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What Is Small Intestinal Bacterial Overgrowth? | All You Need To Know

What Is Small Intestinal Bacterial Overgrowth? | All You Need To Know

Many people do not know that a great percentage of the American population struggles with gastrointestinal symptoms and distress every year. Researchers have diagnosed a wide range of people suffering from the leaky gut syndrome, irritable bowel syndrome, Crohn’s, and celiac disease. However, scientists haven’t yet been able to establish the reason behind the development of the digestive system's complications.

In this Article:

  1. The Discovery of SIBO
  2. What Is SIBO?
  3. What Are the Symptoms of SIBO?
  4. What Causes SIBO and Its Risk Factors
  5. Complications Closely Linked with SIBO
  6. Treatment for SIBO
  7. An Outlook at the Diet for Small Intestine Bacterial Overgrowth
  8. Top Secrets of the Kinds of Foods to Forget About During Phase 1
  9. Great Foods You Are Permitted to Enjoy During Phase 1
  10. Phase 2 - GAPS Diet
  11. The SIBO Supplements
  12. Essential Lifestyle Changes for SIBO

Understanding Small Intestinal Bacterial Overgrowth

The Discovery of SIBO

The Discovery Of SIBO | What Is Small Intestinal Bacterial Overgrowth? | All You Need To Know | treatment for sibo


A short while back, researchers were presented with a new revelation. They are now coming to terms with the reality that there is, indeed, another digestive disorder lurking. That is the ileum bacterial overgrowth or SIBO by another name.

Uncovering More About SIBO

Of course in the past, it was believed to have taken root, but recent developments insinuate something else. The condition has been discovered to be more prevalent than was presumed before. Studies have also revealed that it actually occurs in people struggling with IBS (irritable bowel syndrome) among some other underlying conditions.

What Is SIBO?

What is SIBO? | What Is Small Intestinal Bacterial Overgrowth? | All You Need To Know | what are the symptoms of sibo


SIBO is an acronym for “small intestinal bacterial overgrowth,” and it refers to the accumulation of intense bacteria in the ileum. Of course, the presence of bacteria in the gut is something very normal; no one can dispute that.

A Case of Excess Bacteria

However, excess bacteria in the small intestines may indicate something more serious and will require a little extra attention. A healthy system is characterized by relatively lower levels of bacteria in the small intestines, but it is perfectly normal when the concentration is higher in the colon.

What Is the Ileum?

The ileum happens to be the single longest section of the human digestive tract. It is the section where food intermingles with the digestive juices, and by the end, the bloodstream gets to benefit from the nutrients.

Importance of Proper Digestion

A healthy digestive system strikes a perfect balance between the body absorbing the essential nutrients and the bacterium’s capacity to park the colon into the digestion of foods.

Poor Nutrient Absorption

However, when the bacterial invasion takes over the small intestines, it poses issues with nutrient absorption, resulting in a condition where there develops poor nutrient absorption. These symptoms are closely linked with IBS and may even lead to more serious issues, damage to the stomach lining is one of them.

A person struggling with SIBO has to put up with so much discomfort and frustration. As food finds its way through the ileum, the bacterial overgrowth interferes with the healthy digestive system as well as with the absorption process.

The bacterium associated with SIBO moves ahead to consume some of the nutrients, resulting in fewer nutrients going into the bloodstream, as well as disrupted digestion, which culminates in some undesirable symptoms which include gas, pain, and bloating.

How to Get Rid of SIBO?

Health providers most often try to phase out small intestine bacterial overgrowth via the use of antibiotics, but, there is usually a high relapse rate.  However, most functional medicine providers use herbal combinations, which have a broader spectrum and are generally more effective and much less expensive than the antibiotics like Xifaxan, which is designed to stay in the intestine.

The treatment to cure SIBO requires high levels of patience and perseverance and also some necessary dietary changes. The treatment of SIBO requires the intake of a healthy diet and avoiding a number of foods until that moment when the gut flora achieves its balance once again.  SIBO is best treated by a protocol that takes into account the protective biofilm around the bacteria.  A number of protocols are available that both deal with the protective biofilm and the overgrowth of bacteria.

What Are the Symptoms of SIBO?

The indications of SIBO are quite similar to those showcased by other gastrointestinal disorders such as IBS. In relation to the research conducted by a number of scientists published in the World Journal of Gastroenterology, there is actually more reason to believe that there is a close association between SIBO and IBS.

