBO

by Kelsey Kinney, RD

Last updated on

SIBO diet

If you’re using a low-FODMAP diet to keep your small intestinal bacterial overgrowth (SIBO) under control, you’re not alone.

Listen to this article

However, diet on its own does not cure SIBO. In fact, eating a higher-FODMAP diet in combination with your antibiotic protocol leads to more successful eradication of the bacteria.

Can you get relief for your symptoms by following a SIBO diet? While diet is an important part of healing your gut, it’s not enough to really treat the condition. Check out this article to find out what works for SIBO.

What Is a SIBO Diet?

Are you dealing with SIBO? If so, you may be looking for a way to treat the condition without antibiotics. In most cases, that means adopting a SIBO diet that limits your carbohydrate intake and removes carbs that are difficult for your body to digest or absorb. Some common SIBO dietary protocols are:

  • Low-FODMAP diet
  • Specific carbohydrate diet (SCD)
  • Gut and Psychology Syndrome (GAPS) diet
  • Elemental diet
  • Low fermentation potential (FP) diet
  • Low-starch or even no-starch diet

While these specific diets differ from each other, their general goal is similar: limiting the types of carbs you consume to avoid feeding the bacterial overgrowth in your small intestine that’s driving your SIBO. The low-FODMAP diet, for example, limits FODMAPs, or short-chain carbohydrates that aren’t completely absorbed in the gastrointestinal tracts. FODMAPs can linger in the gut and feed bacteria, resulting in a variety of digestive symptoms.

Free eBook

Optimize Your Gut Health

Download this free eBook to learn more about common issues that impact gut health and digestion.

I hate spam, too. Your email is safe with me. By signing up, you agree to our privacy policy.

What Is Considered the Best Diet for SIBO—And What’s the Problem with It?

The low-FODMAP diet is a common choice for SIBO (and other digestive disorders like irritable bowel syndrome). This diet has been shown to provide at least short-term relief by reducing bacterial overgrowth in the small intestine. (1)

If you’ve tried a low-FODMAP diet for SIBO and noticed significant improvements in your symptoms, it’s easy to think that this must be the answer—a low-FODMAP (or low-carb) diet has cured you!

Unfortunately, this is not the case. A low-FODMAP (or low-carbohydrate) diet will keep symptoms under control simply by starving the bacteria in your small intestine. When these bacteria don’t have food to eat, they aren’t able to metabolize that food, and produce gas as a result. This gas is what causes the common symptoms of SIBO—bloating, abdominal pain, diarrhea (in the case of hydrogen gas), and constipation (in the case of methane gas). (2)

But starving the bacteria over the short term does not eradicate the bacteria, which is what we’re trying to accomplish, as the small intestine is not supposed to contain much bacteria. If you continue this restriction for a long period of time in an effort to kill the bacteria, you’re also starving the bacteria in your large intestine that should be there and that play a vital role in your health.

Simply put, a low-FODMAP or low-carb diet does not eradicate an overgrowth in the small intestine in a short period of time, and continuing on a long-term low-FODMAP/low-carbohydrate diet in an effort to starve the bacteria to death has potential detrimental effects on the bacteria in the large intestine. I have had clients who have been on long-term low-FODMAP diets before working with me who still have positive breath tests for SIBO despite their restricted diet. There is a difference between controlling symptoms and actually clearing the bacteria. We want to do the latter, which has the added benefit of improving symptoms, as well.

What Is SIBO?

The large intestine contains the majority of the digestive system’s bacteria. The small intestine is typically relatively sterile (compared to the large intestine), so when bacteria translocates and overgrows in the small intestine, it causes problems. If there are changes in the number or type of bacteria present in the small intestine, SIBO occurs. For many people, this is caused by an overgrowth of a variety of bacteria that should be in the colon. (3)

SIBO impacts the structure of the small intestine and its ability to function. The condition often causes damage to the mucosa lining the small intestine, which can impair nutrient absorption and lead to leaky gut—a condition where protein molecules can pass through the intestinal barrier into the bloodstream, causing an inflammatory response.

Symptoms of SIBO

SIBO doesn’t always cause symptoms (some studies suggest that up to 15 percent of healthy people are experiencing SIBO without any symptoms). (4) However, some of the most common signs of SIBO include:

  • Diarrhea
  • Constipation
  • Abdominal pain and discomfort
  • Bloating
  • Gas and belching
  • Weight loss and vitamin deficiencies (in severe cases)

SIBO is, unfortunately, an under-diagnosed condition. Many people aren’t aware that SIBO could be causing their symptoms, and many doctors don’t realize how common this condition really is. Some of the most commonly used testing methods (breath tests) have some issues with accuracy. All those factors play a role in making SIBO difficult to diagnose and treat.

The Negative Impact of a Long-Term Low-FODMAP Diet

There have been limited studies on the long-term impact of low-FODMAP diets on microbial balance in the large intestine. The studies that show the impact of short-term FODMAP restriction on the microbiome, however, do not bode well for the long-term implications.

FODMAPs are fermentable carbohydrates that help to feed the beneficial bacteria in the large intestine. When you begin to think about them this way, it becomes a lot easier to understand why adhering to a diet low in the substrates that our healthy gut bacteria thrive on may not be a great idea.

Indeed, the studies to date on the effects of FODMAP restriction show exactly what we would imagine would happen when restricting these beneficial substrates: the overall amount of bacteria was decreased (by 47 percent in this study), along with a decline in bacteria that produce butyrate (a beneficial substance made when probiotics feed on fermentable fibers). (5) While this particular study did not show a decrease in the probiotic strain Bifidobacteria, another study has. (6) In my clinical experience, it is very common to see low levels of both the Bifidobacteria and Lactobacillus strains in my client’s stool tests if they’ve been on long-term low-FODMAP diets.

While these bacteria would likely thrive once again with the addition of prebiotic substances, staying in a chronically diet-induced altered microbiological state is likely not a healthy choice when you start to think about the importance of our microbiome and its effect on our health.

Clearly, more research needs to be done in this area if patients are going to be on long-term low-FODMAP diets. However, after reading this article, it is my hope that you won’t need to be on a long-term low-FODMAP diet to keep your symptoms under control.

What to Use as an Effective SIBO Treatment

So, if you’re not treating your SIBO with diet, what is used to treat it?

Rifaximin

Rifaximin is the most commonly used antibiotic for the treatment of SIBO, and has been shown to be safe and well-tolerated. (7) Figures vary on its efficacy (with rates as high as 87 percent in one study), but on average, it is about 50 percent effective. (8) However, this may not take into account the necessary difference in treatment for those with methane-positive SIBO. A study on those with methane-positive SIBO shows that when rifaximin is combined with another antibiotic, neomycin, it is about 85 percent effective. (9) If you’re getting tested for SIBO, make sure you’re getting tested for both methane and hydrogen. These tests will guide your practitioner in treating you more effectively.

Herbal Antimicrobials

Herbal antimicrobials have been shown to be at least as effective as rifaximin, and about 57 percent of those who fail on rifaximin will succeed on herbal antimicrobials. (10) I have personally seen this the other way around, as well; those who fail on herbal antimicrobials usually do well with rifaximin. Others may need to do multiple rounds of either herbal or pharmaceutical antibiotics to clear the overgrowth.

Whether you choose herbal or pharmaceutical antibiotics, the important thing is that you are using something that will eradicate the bacteria instead of covering up the symptoms with diet change. You’re getting to the root cause of your symptoms!

Healing from digestive disorders can be a long and difficult process. Many people with these disorders get frustrated with doctors who don’t understand the problem, solutions that don’t work, and chronic discomfort. Where can people with this experience turn for answers? Functional Medicine practitioners are a great option, and they can help diagnose and prescribe treatment. Health coaches are another great source of support, and they can actually be the key to unlocking improved digestive health.

ADAPT-trained health coaches have a background in Functional and ancestral health, and they understand the root causes and range of treatments for digestive disorders. Although they can’t diagnose or treat these disorders directly, health coaches can often refer clients to a trusted Functional Medicine practitioner, help clients understand a diagnosis or follow a treatment plan, and support clients in dealing with the frustration that comes with digestive disorders.

Want to know more about digestive disorders and what you can do to help people overcome them? Learn about the ADAPT Health Coach Training Program.

Diet during and after SIBO Treatment

Now that you’re being treated with herbal or pharmaceutical antibiotics, what should you eat?

If you listened to Chris’s podcast with Dr. Pimentel, you’ll know that having happy and fed bacteria is a good thing when treating SIBO—this is not the time to starve them, as they will “hide” and become more difficult to eradicate. Eating FODMAPs and carbohydrates is exactly what you want to do!

Your Diet during SIBO Treatment

In my own practice, I recommend that clients undergoing treatment eat as many FODMAP foods as they can tolerate and that they do not go on a low-carb diet. (I like to see a minimum of 100 grams of carbohydrates daily, and more, if tolerated.)

I also will typically add some kind of prebiotic if the client can tolerate it. A study that compared rifaximin alone versus rifaximin treatment plus partially hydrolyzed guar gum supplementation showed that providing fermentable carbohydrate along with the antibiotic improved success rates from about 62 percent (rifaximin alone) to 87 percent (rifaximin plus guar gum). (11)

Of course, I don’t want my clients to be miserable with digestive symptoms during this time, so treatment is always personalized to each client. Some may have no problems whatsoever eating FODMAPs or high-carbohydrate foods, while others may be very sensitive. I encourage clients to eat the maximum amount that they are comfortable with and remind them that, in the end, feeding these bacteria is a good thing. They may experience some uncomfortable symptoms like bloating or gas during this time, but as long as it does not interrupt their life or cause pain, the more FODMAPs or carbohydrates they can eat, the better.

