Most Frequently Asked Questions About SIBO

sibo diet snacks

Most Frequently Asked Questions About SIBO

We get 100s of questions every month regarding SIBO, below you will find answers to many, if there is something missing please send me an email.

Note: DO not email us about the best supplement to take for SIBO. We have already mentioned everywhere on the site that the best supplement is a probiotic+enzyme with DDS-1 strain in it, and there is only one such supplement in the market and its called CanXida Restore. You can order it at

Is Weight Loss a Symptom of SIBO & Can I Gain Weight on a SIBO Diet?

Weight loss can be a symptom of SIBO simply because of the nutritional deficiencies which arise from failure to digest foodstuffs. Additionally some of the bacteria produced can have a tendency to eat the foods which you should be digesting. All of this contributes to a situation whereby gaining weight can prove particularly difficult because, without resolving the route cause of the digestive dysfunction, then patients are always battling against a condition which is preventing their body obtaining the nutrition it needs. SIBO diets are many and varied. They range from gluten free to the Stone-Age diet and FODMAP advice. Yet no one should really embark on such a diet long-term without consulting a clinician or other practitioner. Many people will find relief from symptoms when they embark on a dietary regime, yet clearly they could also be depriving themselves of nutritional requirements in the long-term and consequences could result. Clearly what needs to be defined is not only if patients are actually suffering from bacterial overgrowth but also what that cause is. Only then can the cause be treated and the patient returned to a life of relative normality. I see many diets advising to restrain or omit certain foodstuffs, yet in some cases, such as lactose free diets, yet, as many of us suffering from lactose intolerance understands, it is virtually impossible.

How Painful is SIBO?

SIBO results in digestive discomfort for the majority of people which can range from minor inconvenience to extreme discomfort. However because of the nature of the illness, other issues can arise which result in symptoms which are not automatically linked to dysbiosis or any of the related illnesses. For example Vitamin B12 is, mistakenly, believed to be a blood condition which can result in nerve damage. The true picture is that B12 deficiency results in metabolic dysfunction which can damage the central nervous system permanently irrespective of whether the blood shows changes or not. Many other nutritional deficiencies can produce a broad range of symptoms, some of which are reversible and others which are not. Therefore it is acceptable to presume that sometimes pain associated with SIBO may not arise from the condition directly but from one or more of the other conditions arising from it.

How Long Does it Take for Xifaxan to Work for SIBO – and is it a good solution?

The generic name for Xifaxan is Rifaximin and it is regularly prescribed to treat not only SIBO but also Travelers Diarrhea. This is because Xifaxan targets bacteria only in the intestine and not throughout the body. Even in trials performed under the support of the patent holder of this drug, it was shown to be only 11% more effective than a placebo in reducing symptoms of IBS in patients without constipation 1 .

Clearly in the short-term in did work for some patients, at least those without constipation, however it is unclear whether it will work in the long term as a permanent solution. Most people who found symptoms improved reported them in the first 2 weeks. The study went on to state, depending on the symptoms measured, that Xifaxan improved symptoms for some patients better than a placebo for up to 10 weeks. Whether this could be considered a success or not is open to debate as it does not seem to resolve the issue permanently and most clinicians would not consider prescribing antibiotics long term. Patients also need to take into consideration the side-effects of ingesting Xifaxan. These can be multiple and include black, tarry stools, sleeplessness and breathlessness. One other side effect which receives little attention is that Xifaxan can cause an overgrowth of C. difficile bacteria in the colon resulting in diarrhea. If symptoms of diarrhea begin or get worse while taking this drug, cease taking it and contact your doctor immediately.

How to Take Xifaxan?

Surprisingly Xifaxan has not been tested for the effects on pregnant women or the fetus so always inform your clinician if you suspect you are pregnant. A course of Xifaxan is usually prescribed for between 7 and 14 days. Normal dosage is one 550mg tablet taken both morning and evening.

Does SIBO Cause Constipation and If, Yes, How?

Yes, one of the symptoms of SIBO is constipation. However whether this particular symptom is a cause of SIBO or an effect of it has not yet been established. It is simply one of the symptoms which will help achieve a diagnosis. One of the reasons constipation can appear as a symptom is that SIBO is associated with a disruption of what are are known as ‘peristaltic waves.’ This is the ripple effect made by the intestines to move the digested food along – otherwise known as motility. These movements can be reduced in frequency, which results in constipation as the food moves more slowly through the digestive tract, or they can be increased in frequency which results in the symptom of diarrhea. This is one of the reasons that people with either or both symptoms can achieve a diagnosis. However just why cleaning waves are disrupted is, as yet, unknown, although links to serotonin production have been suggested.