IBS and SIBO Symptoms

Researchers have come forward to make suggestions with quite a large percentage of them insisting that physicians show some consideration of SIBO before moving forward to provide a definitive diagnosis of IBS.

Common symptoms of IBS and SIBO:

  • Nausea
  • Vomiting
  • Bloating
  • Malnutrition
  • Diarrhea
  • Rashes
  • Fatigue
  • Weight loss
  • Joint pain
  • Rashes
  • Fatigue
  • Depression
  • Rosacea
  • Eczema
  • Asthma
  • Acne

What Causes SIBO and Its Risk Factors

1. Underlying Conditions

There are numerous underlying conditions that are considered to contribute immensely to small intestine bacterial overgrowth. These include chronic pancreatitis, aging diverticulosis, which is a structural complication in the small intestines, Fistula, injury, scleroderma, and lymphoma.

2. Some Medications

Numerous medications including proton pump inhibitors, immunosuppressant medications, immune system disorders, celiac disease, and recent abdominal surgery are also characterized by an increased risk of developing SIBO.

3. Celiac Disease

Celiac disease is a major point of concern as it interferes with gut motility culminating in improper ileum functionality.

In relation to research published in the American Journal of Gastroenterology, 66 percent of patients diagnosed with celiac disease, who closely followed a gluten-free diet prescription, tested positive for bacterial overgrowth.

In carrying out this particular research, the patients in question were subjected to a combination of antibiotics, a change in diet, and finally medications for worms and parasites. The patients involved in the study all reported that the symptoms had been bated and that was because of the SIBO treatment they undertook.

4. Blind Loop Syndrome

The next underlying cause of the condition is the blind loop syndrome. This is indicated by the attribute of the small intestine actually forming a loop and resulting in the food bypassing sections of the digestive tract. This causes the movement of food in a much slower manner through the system. The bacterium thrives quite well in such an environment.

5. Type 2 Diabetes

Various metabolic disorders, for example, type 2 diabetes that’s not properly controlled, are said to result in a number of gastrointestinal disorders. The research published in Diabetes & Metabolism showed that SIBO was observed in about 43 percent of diabetics suffering from chronic-related conditions.

6. Aging

Aging is definitely the next risk factor that leads to one developing small intestine bacterial overgrowth. At some point in time, we begin our aging process, and this process includes the slowing down of the digestive tract.

From the statistics, non-hospitalized adults of ages 61 & over represent a 15 percent prevalence rate of SIBO, and that sharply contrasts with the figure associated with people age 24 to 59 which represents 6 percent. In a publication from the American Geriatric Society, it was revealed that more than 30 percent of disabled older adults are struggling with SIBO.

7. Rosacea

Rosacea happens to be a skin condition that results in rashes on the face and redness as well. The condition showcases SIBO symptoms. Scientists from the Department of Internal Medicine at the University of Genoa in Italy established that rosacea patients showcase a higher rate of prevalence of SIBO.

There is hope for those people who have been struggling with rosacea for a long period of time. The recent study revealed that “an almost complete regression of their cutaneous lesions and maintained this excellent result for at least 9 months,” which of course followed the eradication of SIBO.

Complications Closely Linked with SIBO

Complications Closely Linked with SIBO | What Is Small Intestinal Bacterial Overgrowth? | All You Need To Know | how to get rid of sibo without antibiotics


SIBO needs to be dealt with while still in its early stages. The reason behind this is the fact that if left untreated, it can actually result in some potentially serious health complications. As a matter of fact, bacteria overgrowth in the ileum can culminate in malnutrition, which is one of the most serious concerns with SIBO.

Malnutrition and Deficiencies

Essential nutrients, carbohydrates, protein, and fats are not absorbed in the right way and that results in deficiencies, including vitamin B12 deficiency, iron deficiency, deficiencies in the fat-soluble vitamins, and calcium deficiency.

The above-mentioned deficiencies can cause a number of weaknesses including damage to the central nervous system, weakness, confusion, and fatigue. A lot of people have misconceptions regarding vitamin B12 deficiency, with quite a large number of people thinking of it as a condition that is less prevalent. But this condition is actually quite prevalent and should be dealt with as quickly as possible.