Your Diet after SIBO Treatment

As many sufferers of SIBO know, SIBO has a high rate of recurrence, which begs the question: what should you eat after treatment to prevent another overgrowth? In my eyes, that’s the million-dollar question right now, and it’s a question we don’t have the answer to quite yet.

For now, I have my clients eat whatever they can tolerate on a healthy, real-food, ancestral diet. If they need to restrict FODMAPs slightly or eat rapidly digested carbohydrates to keep symptoms under control, that’s okay. (However, if you can’t tolerate FODMAPs or complex carbohydrates after your treatment, you’ll definitely want to retest to make sure that you’ve completely eradicated the overgrowth in the first place.)

We’ll also investigate any potential underlying causes of their SIBO, such as:

  • Low stomach acid
  • Pancreatic enzyme insufficiency
  • Intestinal motility disorders
  • Poor diet
  • Stress

I know from speaking with Chris that he has come to believe that SIBO—and especially recurring SIBO—is often a symptom of a deeper problem. The solution in that case isn’t just to keep treating the SIBO, but to address that root cause.

There’s a lot we still don’t know about SIBO. As we learn more, some of these protocols may change, but I hope this article has given you a better idea of what you should do to heal from SIBO with the knowledge we have now.

Additional Resources on SIBO:

533 Comments

Join the conversation

  1. I have read quite a lot of the comments here and as yet haven’t read of anyone using Kefir.
    I am 71 years and have had SIBO all my life, I think my SIBO is inherited from my Father. I have exactly the same build as him and noticed when looking recently at several photo’s of him that he has the typical swollen stomach of a SIBO sufferer.
    I didn’t know anything about SIBO until about seven years ago when I read an article in a newspaper giving the symptom’s .
    After reading the article I visited my GP and took a course of Anti-Biotics (AB) which worked very nicely, although after 12 months I needed another course of AB and every 12 months since then the same.
    I also supplement this with drinking three tablespoons of Kefir every morning approximately 30 minutes before eating my breakfast. Since using Kefir I never get any indigestion and can eat anything I want and I eat big meals although I make sure to masticate all food well.
    On the subject of Kefir, sellers of kefir seed state that it should only be used for approx 15 times before throwing out and using renewing.
    I have been using the same Kefir for over 12 months and have found that it has become more potent i.e much thicker. Be aware, if considering kefir that it is very easy to overdose and that if one does overdose the results can be very embarrassing, you will get very little warning!

    • What were your sibo symptoms and what AB did you take to cure it
      Did you have a reaction from the AB? How long were you on it?

      • I’ve taken Zifaxin anti biotic about 4 times in the past year, & it always goes away, but a few weeks later it’s back. I asked my doctor about adding neomyiacin,?but he says they neomycian can cause you to loose your hearing. My gastroenteroligist is not very knowledgeable about SIBO. I’m going to see as doctor at Cedars Sanai clinic, where Dr Pimintel trains the Drs on SIBO. I’m on the Fodmap diet. They have ice cream w no lactose, but that makes me sick. I either have diahrea or I’m constipated.

        • Hi Adele ! My Gastro sent me to cedars as well but the wait time
          To see a doctor is crazy. Can you post about your experience once you go? I’m seeing a different Gastro in my area (San Diego ) this week. Hopefully I have better luck

          • Absolutely Go to Cedars. Call daily for cancellations. You will get in earlier. My daughter got in next day instead of MAY! They are fantastic. Biofeedback is practically curing my daughter’s IBS type constipation and helping prevent reoccurring SIBO

            • That’s awesome! Gives me hope… I have an appointment st cedars as well on march 7th for my sibo. Already tried different doctors in San Diego that did not help.

  2. Hi, and thank you for investigation and help.

    Is it possible to have an overgrowth on bugs that feed on proteine and fat? I have huge problems with longchain carbs AND also proteins and fats too. Thats why SCD Diets fails in my case. I cant even take aminoacid capsules or hydrolized proteine (both highly digestible) without have immediate reaction. How could these bugs (l presume some clostrids and entercocus family members) be diagnose in the SMALL intestine? And how can they be eradicated? Rifaximine and Neomycine? I am struggling since 6 horrific years and have tried many approaches with dietchange and herbal antibiotics. But I have zero changes in the condition.
    Would be amazing having answers.
    Thank you
    Carole

    • Hi Carole,

      Could you please tell me what reaction do you have?
      I know your question is to Kelsey but – maybe you have histamine intolerance. Bacteria can digest protein and fat but i guess only if you dont digest it – aminoacid capsules or hydrolized proteine. Does your amino acids contain histidine?

      • hi Peter
        Reactions like: heartrate increasing, white furry tounge, constipation, brainfog, all mucus lining in mouth and nose drying out, bloating, headache, fatigue, nightly relux…etc.
        I used to have Histamineintolerance, but this was before developing SIBO. I know that my Diaminoxidase is ok again. ALso because the reactions I used to have were exclusively to the list of specific food which cause the Histaminose. ALso the migraene was predominant in the symptoms. But now I have reactions to ALL Proteins and Fats. Yes, all you do not digest. Thats why I think the bugs sit now in the upper digestive system – in the small intestine. The food has less time to be digested. The aminocaps did not contain histidine. Regarding the different proteinpowders I cant tell. I^ve tried different. But the reaction is the same to all proteines. Can be a piece of chicken or a almondflour f.e.
        What experiences with therapy do you have?

        Thank you
        Carole

        • Hi Carole,

          I think your proteins are not so easy to digest as you think – i have a book about Leaky Gut from Case Adams
          /The Science of Leaky Gut Syndrome/
          and there is a chapter about hydrolisation and it explains in more details the problem – not only hydrolized protein is a problem but also enzymes used in its production. If you really want to test if your bacteria is the problem /i think there is 99% chance it is not/ you can try to eat raw eggs or at least raw egg yolks, or sashimi – raw fish or steak tartare – raw meat or coconut oil that you made – because there is no raw coconut oil on the market – all say cold pressed but it is not cold processed. Olive oil may be raw but it needs bile for digestion.

          • Hi Peter
            thanks
            what should happen with the sort of proteins you listed? And if you dont think its bacterias what should then cause those problems? I `ve had several test on colon bacteria confirming I have too much of putrifying bacterias in my colon (like enterococcuss spec. /e.coli)

            • Hi Carole,

              When you eat meat,eggs etc. it will putrefy if you dont digest it – if you have low HCL or pancreatic enzymes – if you take enzymes this will maybe help 10-20% – but when you eat eggs and fish raw they have enzymes and will be absorbed even if your enzymes are not working. There are several diets that recommend raw animal foods- way diet, primal diet, raw paleo, Seignalet diet.
              I think your symptoms are caused by your immune system – i mean the bowel does not want to absorb this molecules and then maybe bacteria digest them. If you check this article – it explains similar thing with fats:Do Refined Oils Cause Leaky Gut?
              http://doctorjkrausend.com/refined-oils-cause-leaky-gut/
              I have read in some forums about people eating only meat and coconut oil and have no success healing their gut – because the meat is cooked and the coconut oil is heated. Also some people say beef is not easy to digest even raw – unlike eggs or fish.

              • Thank you for the informations. I never ate raw meat. But I did the paleo diet which excludes refined oils. I use raw coconut oil already a couple of years now. Fortunately we have it available in every supermarket.
                You might be right about the bowels refusing molecules. My immunesystem is all steared up by this immense stress.

                • Hi Carole, I know its been a while since you posted your issue about trouble with proteins but I’ve only just read it. I have trouble processing proteins and I often get some of the same symptoms you do, especially the racing heart, but I often get fevers and chills, anxiety and insomnia with it too. If I eat meat twice in one day, this can happen. I think it may be caused by Ammonia permeability which can kill you if it gets too high. Certain bacteria/viruses produce too much ammonia and when protein is ingested, it can add to that load if the body can’t eradicate it. I take Yucca every day now to reduce ammonia load. It works well and if I get a flare up, I take 3 a day to eliminate it.

    • Hi Carole! I get emails on most of the conversations on this page and Interestingly so I was reading today about a condition called SIFO. Same symptoms as SIBO but this is an overgrowth of fungus in the intestines that rarely gets discovered. Might be worth looking Into. I plan on doing the same since my symptoms haven’t improved either.

      • Hi thank you for your suggestion.
        I did have candida tested a couple of times. Looks like I am not suffering from fungus. (luckily)

  3. Hi Kelsey,

    My doctor ordered me rifaximin in Canada it is zaxine to treat symptoms of sibo without testing as it isnt available. I have yeast marks on my body could this get worse on antibiotics and what are the chances of getting c. diff on rifaximin. Also when and how much guar gum do you recommend taking?

    • Nat, 5 grams hydrolysed Guar Gum per day. (See blue footnote 8: It will take you to the study. It tells you near the top, in the Abstract (summary) section.

  4. FODMAP is all researchers’ concensus

    Dont think you would be any chance more brilliant than those reseachers

    Sibo = stay away from FODMAP for least 6 months

    • Avoid FODMAPS Except when on Xifaxan (Rifaximin) or the Herbal Protocols. Otherwise, the bacteria you want to eradicate goes into hiding, so to speak, & isn’t as effective.