Can SIBO Cause Bad Breath?

Many people who suffer from the broad array of illnesses linked to gut dysbiosis complain of suffering from what is otherwise sometimes colloquially known as, ‘bowel breath.’ This symptom can be distressing for many and particularly for those who practice strict oral hygiene. A major recognized cause of this problem is a blockage in the bowel. However there are possibilities relating to causation: firstly that food is sometimes moving more slowly through the digestive tract due to less frequent cleaning waves, and, although this couldn’t be considered a ‘blockage’ in itself it is ensuring that the partially digested food hangs around longer than it should and sufferers are, well, suffering some of the indirect consequences. Secondly, food which is over-fermenting in the digestive tract as opposed to simply degrading, can also result in the emission of noxious smelling gases. Thirdly, food which goes into the stomach but is not being degraded due to low levels of stomach acid will also start to ferment rather than degrade and this too can produce an odor.

Can Probiotics Help With SIBO?

There are reports of some people not being helped by probiotics, however the benefits of probiotics for the majority has been well recorded since the early 1900s. Many people find that probiotics help symptoms of SIBO. This is quite likely due to either the combination or volume of bacteria which counteract the imbalance which has occurred within the intestinal system. However if patients can identify which bacteria are producing the overgrowth then this makes finding a natural balance somewhat easier. Clearly patients don’t want to top up an overgrowth of bacteria with more of the same. What they need are more of the bacteria which have become overwhelmed. The aim is to restore the symbiotic balance of the microflora not to make it worse. It has to be said though that in most cases patients symptoms respond positively to including probiotics in their diet. This situation, of course, has to be kept within reason and it is not sensible to overindulge with probiotics.

Can Taking Probiotics Cause SIBO or Make it Worse?

There is no evidence that taking probiotics can cause SIBO. Not only currently but also historically, many cultures used probiotics as a mainstay of their diet. Yogurts, yogurt drinks and kefir, particularly those made from raw milk products, continue to form part of the diet for millions of people. In some SIBO sufferers there are indications however that ingesting probiotics can make their condition worse. Some suggest this is due to specific issues with the cleaning waves of the intestine and how a certain frequency can aggravate SIBO. Others suggest that it is the specific bacteria which are contained in the probiotic which are of an incorrect strain. Again, if you are aware of the strain of overgrowth then you can be certain not to buy products containing that particular kind which may contribute to your problem. Yet despite some people voicing opinions that probiotics are not beneficial in treating SIBO, a study performed in 2010 measured the effectiveness in treating the symptoms of SIBO with probiotics versus treatment with antibiotics found that in the case of abdominal distention at least, probiotics won out. You can read more about the study at this link 2 . The conclusion has to be drawn that even if all probiotics are not beneficial for all the symptoms of SIBO, some probiotics do have beneficial effects on some of the symptoms and these are more statistically significant than those of some antibiotics.

What Probiotics Should I Take for SIBO?

What we have to remember is that research into SIBO is in its infancy in scientific terms. In many cases it is difficult to distinguish between SIBO and IBS because the tests which are performed can be considered to be unreliable. The breath tests basically estimate the location of the bacterial overgrowth based on an estimated time-frame related to when the digested food has reached a certain part of the intestines. We know that this test can produce a lot of false negatives for SIBO which is determined by one specific factor – that there is an overgrowth of bacteria in the small intestine which should reside in the large intestine. This may account for reasons why some people respond differently to different strains of probiotics. Some find that L. Acidophilus works well for them. Most find that a probiotic containing B. bifidum has better effects. For many people it is simply a case of trial and error. CanxidaRestore is one of the best probiotics for SIBO.

Can Pregnancy Cause SIBO?

There is little evidence supporting the fact that pregnancy can cause SIBO, but this situation probably exists simply because little research has been undertaken regarding the issue. What is known is that due to the developing fetus the internal organs are moved to accommodate it. In doing so the digestive system also suffers some disruption. This could, theoretically, influence bacterial overgrowth in some way, however it has not been proven one way or the other.

How To Treat SIBO During Pregnancy?