Other Causes of Nutrient Deficiencies

There are numerous factors that can lead to deficiency, aside from SIBO. Vegetarians and vegans have a greater risk. Along with this same line are those individuals experiencing inadequacies in stomach acid or those who take medications that suppress stomach acid - H2 blockers and proton pump inhibitors among other antacids.

Symptoms of B12 Deficiency

As illustrated above, all the above medications are linked to SIBO. Going by Harvard Medical School’s research, the symptoms of vitamin B12 deficiency can show up either in a gradual way or rapidly. The associated symptoms include anemia, numbness or tingling in extremities, jaundice, memory loss, the decline in cognitive function, weakness, hallucinations, and paranoia.

The British Journal of Haematology released a report where it indicated that megaloblastic anemia, which is a blood disorder that culminates to the loss of red blood cells, is directly linked to bacterial overgrowth in the ileum. This happens as a result of the malabsorption of vitamin B12.

Treatment for SIBO

Antibiotics help a huge deal in the treatment of the small intestinal bacterial overgrowth, but SIBO is a difficult condition to deal with even with the use of antibiotics and in many cases, use of antibiotics may make it worse.

Antibiotics for Bacterial Overgrowth

Research published in the American Journal of Gastroenterology found that whenever SIBO patients are treated with antibiotics, there is a greater tendency that there will develop a high recurrence rate. And aside from that, the gastrointestinal symptoms shot up during the recurrences.

How to Get Rid of SIBO Without Antibiotics

Researchers have succeeded in establishing reliable results and have thus affirmed that herbal remedies are quite effective in the treatment of SIBO. In the research, the researchers indicated a wide range of herbal remedies, as well as stipulations about potential overdose dangers and complications.

Natural Remedies for SIBO

The herbal remedies mentioned in the study were:

  • Oregano oil
  • Wormwood oil
  • Berberine extract
  • Indian barberry root extract
  • Lemon balm oil

Treat the Underlying Conditions

The big question here is on the ways to treat SIBO. It is crucial to, first of all, begin by finding out whether there are some underlying causes at play. That should be closely followed by making the effort to try and do a reverse of the nutritional deficiencies.

How to Cure SIBO Naturally Through Diet

It is critical to note that implementing lifestyle changes, like following a healthy diet, as well as the intake of nutritional supplements, will go a long way towards helping your body regain its normal balance.

1. Consume Smaller Meals

The first recommendation towards overcoming SIBO is to start consuming smaller amounts of food during meal times. Spread out your meals so that you're consuming between 5-6 smaller meals each day, which is a bit of a change from the normal three meals per day, but will be less taxing on your digestive system.

The importance of consuming smaller meals lies in the fact that they enable you to digest foods more quickly, which is crucial in treating SIBO. Overeating can make SIBO more severe and that is of course due to the fact that it causes food to sit longer in the stomach.

2. Take Note of Your Stomach Acid

Aside from that, it can also lead to the alteration of gastric juice production. The production of low amounts of stomach acid is one of the greatest factors that cause SIBO. The stomach acid plays a critical role in killing bacteria in your upper GI regions.

3. Take Probiotics for SIBO

By kick-starting the probiotic supplements, you will be making a major step toward fighting small intestinal bacterial overgrowth. Remember that it is important for you to consume probiotic-rich foods.

According to a pilot study by a number of researchers at the Center for Medical Education and Clinical Research in Buenos Aires, Argentina, probiotics projected a higher efficacy rate as compared to metronidazole for persons struggling with SIBO.

A Study on the Importance of Probiotics

In that particular study, Lactobacillus Plantarum, Lactobacillus casei, Bifidobacterium Brevis, and Streptococcus faecalis were prescribed for five days, whereas the other half was to take antibiotics for five consecutive days.

Everyone who participated in the study undertook a similar diet, which did much towards limiting the consumption of dairy products, leafy green vegetables, legumes, and alcohol.

Results of the Study

The result? An astounding 82 percent of the group that received probiotics reported clinical improvement, whereas 52 percent of the group that was administered with antibiotics showcased clinical improvement.

Aside from playing the part in using the probiotics, it is also essential that you undertake a change in diet. 

An Outlook at the Diet for Small Intestine Bacterial Overgrowth

In an effort to eliminate bacterial overgrowth in your small intestine, it is of paramount importance that you kick-start with a FODMAPs elimination diet for a period of two weeks. As a matter of fact, you're asking yourself what FODMAPs is exactly and all that it entails.

What Is a FODMAP?