  5. Hello Everyone! I have read through all these post seeing if anyone has symptoms in common with me and many do. Since a hiatal hernia repair I have suffered from the most sever stomach pain that puts me in the ER many times. Has anyone had issues with the bio-mesh used for a hernia? I am on the fodmap diet, tried everything in the blogs, will be doing SIBO test this weekend but as of now nothing has helped this pain, it’s so extreme. I just have a feeling if the SIBO test comes back positive it’s just one of other issues going in the abdomen and putting me on an antibiotic is not going to cure it all that is happening. Please let me know if anyone out there has experiencing this terrible pain has had a hernia repair and did they seek help? Did the bio-mesh play a role? I am SO desperate for answers, I can’t imagine a life with this continued pain, it’s unbearable

    of course you see the commercials from the attorneys for the bio mesh issue but I don’t want to be taken advantage of by people seeking to create a class action suit so they can profit and the victims are left with nothing.

    Thank you! This is a wonderful forum and I have learned a lot by everyone’s posts.

    Michelle

    • I’m in a group where people have nerve pain (Pudendal pain). Many of these people have had procedures using the mesh, & they’ve gone thru extensive surgeries to get rid of the mesh, which is causing them horrible pelvic pain. It has traveled all over their pelvis & done awful nerve damage & is causing them horrible pain. You need to get it removed. I don’t understand why they are using it. It should be outlawed in my opinion.

  6. I’m kind of confused and a little frustrated. My gastroenterologist just put me on the SIBO diet and told me to stay on it two weeks while taking an antibiotic to kill bad bacteria, then follow up with the GAPS diet after. This article seems to say that might be wrong because the bacteria will hide if I do that. What should I do? Help! Thanks!

    • Hi Ann. I think the idea of doing the antibiotic first then the diet is because the antibiotics should kill most of the bacteria, so the follow up diet is just to make sure it doesn’t return

    • Dr. Axe suggest a 3 week protocol followed by Gaps.. have you tried or read this? I’m thinking of trying it… as we are on Gaps and thinking this might of been the reason we haven’t healed completely…. the missing link 🙂 Cheers!

      https://draxe.com/sibo-symptoms/

  7. Solutions for my SIBO:
    (Before I found this combination, I was flat on my back for weeks at a time with SIBO)

    When I feel it coming on / bloating:
    – Oregano oil: “Oreganol” brand found at natural grocer. Put about 5 drops in a couple of ounces of water, drink before going to bed. Stuff is amazing! It kills off excess bacteria for me overnight. Tried other brands, like this one the best.
    – Garlic: “Kyolic Extra Strength Reserve” brand. I take 3 capsules along with the oregano oil before bed. Combination of the garlic and oregano seems to work the best.

    Ongoing/daily:
    – Intestinal cleanser: “Perfect 7” brand by All One. http://www.all-one.com. Fantastic at keeping my stomach and intestines working properly. Use before bedtime.
    – Miralax: I use generic from Costco. Add to Perfect 7 routine if I’m feeling a bit “stuck”.

    Other: No gluten! I eat spelt bread. No dairy – except raw or good quality yogurt.
    Results:
    – Daily routine / work back to normal
    – Once a week, able to eat pizza, ice cream, popcorn. I just don’t overdo it.
    – Able to eat anything at special events: buffet, super bowl party, etc. I just be real careful what I eat for several days before and after.
    – Occasional flare ups: real bad one this week, but its the 1st bad flare up in over a year. Had to take 3 days off work. 1st day I rotated the oregano oil / garlic and the Perfect 7. Last 2 days for recovery (flat on my back, watching movies). Back to the SIBO diet for a few weeks, then I will be fine again.

    Elapsed time: Felt better within days, even better in a few weeks. Tons better in a couple of months. 6 months later I literally forgot about the SIBO (except for watching what I ate).

    I still have SIBO, but it is (almost) completely in control.
    Hope this helps! Ask questions if it doesn’t make sense.

    • I have SIBO as a result of a small bowel resection including cecal valve caused by Crohn’s disease. I take xifaxan about every other month and it seems to help but not great. I need to change my diet.

    • Hi, I’m planning to start on low FODMAP foods and really confused about garlic. It’s listed as the number 1 food to avoid along with onions, yet it’s touted as the number 1 supplement to take to kill bacteria. Should I take it or not?

      • Onions and garlic are of the same family. They are high in fructans. Apparently humans do not have the right enzymes in our systems to break down this type of fructo-oligosaccharide, according to several articles and the creator of the FODMAP diet. Once you begin the diet and have it established for about 6-8 weeks, you can begin to add things back into your diet one at a time so you can see if you have reactions to that item.

        • Thanks, so I shouldn’t be taking garlic to kill the bad bacteria. May I ask you which herbs to use instead?

          • Many use oregano. It all depends on your body, what type of SIBO you have, and the interaction with other foods you may be eating. Truthfully it’s a crap shoot but keep trying because one day you will find what’s right for you. Neem has also worked well for some people and you can buy it to use as tea. It’s somewhat bitter so I combine it with other teas such as white peony or lavender or even chamomile.

          • even though you should avoid garlic, you can still take allicin, it is extracted from garlic so it is not the same as taking a garlic supplement. I’ve taken allimax pro, that combined with oregano oil and some others is what my dr. Prescribed

  8. Looking for a Dr in the Philadelphia area (Bucks co) that Is willing to do the breath test and is able to treat SIBO

  9. Treatment hasn’t really helped my case. I am experiencing excessive body odor and not sure that it’s due to the bacteria anymore. I noticed whenever I don’t fully empty (go to bathroom due to lack of intestinal waves) everyone around me can smell something. They can’t stand being around me.

      • I’m not sure why the odor. I am in the process of seeing a motility expert since I know the odor is being caused by the slow movement (or break down) of the food. I am hoping something soon will help. It’s ruining my life

  10. I am currently on my second round of rifaximin treatment. What I really wanna know is what is the bottom line problem that caused this and my suspicious is low stomach acid due to low thyroid problem. What other tests should I suggest my Gastro as he seems a bit out of ideas

  11. Does anyone else have trouble sleeping due to the stomach pain/bloating? Some nights I am awake all night, and I was wondering if anyone has found any type of remedy that helps in this situation.

    • Your issues could be parasites… I’d look at a good herbal cleansing protocol. It really help with SIBO but you may find that it clears you from more than just unwanted bacteria in your small intestines.

    • I’ve had help recently with two Kavinace (kinda expensive) per night, plus a melatonin. Now brands GABA is a cheaper alternative, just started it.
      So far, in a few years of research, I have seen NOBODY who has cured SIBO.
      I’ve had results recently, and this sounds odd, by massaging my stomach, a lot and vigorously. And, I don’t make money off this suggestion, I’m an engineer.

      • I haven’t tried those, will look into them. I agree, massage helps… and yes, I have tried one supplement/remedy after the other, all very expensive, none effective. There is not a lot of incentive for anyone to solve this problem as you say, since it affects so few people, and since if there was a solution we would stop paying all this money for these ineffective products we hope will cure us. I think I am going to lay off the cures for a while, stop going to doctors, and just focus on finding a way to live with this awful condition. I have had it for six years now and it does not seem to be alleviated by anything I’ve tried. Have you heard of any support groups for people with this?

        • Hey Lauren and Sibo Warriors

          I almost teared up when I saw your posts I’m feeling the same right now (just 2 years though…). I think there are some support groups on FB or the forum ibsgroup.org where Sibo is also discussed (but not really understood…).

          I’ve also laid back the supplements they made me nothing or got even worse (probiotics & HCL caps…) and now try to go on with life.

          About insomnia I have had it especially after eating “not recommended” foods like onions, or being on the computer too late at night. There should be some plants that help insomnia too, or deep breathing (which is hard with a pregnant-like belly :s).

          • That is one of the worst parts of this condition: I cannot breathe deeply because my diaphragm seems to have no space to move. I also get a vertigo when I lie still for too long with my bloated stomach. Does that happen to anyone else? The massage helps, and yoga helps, but it’s just a problem when I need to lie still so I can fall asleep, and I am not able to do that. Last night I was up most of the night. I am not sure which foods to eat or not, everyone says something different and I don’t seem to notice much difference in my condition regardless of what I eat.

            I am reading a good book called “How to be Sick.” It applies Buddhist wisdom to dealing with a chronic untreatable illness which I am starting to think this is. The practices are great. I need to remember to do them more.

            • You have to do a really low carb diet do see benefits. I have been doing keto (under 20 net carbs). Feel like a million bucks right now, stomach distress gone, memory coming back, sleeping better. It’s a drastic diet but it works! (Well at least it does for me). I feel your frustration with not know what works, the answer for everyone is different. Keep tying!

              • Same here, only keto diet has worked for me. I only eat SIBO-approved foods on keto and remove what I can’t tolerate (dairy products, nuts, seeds).

                • Do you count carbs from vegetables like cucumbers for example or only starches and fructose from fruits?
                  Cucumbers have some fructose but it should not be malabsorbed and will nod feed bacteria?

          • Oh also, regarding support groups, I am part of that FB group and I know the ibsgroup also – but I am starting to feel like being online complaining about symptoms that will not go away is not helping. I am not sure what type of support group I am looking for to be honest, maybe there could be some kind of group with a positive focus, like things we can do to feel better such as massage, yoga, or just talking to someone who understands?

            • I totally agree with attempting to gain positive insight. I have suffered with this for many many years, trying multiple products that have done nothing really. Sometimes just knowing that someone else is rooting for you to have a good day can boost your mood!! I am sick of hearing myself complain so to go to one of those sites where everybody is complaining would be overwhelming for me. You have a super idea there!