Many women report excess gas during pregnancy and will be prescribed antacids or proton pump inhibitors to minimize the problem. There are indications that these products may cause or contribute toward SIBO and this reference gives some idea of the issues involved: 3 . Because of the relationship between low stomach acid and the development of bacterial overgrowth it is therefore imperative that women identify if their gas is caused by low stomach acid or high stomach acid. The presumption by many clinicians is that gas and indigestion are as a result of high stomach acid, however low stomach acid can also cause these symptoms. By giving antacids which are alkaline in nature or proton pump inhibitors which stop the production of acid completely, the low stomach acid situation is being made worse and this may contribute to bacterial overgrowth. Testing for low stomach acid should be a starting point for treating SIBO during pregnancy. Providing the growing fetus with nutrients is obviously a primary concern to the pregnant mother and no dietary restrictions should be embarked upon or medications ingested without consulting a clinician.

How To Lose Weight With SIBO?

SIBO is not, and never should be considered as a weight loss mechanism. If you stop thinking about weight as an isolated issue and start thinking about weight as being reflective of your own healthy state, then the above statement begins to make a lot more sense. Your ideal weight should not be a size and shape based on one resembling someone else. Your ideal weight is the one where you are healthy. If your weight impedes or restricts your movement or generally prevents you from doing what you want to do, then this is not your ideal weight. If your weight is in someway detrimentally affecting your health, then this is not your ideal weight. Maintain your weight at a level which allows you to remain healthy and which also allows you to perform the activities you wish to do. Being either overweight or underweight is not conducive to fitness. SIBO sufferers tend, on the whole, to lose weight because their digestive system is not functioning normally and is not a condition to aspire to simply to acquire a shape which you deem to be more acceptable.

Is Garlic a Good Treatment for SIBO?

Although this herb is in popular use today as a food flavoring, garlic has long since been known for its health benefits and used in a variety of treatments to resolve anything from warts to high blood pressure. The main active compound in garlic is allicin which also gives garlic its distinctive smell when crushed. However allicin can be affected by a variety of processes, and is most active when taken from garlic in its fresh form. Unfortunately, although specific research has not been undertaken relating to garlic directly, irradiating foods can destroy certain enzymes, of which allicin may be one. Because of this, and because most people are unaware which foods have been irradiated, it is better to buy garlic fresh and local (or even to grow your own) if you want to see if it alleviates your SIBO or IBS symptoms.

Can Milk Cause SIBO Symptoms?

Because SIBO is a disruption to the normal microflora which degrade food and enable absorption of nutrients, patients suffer a variety of allergies and intolerances. Milk or dairy sugars are one of the most frequent intolerances seen and as such many people are told to avoid milk or dairy products to reduce symptoms. However since lactose, the dairy sugar in milk, is used in not only food production but also by the medical industry as a sweetener or in coatings, it is very difficult to avoid this sugar completely. However reducing your milk intake will, of course, help to reduce your symptoms because your already dysfunctional digestive system will not have to attempt to digest it.

Is Zinc Deficiency Linked to SIBO?

Simply because the nature of SIBO, and its possible causations, involve malabsorption of nutrients from foods, many patients will find they are deficient in many common elements and vitamins. Zinc, where it is tested for, is one of the elements which many patients usually find they are deficient in. This is not usually related to a lack of dietary zinc, but simply because they cannot absorb it.

How Long To Get Rid of SIBO?

At the moment orthodox medicine has not provided a ‘cure’ for SIBO and at best controls the symptoms. This is done in a variety of ways which usually starts with a course of antibiotics. However, as mentioned in an earlier answer, research indicates that the symptoms, even after a course of Xifaxin, will only be mitigated for around 10 weeks. Other medications which can be provided usually relate to antimicrobials. Many clinicians prefer this course of action rather than prolonged use of antibiotics.
Some people prefer to remedy SIBO by using herbal remedies sometimes combined with dietary controls. This practice seems to provide sufferers with better long-term results but can take longer to achieve. Many naturopaths and patients report that anything between 1 to 2 years is normal before seeing substantial results. However the evidence supporting these treatment methods are anecdotal only.

Are SIBO Symptoms Worse At Night?

SIBO is often said to be caused by a reduction in frequency of what are known as ‘cleaning waves.’ These are the contractions made by your intestines to move food along the digestive tract. Cleaning waves are more frequent at nighttime when you sleep and if your are not eating and if cleaning waves are reduced then both the food and bacteria tend to build up. This is why, in some cases, the symptoms of SIBO can be worse during the night.

Is Peppermint Oil Good For SIBO?

Surprisingly enough peppermint oil is one of the few traditional treatments which has received some scientific attention in the treatment of SIBO. This case report 4 provides further information on how enteric-coated peppermint oil reduced the IBS-like symptoms and hydrogen production in a patient diagnosed with SIBO. The indications are that peppermint oil will indeed beneficially affect at least some people with SIBO.

What are SIBO Mental Symptoms?