It is simple. They are actually those foods that aren’t fully absorbed into the system and as a result, end up fermented in the digestive tract. It is indeed this fermentation that nourishes the bacteria present, and this is where the main problem lies. As a matter of fact, it gets more complicated to fight SIBO as well as the SIBO symptoms.

Top Secrets of the Kinds of Foods to Forget About During Phase 1

  • Fructose - This is usually found in some fruits and fruit juices, processed cereals, honey, high-fructose corn syrup, baked foods, processed sugars, and maple syrup.
  • Fructans - This comprises garlic, wheat, artichokes, asparagus, onion, leeks, cabbage, and broccoli.
  • Lactose - Under this falls the various processed products with the dairy-added lactose as well as the conventional dairy.
  • Polyols - This includes isomalt, sorbitol, maltitol, lactitol, xylitol, and erythritol which are commonly found in sugar-free gum, mints, as well as some top medications.
  • Galactans - This category includes legumes, Brussels sprouts, cabbage, and soy.

The great importance to actually stick with total elimination of the outlined list of the foods “to avoid” during the time frame is something that cannot be underrated at all. It is obvious that after reading the list, you are left with the feeling that everything is exhausted and left out, leaving you with no other good options.

Come on! You have to look further since there will usually be better ways of doing things, and by that, I’m referring to the point that there is still plenty of the so-called “great tasting” and healthy foods that you can still consume while sticking to the SIBO diet.

Great Foods You Are Permitted to Enjoy During Phase 1

  • Raw hard cheeses
  • Wild-caught tuna and salmon
  • Free-range eggs and poultry
  • Grass-fed beef and lamb
  • Leafy greens
  • Almond or coconut milk
  • Cucumbers
  • Bananas
  • Grapes
  • Pineapple
  • Cantaloupe and honeydew melons
  • Strawberries
  • Quinoa
  • Sprouted nut butter

The main objective of the SIBO diet food list lies in the fact that it targets repairing the intestinal lining, gets rid of bacterial overgrowth, eases inflammation, as well as consumes a diet rich in the essential nutrients that your body hadn’t been absorbing earlier on.

SIBO Food Guide

It is in the elimination phase that you should have with you a supply of foods from the above stipulated “enjoy list.” In case you slightly deviate by taking in any foods under the category FODMAPs, it is recommended that you go back to where you were initially. That implies you will once again get started on the two-week time frame once more.

The wild-caught tuna, grass-fed beef, lamb, eggs, free-range poultry, and salmon happen to be among the top easy-to-digest foods. According to the top health and wellness experts, they are said to verse your body system with the essential energy as well as nutrients.

Fruits and Vegetables on SIBO Diet

As a matter of fact, the FODMAPs duration locks you out of so much. However, you still have the freedom to enjoy a number of fruits including bananas, tomatoes, blueberries, grapes, cantaloupe, pineapple, and honeydew melons.

1. Pineapples

You need to remember this for a go! While your body system slowly heals from SIBO, consuming the fresh pineapple, which is said to be quite rich in bromelain every day, can go a long way towards helping tone down inflammation, while at the same time, aiding digestion. Bromelain comes with numerous and unbelievable health benefits, more so those that do arise from the various digestive disorders, asthma, allergies, and joint pain.

2. Bananas

Additionally, it is worth mentioning the fact that bananas and pineapples do a lot towards giving a major lift to the bodily energy levels. They are among the top and reliable sources for both manganese and potassium. The human body system, as a matter of fact, requires that in a great way especially during that period when it is healing from SIBO.

3. Leafy Greens

The leafy greens, carrots, cucumbers, quinoa, squash, and the sprouted nut butter also fall under the "enjoy list." A much closer outlook definitely reveals that one can uphold a healthy lifestyle and still get to enjoy the finest things in life.

The problem with most of the people is they get in a rut only consuming certain foods during Phase 1 and this in its own sense is a mistake. It helps to be as diverse as you can be provided you are adhering to the right diet.

Phase 2 - GAPS Diet

It is now two weeks since you put a halt to consuming FODMAPs. This is definitely the best moment to actually move ahead and to start on the GAPS diet plan and the protocol it pulls along with. According to top experts in the health arena, this kind of diet does a lot towards helping you repair the leaky gut syndrome, preventing toxins from entering the bloodstream, as well as rebalance bacteria throughout the digestive tract.