              • Thanks Pam, I am rooting for YOU to have a good day today : )

                If you are interested in picking up the book I mentioned in my above post, maybe we could have something like a book group where we discuss a chapter at a time and try to relate it to what we are going through and how to cope with it.

                • Lauren, would love to say yes to the book, but I am in the middle of 2 other books right now. One is related to the mind, the other is “fun”. 🙂 I appreciate you rooting for me today! I have had a fairly good day, so thank you! Rooting for you as well! Staying on my diet usually helps. I have tailored several of the diets, combined what I have gleaned from them, and I try throwing in a few odd items every week so my body doesn’t get sick of the same thing all the time. What is something that helps you?

                • Thanks Pam! What kind of diet do you follow? I haven’t found a diet or anything that helps… I kept extensive journals for years and did not see any connection between what I eat or do and how I feel, the pain comes at random and I can’t predict when it will be more mild or when more severe.

                • Lauren, I have had issues since I was young, and I’m 57 now. So it’s been difficult to say the least. However, about 5 years ago, I made some changes according to the FODMAP diet. Dr. Sue Shepherd developed it. I started there, then cut out all dairy, all sugar, gluten, and chicken and turkey. I eat steak (I know that’s really weird because it’s supposed to be hard to digest) every day and sometimes I can eat ham. I use only coconut oil to cook with as olive oil seems to aggravate my gall bladder for some reason. I, too, have good days and bad days and sometimes it seems to have absolutely nothing to do with what I eat. I do know that if I vary my diet by adding dairy or gluten or sugar, I pay for it. Maybe not the same day, but it can be days later. They (doctors) say that can’t happen, but it does. So I’m sure you’ve been on this wonderful roller coaster as well. I started by eliminating most everything and I keep trying to work things in that work well with my system. I certainly hope that you can find something that works well for you. Last evening was a bad belly evening, but this morning seems a bit better, but belly is LOUD today! LOL. Hope you have a terrific day today! Make the most of every good minute! 🙂

                • Thanks Pam! Wow, you have been living with this for a long time! What gives you the motivation to keep going?

                  My belly gets very LOUD at times too… But I almost prefer that, because when it is quiet it seems that no movement is happening and I tend to get headaches then.

                  I have slept well for two nights in a row, that is a treat. I have a very tough week at work coming up. I’m trying to remember to keep things in perspective. Coffee helps me, I am going to go get some right now! I hope you have a wonderful day…

                • Lauren, so glad to hear you have slept well for a few nights! Sleeping issues wear us out, for sure. I get headaches when the “stuff” slows down as well! Feels like my system is being poisoned, at least that’s what I tell my husband I feel like. Then things speed up again and the noise comes back :). I am wondering if there’s any way we can exchange emails so we can get off this blog? My doctor is having me try a new medication and it does seem to be helping a bit. Only on day 2 so we’ll see. Do some deep breathing today to prep for your stressful week. And I will be sending you positive vibes as well!

                • Ladies look into ATRANTIL and also look into a motility supplement – you need to keep things moving otherwise if it gets stagnant it leaves you open for bacteria to grow.
                  Also doing a round of kill sups may help – along with butyrate – many are low in this and when you are it leaves our guts open for bad bacterial growth.

                • Tanya, just tried Atrantil two weeks ago. Very strange side effects and they told me to stop taking it. Another one down.

                • Your side effects could have been die off – it can cause that when you start it. It did for me and for my daughter – but 30’days into it you can start to see the benefits – these supplements can sometimes create a flu like die off – the question is can you handle it ? The only way to get rid of this bad bacteria is to overcrowd it and this can cause die off. You will not heal unless you go through die off.

                • Tanya, thank you for the information regarding the die off. I am all too familiar with all of this as I have had it for about 25 years. I had extreme nightmares, and I don’t usually even dream. I stopped it for two nights and did not have nightmares. I began it again, and had nightmares. It’s not even supposed to break the brain barrier, however, it obviously did with me. I have many strange reactions to medications and supplements. That’s why the actual maker of the Atrantil told me to discontinue it and not take it at all. Weird, yes. Abnormal for me, no.

                • I totally get it …I am super sensitive myself to many things – I like you have had similar reactions to many protocols – so I understand your hesitancy to continue. How do you react to fermented foods? Have you tried the fast tract diet ? Many have success on this plan.

                  i hope we can all heal going forward ….it takes time and patience and persistence …..

                • Thanks, Tanya. There are times when I can do limited fermented foods, but very rarely. I do apple cider vinegar periodically to help balance all the antacids I take. That seems to be the only thing I can tolerate right now. About twice a year I may have a few sips of wine, but I only do it when I am feeling OK. For some reason, the colder weather (I am in Michigan, brrrr) seems to make everything worse. Most likely having to do with the muscle spasms since we tend to stiffen up more with the freezing temps. I am dairy free, gluten free, and sugar free. I don’t even do “fake” sugar. And I try to get as much organic as I can. What have you found that works for you?

                • Sorry Pam for my delay in post.
                  You asked what works for me – well I have been on every diet imaginable and every combination as well – I decided a year ago to forgo the cookie cutter diets of low histamine, gaps, fodmaps, AIP, fast tract diet, etc and find a middle ground to what works for me. Over the years I’ve done them all.

                  What I realized after much research and gut podcasts etc – The key to healing the microbiomme is diversity. Introducing different greens and coloured veggies ….different fruits and coloured fruits …etc to help create a strong microbiome.

                  If there are certain foods I don’t tolerate I take them in small amounts ….even a tsp will do. So for example if a food is particularly high histamine but low in fodmaps ….I will take a small amount of it ….because it does carry health benefits ….high oxidant rich foods – anti inflammatory foods etc are all healthy and beneficial for us, but maybe they are high fodmaps or higher histamine….so I try and balance the rest of my plate out with lower histamine foods and lower fermentable foods etc.

                  I have been able to expand my diet this way. I always take a digestive enzyme with each meal. To help with absorption and break down of foods. I am dairy free, gluten free, etc and have been for 8 plus years.

                  I don’t believe in a cookie cutter approach and I have taken on many protocols. We can get nutritionally depleted if one continues to limit their scope of foods to a handful items. Then this will lead to other health issues with thyroid and adrenals etc.

                  I do ok with certain grains. I believe my body needs fibre, and I do well with it. I am able to eat buckwheat, amaranth etc. I feel we need these fibres to clear estrogens and detox. For me meat is not a huge part of my diet. For example a typical breakfast for me is 2 egg yolks, a bunch of fried kale in olive oil and real salt, two pieces of my allergin free buckwheat bread with sprouted pumpkin butter on it, all of this on a plate drizzled in more olive oil and lots of real salt.

                  Also I take larch ….this helps feed the good bacteria. I do take a few other things as well, but for me I try to gather my vit and minerals via my foods. My body works better this way.
                  I am trying quercitin to help lower the histamine load. I tried DAO but I didn’t notice much difference.

                • Sounds like you have really done it all. And figured out at least a somewhat balance for yourself. I also believe it is an individual thing, that we are all made differently inside as well as the outside, and there are some things that are tolerated differently in our systems. I also have given up on the cookie cutter diets, figuring out what works and doesn’t work for me. There is so much variety out there, I don’t want to limit myself, or my body, to ultimate nutrition.
                  I also do minimal grains, mostly oatmeal and ground flaxseed every morning. But I do granola, an organic one by Bob’s Red Mill. And I add in cacao bits for a treat. I do love kale and eggs, but not in the morning 🙂 And real salt is my friend as well!! I use lots of it. Olive oil is a bit heavy so I do all my cooking with coconut oil. Lighter and has a higher heat tolerance and doesn’t taste like coconut at all. I have a very low tolerance for spices and am allergic to onions and garlic which makes me sad because I would love to spice up my foods a bit more. I do oregano, mostly fresh from my garden, and dry it for the winter so I still have some throughout the year. Periodically i will do oregano oil as well.
                  What is larch and where do you find it? I will do some research on it! I cannot take vitamins in any form as supplements because they irritate my stomach and intestines. So I also get all from fresh foods.
                  I’m feeling a bit like I’m on the mend from my last awful bout of feeling sick, was down to 89 lbs 2 years ago and have gained back about 15. Making headway but it’s always so slow to get it back.
                  Let me know how the quercitin works for you!

                • Hi Pam,

                  Is Atrantil the new medication? I just tried that for 30 days, it did nothing – if anything made the constipation a bit worse – though that might have been from the low-carb diet which they recommend, giving me less fiber than usual.

                  I used to live in Michigan! I am curious whereabouts you are… Yes, I would love to exchange contact info and be able to be in touch without this site; perhaps we could do this by ‘friending’ each other on facebook first – then we can message each other our contact info privately. If you have fb, look me up under the SIBO-C support group. I live in NY. If you have trouble finding me there, lmk and we’ll figure out another way.

                  I hope your day goes well today

                  –Lauren

              • PAM.
                you mentioned in a later comment that you are taking antacids?! Your stomach acidity is the foundation for proper bacteria in your gut. You understand that right? Can’t get rid off SIBO taking antacids, unless you know something I don’t know.

                • Craig, yes, I totally understand that antacids aren’t the way to go, however, it is the only way I can function, even a little bit. Many days I am so nauseous I can’t do much of anything. The antacids make my life bearable. And the bloating actually hurts me, to the point that I look and feel 6-8 months pregnant after a meal, even a small one at times. So until I find a way to get this SIBO to cooperate (and it does at times and then I don’t even have to take antacids) and so I can live my life as a half-way normal individual, I will take them as needed. So yes, I know they aren’t an answer, but they are a relief to me. Thanks!

          • For sleep.
            Look On line for supplement:
            Agar 35, a Tibetan herb mix. Really works.
            Dorbe

          • Hi Dorbe. I’m sorry you are struggling with this too. For me, focusing my energy on how to deal with this problem rather than how to fix it is working right now, since most of my attempts to fix it were costly, time consuming, and seemed more likely to make the problem worse than better. I am reading some great books about chronic illness and getting through difficult situations in life that give me inspiration and helpful tips. Regarding the insomnia, my brother suggested an over the counter product called “Z-Quil.” It is like the ingredient in “Ny-quil” that helps you get to sleep, without the cold-symptom relieving elements. It is not heavy-handed, but it does help me get to sleep when my stomach is hurting. It makes me drowsy enough that I can ignore the pain briefly and fall asleep. You have to make sure to take it early enough though, so you can still get a full night’s sleep. If you take it too late you may still feel drowsy in the morning.

      • Pain and bloating during the night indicates you are likely eating foods that are feeding a small intestinal bacterial overgrowth (SIBO). When SIBO is the primary driver for insomnia (anxiety is often common), the degree of the overgrowth will determine how aggressive you need to be about sleep support. Early onset SIBO often needs only a little support; e.g. 3mg melatonin, 100mg 5-HTP, herbal teas, etc.

        Progressively worsening SIBO will often require “stronger” support, including the product Kavinace; which I recommend to patients often. As SIBO growth worsens and your body’s sensitivity to it become for sensitive even strong sleep medications like Ambien and Klonopin become ineffective.

        SIBO diagnosis and treatment is critical to a hand on insomnia. I also recommend urinary neurotransmitter testing to identify your circulating neurotransmitter levels to determine if your overall nutritional needs and create a brain-balancing strategy.

      • Hi, I get relief from various gastro issues by using a heating pad on my abdomen while laying down. just an idea

  12. This doesn’t make sense, sorry. Being a holistic health coach and someone who is trying to solve sibo for herself, this theory does not make sense. I wonder if the author ever had to deal with this herself or is she just going after the latest theories?

  13. To say FODMAPS are high carbs is a bit misleading- they are short chain carbohydrates that 30-40% of people lack enzymes to digest. FODMAPPERS can eat lots of high carb foods! Otherwise, interesting article, though I think you need to read up on FODMAPS- try Sue Shepherd/Monash Uni/Box Hill Hospital…

  14. what a [edit] overly simplistic article. rifaximin doesnt work most of the time, and to imply that the treatment is as simple as oh just have some rifaximin and you’re good gives off a vibe of ignorance on your part.

    • Rifaxin is temporary relief, and expensive, hence it is a big money maker for big pharma. Ceylon liquid cinnamon or GSE kill everything. This is a great disease for big pharma, no real cures stated by anyone that you have read about….correct? We each have 100 different supplements and no cure, but lots of profit.

  15. Im not sure I understand. So we are supposed to eat ‘normally’ during the time we are trying to get rid of the SIBO?
    It’s so confusing, there are so many diets and opinions and guidelines out there .. I’m 20 years old and trying to get rid of SIBO. I’ve just finished 14 days of antibiotic and now am planning on taking Atrantil with Oil of Oregano capsules and Digestive Bitters as well as Biotics IPS. But I am very at most as to how to eat. Do I eat “normal” food like said in the article above or do I follow some kind of low fodmap etc? I’m going to stay gluten and lactose free but besides that, I don’t understand what I have to eat.. 🙁

    • Hey Alix, I am also 20 and trying to fight off this crap thats controlling my life. I took Rifaximin while eating a low carb/no sugar diet, although it helped I relapsed within a week. I am now on oil of oregano and trying the route of eating lots of carbs and sugar during the treatment. It is not fun I can tell you that haha. I believe as long as you are taking an antibiotic you want to be eating the bad stuff. Once you are off of them you want to avoid them until your stomach heals and you can tolerate them. Another option I have heard of is taking something called Interface plus which makes it easier to kill the bacteria. I have not tried it yet.

      • This doesn’t make sense…people who can’t digest FODMAPS lack the necessary enzyme- and there is no ‘cure’ for that except to restrict FODMAPS…no biggie, there is a wide variety of foods you can eat…when FODMAPS are eaten, the gasand bacteria from undigested carbs can spill over into the small intestine- hence, why FODMAPPERS are prone to SIBO. Simple. Not restricting so that they can’t ‘hide’ sounds totally wrong. Restricting FODMAPS to reduce the problem- well, that’s not really rocket science.

        • Avoiding fodmaps for a long period of time is not good for you. The problem here isnt that we are having a hard time digesting fodmaps, but that we have too much bad bacteria. Fodmaps feed the bacteria, so once they are eliminated then fodmaps can be reintroduced

          • The real FODMAPS diet has an elimination phase and a reintroduction phase, so its not about total avoidance, but it is about reducing by-product gasses until symptoms such as SIBO reduce. People who lack the enzymes learn what their tolerances are, and experts such as Monash University recommend reintroduction, to your own level of tolerance.

        • THAT doesn’t make sense! I went from being able to eat anything I wanted with no gas, taking a normal poo every day, to gas & bloating with every meal and chronic constipation. I have SIBO, it was caused by taking probiotics. I have a hard time believing that it’s just normal to not be able to digest FODMAPs.

          • Hi- No it’s not ‘normal’ to not be able to digest short chain carbohydrates, AKA Fodmaps, but there is a lot of expert advice such as the names I posted above. IBS is however extremely common! I get your frustration. Also, in the day and age of bloated guts, aisles and aisles of ‘digestive aids’, type 2 diabetes epidemics, obesity becoming the new normal- what is ‘normal’?

            • Hi- No it’s not ‘normal’ to not be able to digest short chain carbohydrates, AKA Fodmaps, but there is a lot of expert advice such as the names I posted above. IBS is however extremely common! I get your frustration. Also, in the day and age of bloated guts, aisles and aisles of ‘digestive aids’, type 2 diabetes epidemics, obesity becoming the new normal- what is ‘normal’? PS if the probiotic is inulin it’s highly FODMAP- no way could I tolerate it, at all…

    • it is all very confusing. I have been researching again today how to get some control over the bacterial issue. Crazy as it seems I can take vegetarian gel capsules, fill them with cinnamon and take 3 capsules a day for 3-4 days and usually the SIBO symptoms go away. This time I had to follow it with a round of xifaxin. I get the SIBO intermittently and prefer to treat everything I can with natural remedies. I have no large intestine and that seems to cause part of my problem. I found a good probiotic which seems to help but apparently I need to step up my game and be more careful what I eat. problem is different web sites tell yes and no to the same foods. I use a heating pad on my abdomen while I lay down and I get relief that way. I have Crohn’s, IBS and several surgeries have left me with side effects that are less than wonderful. Stress aggravates the Crohn’s and SIBO stresses me, hello merry-go-round. I think the best anyone can do is research when you need to, don’t be afraid to argue with your Dr. if you disagree, and Be Your Own Advocate! You are the one living in your body and you know more about how it works or reacts than the Dr. does. Stand up for yourself. since I have done this I feel much less like a victim. No my GI Dr. does not always like it but he isn’t sick, I am. I never know from one day to the next if I can even leave the house. He is healthy and does not have the same low quality of life as I do. If I am lucky an appointment with him lasts 10-15 mins, every 3-6 months and he’s gone so I speak up!! Nobody is going to fight for you but you. Question every treatment option, test, med, whatever they throw at you. By the way I do this as nicely as I can but I get my point across. I was sick last year for 9 months, barely able to eat, on the couch, I pain. GI Dr. tested me every way he could think of and all the tests came back normal. I lost 25 lbs and was scared and angry. My Husband and I finally looked at what happened right before I got sick and realized I had started taking Lexapro for anxiety and depression. when I got off the Lexapro I immediately got better. Why do we tell them all the meds we are on if they do not pay attention. I researched the Lexapro and eventually came upon an article that described exactly what was happening to me as a possible side affect. I should have been more proactive earlier but I thought one of the tests would show the problem. just saying, take care of yourself!

    • Eating “normally” doesn’t not mean eating gluten, dairy, soy or other foods you have a true sensitivity to or are gmo etc. She means eating some fodmap foods, because the bad bacteria are easier to kill with the treatments when they are feeding, not dormant. So when you eat fodmaps during treatment as opposed to avoiding them completely the bad (and good) bacteria feed on them and become active so the antimicrobial treatments have a higher success rate. Even tho this may mean a temporary worsening of symptoms. Plus the more good bacteria are needed to combat the bad. Not feeding on any fodmaps for long periods isn’t good.

  16. Hello,

    I’m a 30 years old from Romania and after the hp treatment with ( amox + claritom + pantoprazole – 7 days and continues ipp treatment for 4 weeks ) started to feel better but in a short while i developed some symptomes that “killed” me. After attending a weeding, one morning, after breakfast ( bread, eggs, cheese ) i felt really bad – headache, abdominal pain, muscle fatigue/pain, palpitations. I had no problem with bread before, in my HP/gastritis i was eating butter with toast without any problem. Then i noticed that after eating chocolate, or drinking coffee, i feel leg muscle fatigue. So.. i have this intolerance which is clear after the treatment for HP ( which was eradicated – stool test confirmed )… after eating those maccarons cookies, i got very bloated, palpitations. bromazepam and trimebutine maleate is helping a lot !
    in romania GI are not familir with this problem, i asked 3 of them, they said that my symptoms have nothing to do with bacterial overgrowth. The herbal medication is not available in Romania, but i found them in UK and i can you them – Candibactin-AR and Candibactin-BR …. the LBT is not available soooo.. what should i do? any advice !

    p.s. with the sibo diet, i feel very good, energic, no joing pain, no tension allergy … otherways, if i eat 2-3 slices of bread, or pizza, chocolate, my status changes, i can not sleep, palpitations and joint pain.