Benefits of a GAPS Diet Plan

This particular nutritional plan also plays quite a major role towards phasing out some frustrating complexities such as food sensitivities, giving the immune system a boost, spark an improvement in neurological functioning, heal IBS, tone down depression, as well as reduce your anxiety levels.

SIBO Foods to Avoid During GAPS

There are numerous foods that you must avoid in the course of this plan. Any form of grain, high-starch foods, processed sugars, non-organic meats, as well as dairy products must be kept away from your diet as much as possible.

Give Your Body Time to Heal

You know it much better than anyone else whether your system is still healing from SIBO. It is engaging in your digestive tract system repairs with the target of getting your body to strike its perfect balance at the center stage.

It is advisable that you take your time to actually read and comprehend the GAPS diet before moving ahead with it. The protocol is inseparable from the diet, and thus, you are advised to follow it keenly. Some aspects might appear minute thus raising the tendency to overlook them which shouldn’t be the case since they matter.

Tips when Doing a GAPS Diet

Here are important guidelines in relation to the GAPS diet:

  • Use ghee or coconut butter while preparing your meals.
  • Take a cup of bone broth with each meal.
  • Avoid eating fruits with meals; instead, consume fruits between meals.
  • Avoid consuming the store-bought yogurt; the raw dairy fermented for 24 hours or even much longer is the way to go.
  • Introduce the probiotic-rich foodstuff slowly (kombucha, cultured vegetables, and natto).
  • In each and every meal, remember to include a tablespoon of fermented vegetable juice (it is easy to access the Sauerkraut juice).

Some people find that the GAPS diet guidelines intimidate them. These guidelines shouldn’t intimidate you in any way. You'll adjust to it within a very short time frame, and without you realizing it, your digestive tract system will be progressing with healing from SIBO.

Coconut Oil for SIBO

Additionally, it is also important to point out the fact that you need to incorporate coconut oil whenever you can at this critical stage. Mayo Clinic shed light on the matter stating that the medium-chain triglycerides are a lot much easier to digest for persons struggling with blind loop syndrome.

The medium-chain fatty acids associated with coconut oil are definitely among the top reasons why they are greatly regarded as the healthiest fats on the planet.

The SIBO Supplements

This focuses on the joint supplements that show up in line with the SIBO symptoms and nutrients as well. There is a great need to overcome the nutritional deficiencies sparked by SIBO. It is critical that you make a close follow-up on the RDA levels that come with each considering that the supplement research for overcoming SIBO is still in its infancy stages.

  • Vitamin B12
  • Vitamin K
  • Vitamin D
  • Probiotics
  • Zinc
  • Digestive enzymes
  • Iron

Essential Lifestyle Changes for SIBO

You need to put it at the back of your mind that the adoption of a number of lifestyle changes may go far and wide towards helping you provide healing to the digestive system complication that you may be struggling with at this particular moment.

1. Smaller Meals and Proper Chewing

Both phase 1 and phase 2 of the SIBO diets require that you take in small meals spread out three to five hours away from each other. It is also crucial that you ensure you are chewing each bite thoroughly since digestion actually starts in the mouth.

2. Stay Hydrated and Active

Take in the recommended amount of fresh water as well since that will help keep you well-hydrated. It is also important to outline that you need to try your level best to manage stress. Yoga, Tai Chi, Barre, acupuncture, and other exercises can do much towards assisting you to get rid of stress. As a result, you are left free and motivated to focus on your SIBO diet. While handling the SIBO symptoms, it is of paramount importance that you leave enough time for your body to carry out all the necessary repairs, while at the same time, eliminating the bacterial overgrowth in the ileum.

3. Move from FODMAPS to GAPS

By choosing to do away with FODMAPs, and as a result, resorting to transitioning to the GAPS diet and the accompanying protocol, you will be on your way towards healing.

Watch this video about SIBO with Dr. Stephen Smith:


This comprehensive article has hopefully given you some ideas for moving forward. The remaining part is for you to put to play all the above-recommended tips and advice, and you will be sure to lead a happier and healthy life.

What are your thoughts about SIBO? Let us know in the comments section below!

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Editor’s Note – This post was originally published on June 13, 2017, and has been updated for quality and relevancy.
Disclaimer: These statements have not been evaluated by the Food and Drug Administration. None of the nutritional products mentioned is intended to Diagnose, Treat, Cure or Prevent Any Disease.