    • Hi Dany

      Try reading about histamine intolerance. From what I have read it can be a consequence of Sibo.

  17. Thanks for this article! I’m researching SIBO for my final presentation of my Dietetic Internship. I knew that the low FODMAP diet was more an indicator than a solution to the condition, but I wasn’t sure about recommendations. This is the info, and journal articles, I needed.

  18. I have been struggling with SIBO (methane) for almost six years now. I have been to five well-respected gastroenterologists in the NYC area, as well as numerous dietitians, biofeedback therapists, acupuncturists, holistic doctors, you name it… I have tried numerous rounds of antibiotics which only made me feel sicker, and many diet changes including all raw vegetables, no raw vegetables, gluten free, low FODMAPS, vegan, vegetarian, grain-free, nut-free, low-residue (mainly chicken, eggs, and broth)… nothing has helped. At this point I am losing hope that anything ever will help. I am trying to learn to live with this condition. However, I feel like I have died and at the same time I keep living. It is a very strange condition. My social life has diminished, because due to my symptoms of bloating, dizziness and stomach pain (not to mention all the burping, farting, and loud stomach gurgling) it is not pleasant to be around other people. I also am extremely fatigued much of the time. I feel like everything I’ve ever loved has been torn from me, yet I am still here… not sure how to go on. I’m not even sure why I’m writing this, but perhaps because I don’t know anyone personally who suffers with this condition yet I know others are out there and would like to connect and find out how others are going on with their lives despite this condition. If anyone would like to write me back maybe we can somehow support each other through this nightmare ? Thank you…

    • Lauren, have you given Atrantil a try? Non-prescription, I’ve heard it’s helped some SIBO methane cases. It deals with archae rather than bacteria. Sorry to hear you’ve had such a long road with SIBO. I’ve been trying her al antibiotics forrecurran e of hydrogen type, but tomorrow will call the GI MD and hope they can help figure out the reason for recurrence. Anyone had success using Iberogast or Motilpro to prevent recurrence?

      • I have used both Iberogast and Motilpro with patients. I have seen Iberogast working better than Motilpro. Motilpro typically works for people with low serotonin activity, but taking straight 5-HTP is a lot more cost effective way to do this. If Iberogast is helpful, it is important to also determine if Betaine HCL before meals is needed. Also, enteric coated peppermint oil can improve Iberogast’s activity.

        • Hi Lauren, I’m so sorry for you. I’ve been feeling exactly the same as you! I’ve tried so many different things but finally I’ve found that giving up sugar and white carbs has made my symptoms completely disappear! I don’t know if it’ll help you but thought I’d share. xx

    • Lauren … I feel your pain. I have been through all that “trying everything” over about 26 years of chronic illness. I even ended up doing a PhD in the Vagus Nerve and Mindfulness and qualifying as a hypnotherapist. My latest thing is starting my own blog, on the vagus nerve and the conditions I have – just did a 4 part on SIBO after attending (via webcast) two conferences run by holistic and main stream SIBO experts. You might find something you like here
      http://www.wellbeingatworkdr.com. The 3rd one is on all the diets I found or tried and a bit of a where they conflict thing … because boy do they.

    • I have been feeling the same way lately…..I have given up all my favorite foods…and have been reduced to broths….smoothies….watered down coffee…..and water…..and still….my stomach is swollen and painful…..tried to do yoga with my daugther this morning and became so dizzy I had to stop…then fell and hurt my knee and right arm….I am angry…because I’ve been eating healthy for years….drinking water and became a runner several years ago…..I began suffering from fatigue…and stopped running…then depression….then laid off from my job resulted in eating unhealthy…and then the swelling and painful belly began creeping up on me…I’m down right angry about it…it has been debilitating…..and nobody around me understands…..so I get it…..right there with you….very difficult to be positive when you’re always hungry and tired and bloated…..

      • Hi Linda,
        Thank you for responding. I have felt the same way, after eating healthy for so long, it is depressing to be so ill and have to give up so much of what you like, both in terms of food and in terms of the activities that can no longer be done. For a while I did what you were doing and ate a very limited diet, but now I am starting to expand what I eat again. It honestly doesn’t seem to make a difference what I eat, the swelling and bloating are bad nonetheless. However, the dizziness improves for me when I eat more heartily.

        How long have you been living with this condition?

        I hope we can keep in touch and support each other, like you said most people don’t understand because they have never experienced such a thing, and I would never have imagined either until it happened to me. I try to maintain hope that I can heal from this some how, and maybe we can share ideas about things we are trying and how they work out.

    • Hello Lauren;
      This year I started getting the severe symptoms you described with the methane type of SIBO….bloating, etc…not being able to process anything….however, I discovered the Antratil and discussed the product with my Functional Medicine practitioner and am now on day 28 of using it and have experienced a huge turn around….my constipation is much relieved…..my digestion is vastly improving…..look up Atrantil at atrantil.com….study it….Chris Kessers website has some info about it……call up the company……it has a high success rate!!…..Blessed Be your journey…

      • Thank you for writing to me Susanne! Someone else had also just told me about Atrantil and I already have 3 packages of it on its way to me! I hope that it will help me too. I am curious about the recommendation to eat a “low carbohydrate” diet while using it – can you give me an idea of what your diet is like while you’ve been taking it? I want to make sure I do everything possible to increase its chances of working. Thanks again for the recommendation!

    • Wow Lauren..I wish you and my mom could talk by phone. She is 94, has this condition and its making her miserable. She only weighs 85 lbs..and dreads …truly dreads eating. She lives with us.

      Dianne Templeton Gardner

      • I’m sorry to hear about your mom. Has she been sick with this for a long time? I used to weigh about the same, but I have since found ways of eating that allow me to have more of a healthy life in spite of my condition.

    • Hi Lauren,

      My son is currently experiencing Sibo. The psychological and social aspects of this disease worry me. I think you certainly have a role to play and could provide some solutions for how to deal with SIBO beyond the physical. I would be interested to hear more advice if your able to share it.

      • Hi Dave,
        I am not sure if I have much to offer in that regard. My mom just gave me a book that seems helpful so far, it is about living with a chronic medical condition. It’s got rather a gloomy title: “How to Be Sick” by Toni Bernhard, but it applies Buddhist wisdom to the predicament of living with a chronic illness. If your son is looking for someone to write to, or is interested in reading that book and discussing it with someone, please reach out to me. All best,
        –Lauren

    • Hi Lauren, I totally relate. It’s been 10 years for me and I’ve tried numerous diets and doesn’t seem to matter how I eat I still get the same symptoms. It’s so frustrating and confusing. For me I have just been trying to figure out all the possible things that contribute to this. I found diy health blog by Angela has given me helpful information. She suggests some tests you can do at home – like for instance I know I have low stomach acid and that can lead to SIBO. It’s just so confusing and complicated when it can be more then one thing causing/contributing to my symptoms. But I am still hopeful. I am about to start a round of herbal antibotics – allimed, berberine and neem to get rid of SIBO. Considering trying an elemental diet too. Let me know how you get on with your antibotics. Goodluck 🙂

      • Thank you, good luck to you too! I am about to try Atrantil, I have heard it has a good success rate. I will let you know how it goes, and would be interested to hear your experience with the things you’re trying too.
        All best,
        –Lauren

    • Hi Lauren, You could have been writing about me as well. I can empathize easily.

      That said, one of the leaders in Functional Medicine is located in Sandy Hook, CT. I would highly recommend working with her. She really knows her stuff and will help you get to the root cause of your issue. (I just began working with another Functional Medicine MD closer to my home.) Keep us posted if you would. Here is the doctor’s info. I would call the office: drkarafitzgerald.com

      • I am only on day 10, they say to give it 20-30 days to work. So far I have not noticed any improvement.

      • Day 29, still no change… so disappointing. I don’t know what else to do from here. This condition rules my life, I rarely go out, don’t keep in touch with my friends, I just want to sleep all the time. I need to find some way to live with this.

  19. I am a registered naturopathic doctor in Stillwater, Minnesota (www.stillwaternatural.com) and treat/manage SIBO on a daily basis. SIBO cases come in many varieties, but we find a combination of herbal antibiotics, prescriptive antibiotics and lifestyle changes most effective in reducing SIBO activity and improving quality of life.

    Rifaximin is a great antibiotic (97% of t stays in the GI tract), but as research points out, it is not the ultimate solution. Many insurance companies also require treatment failures with lower-cost antibiotic before approving Rifaximin. Metronidazole (Flagyl) better than most. Neomycin can also be used. Neomycin is typically prescribed along with Rifaximin in methane producing (diagnosed through lactulose breath testing) cases. Metronidazole has good research supporting its use for Rifaximin resistant SIBO; it is also used to treat C. diff which is an unfortunate side effect of antibiotic.

    In order to keep C. diff at bay and to help maintain a health gut lining I recommend patients using antibiotic to take Saccharomyces boulardii 2.5 billion twice daily with antibiotics and a quality probiotic at bedtime.

    It is very important to always use herbal antibiotics before using prescriptive antibiotics! 1.) Herbal antibiotics will start the SIBO die-off. 2.) They also kill yeast (Candida) which is always overgrown when you have SIBO. 3.) You can dial the treatment intensity up or down, which you can not do with prescriptive antibiotics. This is important because the die-off reactions can be intense, including lots of diarrhea, so its nice to adjust so you can function in life. 4.) 25% of the time, herbal antibiotics are more effective than prescriptive antibiotics.

    It is also critical to follow up your 1-2 courses of prescriptive antibiotics with 1-3 months of herbal antibiotics. Relapse is so common with SIBO and herbal antibiotics will continue to reduce the SIBO population.

    Prokinetics are vital to help maintain a healthy mass motor complex. Other things to consider include: betaine HCL challenges and supplementation if needed, food sensitivity testing, hiatal hernia assessment and treatment, rule out intestinal adhesions and address any with massage, etc.

    Our clinic is getting a QuinTron breath analyzer in-house to better support our GI patients. This will help us test (lactulose breath testing for hydrogen and methane) more people by reducing out-of-pocket costs and getting results quicker.

    Due to being located in a Lyme disease endemic area, we typically diagnose SIBO in over 65% of our Lyme patients with SIBO being the only thing causing patient symptoms in 33% (1 in 3) patients. Check out my blog on this topic. http://www.stillwaternatural.com/single-post/2016/04/24/Do-you-have-Lyme-Disease-or-SIBO

    Finally, I personally did the homemade Elemental Diet this past year for 2 weeks. I am a naturopathic doctor and have done many intense treatments on myself over the years, but nothing was more challenging than the Elemental diet. This is defiantly contraindicated in most of my patients and should never be done if you are under weight or ever had an eating disorder. I am experimenting using it in shorter time periods prior to Rifaximin treatment and periodically along with herbal antibiotic for 3-4 days.

      • Hi Katie,

        I initially use the classic herbal approach: oregano oil containing gel caps (Metagenics), Berberines (Thorne Research) 1000mg BID and I add in Neem (Himalayan). I later switch to an enteric coated gut product from MediHerb that contains oregano oil, berberines and andrographis. Methane produces must use a freeze dried garlic supplement in addition to other herbals.

        Some people who can not tolerate this approach or did and still have problems can try a couple months of nano-silver spray (Results RNA).

        Other things to consider are partial Elemental diets and food rotations.

[gravityform id="9" title="false" description="false" field_values='popup_name=Recipe Offer']
<script type="text/javascript">var gform;gform||(document.addEventListener("gform_main_scripts_loaded",function(){gform.scriptsLoaded=!0}),window.addEventListener("DOMContentLoaded",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener("DOMContentLoaded",o):document.addEventListener("gform_main_scripts_loaded",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook("action",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook("filter",o,n,r,t)},doAction:function(o){gform.doHook("action",o,arguments)},applyFilters:function(o){return gform.doHook("filter",o,arguments)},removeAction:function(o,n){gform.removeHook("action",o,n)},removeFilter:function(o,n,r){gform.removeHook("filter",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+"_"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){"function"!=typeof(t=o.callable)&&(t=window[t]),"action"==n?t.apply(null,r):r[0]=t.apply(null,r)})),"filter"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});</script> <div class='gf_browser_unknown gform_wrapper qc_box_container_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_9' ><form method='post' enctype='multipart/form-data' id='gform_9' class='qc_box_container gform_legacy_markup' action='/why-diet-alone-is-not-enough-to-treat-sibo/comment-page-7/' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><li id="field_9_1" class="gfield field gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_1' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_9_1' type='email' value='' class='large' placeholder='Your Email' aria-required="true" aria-invalid="false" /> </div></li><li id="field_9_2" class="gfield health-concern field field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_2' >I want to improve my...</label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_9_2' class='large gfield_select' aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>I want to improve my...</option><option value='Weight' >Weight</option><option value='Energy' >Energy</option><option value='Digestion' >Digestion</option><option value='Brain' >Brain</option><option value='Overall Health' >Overall Health</option><option value='All of the Above' >All of the Above</option></select></div></li><li id="field_9_4" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_4' id='input_9_4' type='hidden' class='gform_hidden' aria-invalid="false" value='9905' /></div></li><li id="field_9_5" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_5' id='input_9_5' type='hidden' class='gform_hidden' aria-invalid="false" value='Recipe Offer' /></div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Download eBook' onclick='if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} jQuery("#gform_9").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='9' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_9' value='WyJbXSIsIjVkYTAyNjYxOTg4ZDNhZGQwOTU0Yzc4NDcyNDk5YmM4Il0=' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' /> <input type='hidden' name='gform_field_values' value='popup_name=Recipe+Offer' /> </div> <p style="display: none !important;"><label>&#916;<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js" name="ak_js" value="2"/><script>document.getElementById( "ak_js" ).setAttribute( "value", ( new Date() ).getTime() );</script></p></form> </div>
[gravityform id="9" title="false" description="false" field_values='popup_name=Weight Loss']
<div class='gf_browser_unknown gform_wrapper qc_box_container_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_9' ><form method='post' enctype='multipart/form-data' id='gform_9' class='qc_box_container gform_legacy_markup' action='/why-diet-alone-is-not-enough-to-treat-sibo/comment-page-7/' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><li id="field_9_1" class="gfield field gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_1' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_9_1' type='email' value='' class='large' placeholder='Your Email' aria-required="true" aria-invalid="false" /> </div></li><li id="field_9_2" class="gfield health-concern field field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_2' >I want to improve my...</label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_9_2' class='large gfield_select' aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>I want to improve my...</option><option value='Weight' >Weight</option><option value='Energy' >Energy</option><option value='Digestion' >Digestion</option><option value='Brain' >Brain</option><option value='Overall Health' >Overall Health</option><option value='All of the Above' >All of the Above</option></select></div></li><li id="field_9_4" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_4' id='input_9_4' type='hidden' class='gform_hidden' aria-invalid="false" value='9905' /></div></li><li id="field_9_5" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_5' id='input_9_5' type='hidden' class='gform_hidden' aria-invalid="false" value='Weight Loss' /></div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Download eBook' onclick='if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} jQuery("#gform_9").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='9' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_9' value='WyJbXSIsIjVkYTAyNjYxOTg4ZDNhZGQwOTU0Yzc4NDcyNDk5YmM4Il0=' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' /> <input type='hidden' name='gform_field_values' value='popup_name=Weight+Loss' /> </div> <p style="display: none !important;"><label>&#916;<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js" name="ak_js" value="71"/><script>document.getElementById( "ak_js" ).setAttribute( "value", ( new Date() ).getTime() );</script></p></form> </div>
[gravityform id="9" title="false" description="false" field_values='popup_name=Sweeteners']
<div class='gf_browser_unknown gform_wrapper qc_box_container_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_9' ><form method='post' enctype='multipart/form-data' id='gform_9' class='qc_box_container gform_legacy_markup' action='/why-diet-alone-is-not-enough-to-treat-sibo/comment-page-7/' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><li id="field_9_1" class="gfield field gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_1' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_9_1' type='email' value='' class='large' placeholder='Your Email' aria-required="true" aria-invalid="false" /> </div></li><li id="field_9_2" class="gfield health-concern field field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_2' >I want to improve my...</label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_9_2' class='large gfield_select' aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>I want to improve my...</option><option value='Weight' >Weight</option><option value='Energy' >Energy</option><option value='Digestion' >Digestion</option><option value='Brain' >Brain</option><option value='Overall Health' >Overall Health</option><option value='All of the Above' >All of the Above</option></select></div></li><li id="field_9_4" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_4' id='input_9_4' type='hidden' class='gform_hidden' aria-invalid="false" value='9905' /></div></li><li id="field_9_5" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_5' id='input_9_5' type='hidden' class='gform_hidden' aria-invalid="false" value='Sweeteners' /></div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Download eBook' onclick='if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} jQuery("#gform_9").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='9' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_9' value='WyJbXSIsIjVkYTAyNjYxOTg4ZDNhZGQwOTU0Yzc4NDcyNDk5YmM4Il0=' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' /> <input type='hidden' name='gform_field_values' value='popup_name=Sweeteners' /> </div> <p style="display: none !important;"><label>&#916;<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js" name="ak_js" value="80"/><script>document.getElementById( "ak_js" ).setAttribute( "value", ( new Date() ).getTime() );</script></p></form> </div>
[gravityform id="9" title="false" description="false" field_values='popup_name=Skin']
<div class='gf_browser_unknown gform_wrapper qc_box_container_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_9' ><form method='post' enctype='multipart/form-data' id='gform_9' class='qc_box_container gform_legacy_markup' action='/why-diet-alone-is-not-enough-to-treat-sibo/comment-page-7/' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><li id="field_9_1" class="gfield field gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_1' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_9_1' type='email' value='' class='large' placeholder='Your Email' aria-required="true" aria-invalid="false" /> </div></li><li id="field_9_2" class="gfield health-concern field field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_2' >I want to improve my...</label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_9_2' class='large gfield_select' aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>I want to improve my...</option><option value='Weight' >Weight</option><option value='Energy' >Energy</option><option value='Digestion' >Digestion</option><option value='Brain' >Brain</option><option value='Overall Health' >Overall Health</option><option value='All of the Above' >All of the Above</option></select></div></li><li id="field_9_4" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_4' id='input_9_4' type='hidden' class='gform_hidden' aria-invalid="false" value='9905' /></div></li><li id="field_9_5" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_5' id='input_9_5' type='hidden' class='gform_hidden' aria-invalid="false" value='Skin' /></div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Download eBook' onclick='if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} jQuery("#gform_9").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='9' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_9' value='WyJbXSIsIjVkYTAyNjYxOTg4ZDNhZGQwOTU0Yzc4NDcyNDk5YmM4Il0=' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' /> <input type='hidden' name='gform_field_values' value='popup_name=Skin' /> </div> <p style="display: none !important;"><label>&#916;<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js" name="ak_js" value="43"/><script>document.getElementById( "ak_js" ).setAttribute( "value", ( new Date() ).getTime() );</script></p></form> </div>
[gravityform id="9" title="false" description="false" field_values='popup_name=Heartburn/GERD']
<div class='gf_browser_unknown gform_wrapper qc_box_container_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_9' ><form method='post' enctype='multipart/form-data' id='gform_9' class='qc_box_container gform_legacy_markup' action='/why-diet-alone-is-not-enough-to-treat-sibo/comment-page-7/' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><li id="field_9_1" class="gfield field gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_1' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_9_1' type='email' value='' class='large' placeholder='Your Email' aria-required="true" aria-invalid="false" /> </div></li><li id="field_9_2" class="gfield health-concern field field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_2' >I want to improve my...</label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_9_2' class='large gfield_select' aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>I want to improve my...</option><option value='Weight' >Weight</option><option value='Energy' >Energy</option><option value='Digestion' >Digestion</option><option value='Brain' >Brain</option><option value='Overall Health' >Overall Health</option><option value='All of the Above' >All of the Above</option></select></div></li><li id="field_9_4" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_4' id='input_9_4' type='hidden' class='gform_hidden' aria-invalid="false" value='9905' /></div></li><li id="field_9_5" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_5' id='input_9_5' type='hidden' class='gform_hidden' aria-invalid="false" value='Heartburn/GERD' /></div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Download eBook' onclick='if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} jQuery("#gform_9").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='9' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_9' value='WyJbXSIsIjVkYTAyNjYxOTg4ZDNhZGQwOTU0Yzc4NDcyNDk5YmM4Il0=' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' /> <input type='hidden' name='gform_field_values' value='popup_name=Heartburn%2FGERD' /> </div> <p style="display: none !important;"><label>&#916;<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js" name="ak_js" value="197"/><script>document.getElementById( "ak_js" ).setAttribute( "value", ( new Date() ).getTime() );</script></p></form> </div>
[gravityform id="9" title="false" description="false" field_values='popup_name=Gut Health']
<div class='gf_browser_unknown gform_wrapper qc_box_container_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_9' ><form method='post' enctype='multipart/form-data' id='gform_9' class='qc_box_container gform_legacy_markup' action='/why-diet-alone-is-not-enough-to-treat-sibo/comment-page-7/' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><li id="field_9_1" class="gfield field gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_1' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_9_1' type='email' value='' class='large' placeholder='Your Email' aria-required="true" aria-invalid="false" /> </div></li><li id="field_9_2" class="gfield health-concern field field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_2' >I want to improve my...</label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_9_2' class='large gfield_select' aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>I want to improve my...</option><option value='Weight' >Weight</option><option value='Energy' >Energy</option><option value='Digestion' >Digestion</option><option value='Brain' >Brain</option><option value='Overall Health' >Overall Health</option><option value='All of the Above' >All of the Above</option></select></div></li><li id="field_9_4" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_4' id='input_9_4' type='hidden' class='gform_hidden' aria-invalid="false" value='9905' /></div></li><li id="field_9_5" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_5' id='input_9_5' type='hidden' class='gform_hidden' aria-invalid="false" value='Gut Health' /></div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Download eBook' onclick='if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} jQuery("#gform_9").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='9' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_9' value='WyJbXSIsIjVkYTAyNjYxOTg4ZDNhZGQwOTU0Yzc4NDcyNDk5YmM4Il0=' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' /> <input type='hidden' name='gform_field_values' value='popup_name=Gut+Health' /> </div> <p style="display: none !important;"><label>&#916;<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js" name="ak_js" value="186"/><script>document.getElementById( "ak_js" ).setAttribute( "value", ( new Date() ).getTime() );</script></p></form> </div>
[gravityform id="9" title="false" description="false" field_values='popup_name=Food Additives']
<div class='gf_browser_unknown gform_wrapper qc_box_container_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_9' ><form method='post' enctype='multipart/form-data' id='gform_9' class='qc_box_container gform_legacy_markup' action='/why-diet-alone-is-not-enough-to-treat-sibo/comment-page-7/' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><li id="field_9_1" class="gfield field gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_1' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_9_1' type='email' value='' class='large' placeholder='Your Email' aria-required="true" aria-invalid="false" /> </div></li><li id="field_9_2" class="gfield health-concern field field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_2' >I want to improve my...</label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_9_2' class='large gfield_select' aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>I want to improve my...</option><option value='Weight' >Weight</option><option value='Energy' >Energy</option><option value='Digestion' >Digestion</option><option value='Brain' >Brain</option><option value='Overall Health' >Overall Health</option><option value='All of the Above' >All of the Above</option></select></div></li><li id="field_9_4" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_4' id='input_9_4' type='hidden' class='gform_hidden' aria-invalid="false" value='9905' /></div></li><li id="field_9_5" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_5' id='input_9_5' type='hidden' class='gform_hidden' aria-invalid="false" value='Food Additives' /></div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Download eBook' onclick='if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} jQuery("#gform_9").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='9' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_9' value='WyJbXSIsIjVkYTAyNjYxOTg4ZDNhZGQwOTU0Yzc4NDcyNDk5YmM4Il0=' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' /> <input type='hidden' name='gform_field_values' value='popup_name=Food+Additives' /> </div> <p style="display: none !important;"><label>&#916;<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js" name="ak_js" value="232"/><script>document.getElementById( "ak_js" ).setAttribute( "value", ( new Date() ).getTime() );</script></p></form> </div>
[gravityform id="9" title="false" description="false" field_values='popup_name=Diet-Heart Myth']
<div class='gf_browser_unknown gform_wrapper qc_box_container_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_9' ><form method='post' enctype='multipart/form-data' id='gform_9' class='qc_box_container gform_legacy_markup' action='/why-diet-alone-is-not-enough-to-treat-sibo/comment-page-7/' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><li id="field_9_1" class="gfield field gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_1' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_9_1' type='email' value='' class='large' placeholder='Your Email' aria-required="true" aria-invalid="false" /> </div></li><li id="field_9_2" class="gfield health-concern field field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_2' >I want to improve my...</label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_9_2' class='large gfield_select' aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>I want to improve my...</option><option value='Weight' >Weight</option><option value='Energy' >Energy</option><option value='Digestion' >Digestion</option><option value='Brain' >Brain</option><option value='Overall Health' >Overall Health</option><option value='All of the Above' >All of the Above</option></select></div></li><li id="field_9_4" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_4' id='input_9_4' type='hidden' class='gform_hidden' aria-invalid="false" value='9905' /></div></li><li id="field_9_5" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_5' id='input_9_5' type='hidden' class='gform_hidden' aria-invalid="false" value='Diet-Heart Myth' /></div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Download eBook' onclick='if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} jQuery("#gform_9").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='9' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_9' value='WyJbXSIsIjVkYTAyNjYxOTg4ZDNhZGQwOTU0Yzc4NDcyNDk5YmM4Il0=' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' /> <input type='hidden' name='gform_field_values' value='popup_name=Diet-Heart+Myth' /> </div> <p style="display: none !important;"><label>&#916;<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js" name="ak_js" value="103"/><script>document.getElementById( "ak_js" ).setAttribute( "value", ( new Date() ).getTime() );</script></p></form> </div>
[gravityform id="9" title="false" description="false" field_values='popup_name=B12']
<div class='gf_browser_unknown gform_wrapper qc_box_container_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_9' ><form method='post' enctype='multipart/form-data' id='gform_9' class='qc_box_container gform_legacy_markup' action='/why-diet-alone-is-not-enough-to-treat-sibo/comment-page-7/' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><li id="field_9_1" class="gfield field gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_1' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_9_1' type='email' value='' class='large' placeholder='Your Email' aria-required="true" aria-invalid="false" /> </div></li><li id="field_9_2" class="gfield health-concern field field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_9_2' >I want to improve my...</label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_9_2' class='large gfield_select' aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>I want to improve my...</option><option value='Weight' >Weight</option><option value='Energy' >Energy</option><option value='Digestion' >Digestion</option><option value='Brain' >Brain</option><option value='Overall Health' >Overall Health</option><option value='All of the Above' >All of the Above</option></select></div></li><li id="field_9_4" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_4' id='input_9_4' type='hidden' class='gform_hidden' aria-invalid="false" value='9905' /></div></li><li id="field_9_5" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" ><div class='ginput_container ginput_container_text'><input name='input_5' id='input_9_5' type='hidden' class='gform_hidden' aria-invalid="false" value='B12' /></div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Download eBook' onclick='if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} jQuery("#gform_9").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='9' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_9' value='WyJbXSIsIjVkYTAyNjYxOTg4ZDNhZGQwOTU0Yzc4NDcyNDk5YmM4Il0=' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' /> <input type='hidden' name='gform_field_values' value='popup_name=B12' /> </div> <p style="display: none !important;"><label>&#916;<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js" name="ak_js" value="23"/><script>document.getElementById( "ak_js" ).setAttribute( "value", ( new Date() ).getTime() );</script></p></form> </div>
[if lte IE 8]
[if lte IE 8]
[name="ef_transaction_id"]
[name="ef_transaction_id"]
[if lte IE 8]
[if lte IE 8]
[name="ef_transaction_id"]
[name="ef_transaction_id"]