Many people with SIBO have symptoms relating to anxiety, low mood and brain fog. As I stated in several other sections of this website, these symptoms are rarely as a direct result of the bacterial overgrowth itself but are related to the individual compounds which are not absorbed by the body because of the imbalance of the microflora and, sometimes, the cause of the overgrowth. Non-absorption of certain vitamins for example will result in anxiety and reduced mental function and capacity.

Can SIBO Symptoms Come and Go?

Yes, some SIBO symptoms can come and go. This is because many of the symptoms of SIBO are triggered by certain foods, medications, exercise and anxiety. Many people find however that although some symptoms are intermittent, others tend to remain static. This is because SIBO in itself can cause nutritional deficiencies and indirect chemical imbalances which do not respond immediately to a sudden change in diet or circumstances.

SIBO and Peanut Butter

Some people find that peanut butter more so than peanuts themselves make their SIBO symptoms worse. This is sometimes attributed to the toxin aflatoxin which can build up if peanuts are left in an environment which is conducive to producing mold. More so however peanuts contain a high amount of Omega 6 relative to Omega 3. It is not that Omega 6 is bad for you, simply that the ratios of it in peanuts and peanut butter are high. For those that cannot live with their peanut butter ‘fix’ there are however some peanut butter products which, helpfully, contain no peanuts!

Is Diet Soda Bad for SIBO?

Sodas in general contain high amounts of sugars which can feed bacteria and encourage overgrowth. Diet sodas in particular usually many different chemical sweeteners which bacteria love. Try to cut back on the soda habit in general. A lot of anything isn’t good for you and there is little in soda which actually benefits the human body even if you aren’t a SIBO sufferer. To assist in breaking the habit you could always try sipping fresh lemon juice squeezed into a cup of water. Lemon has a pH which is similar to that of stomach acid and will assist not only with thirst but will also aid digestion.

Can I Eat Nuts?

Well, just to make your head spin, in direct contrast relating to the information and patient feedback regarding peanuts, many SIBO diets maintain that nuts can be consumed as part of a SIBO diet – that is though for fresh nuts only and not those that have been processed with added sugar. Again this comes down to personal reaction. If eating nuts adversely affects you, then stop.

Is Oregano Oil Good for SIBO?

Oregano Oil or Oil of Oregano is looking like the new kid on the block when it comes to treating SIBO. Many clinicians are recommending at least a trial of this herbal remedy to resolve patient symptoms. The range of illnesses this herbal extract is said to treat are many and varied, however for the purposes of our SIBO sufferers this particular research study probably provides the best reference 5 . What is shows is a study comparing the benefits of oregano oil to those of the antibiotic Xifaxan (Rifaximin) and, believe it or not, oregano oil came out on top. All of the patients had lactulose breath tests (LBT) to confirm a diagnosis of SIBO. Of the patients given the herbal treatment 46% had a negative breath test on follow-up. Of those given the antibiotic 34% tested negative on the breath test. When the remaining patients on the antibiotic arm of the study were offered the herbal treatment 31.8% took up the offer and 57.1% of those people returned a negative LBT after treatment. The study also went on to report adverse side effects and stated that: ‘of the patients given antibiotics 1 case of anaphylaxis, 2 cases of hives, 2 cases of diarrhea and 1 case of Clostridium difficile.’ This is in comparison to the 1 case of diarrhea in patients given oregano oil which even then did not achieve the status of statistical significance. So, yes, even though the research does not indicate the same spectacular success as achieved with in the rosecea study which is also mentioned in FAQs, oregano oil performed better in this trial than did antibiotics. Yet it should be noted that simply because oregano oil is a natural treatment this does not mean it should be used without clinical supervision. Clearly the product has a high level of potency and for that reason, no matter who you are, you should first approach a medical professional for guidance on using it correctly.

Is Intermittent Fasting Good for SIBO?

I’ll be perfectly honest, I am not a fan of fasting. I am even less of a fan when I hear of it being beneficial and recommended by individuals who are perfectly healthy. When it comes to detoxing here is a news flash: the body has its own detoxification system in the liver and the kidneys. But if you find fasting easy and by that I mean it causes you no problems or anxiety whatsoever, and it reduces your SIBO symptoms, then by all means continue. However the stomach and intestines can already be damaged by the overgrowth and the subsequent problems, by limiting foodstuffs this damage can be aggravated. Many people find that although they cope with the fasting itself quite well, when they start to eat again they experience stomach pains and excess gas which are worse than before they started the fast. Eating little and often, or ‘grazing’ as it is sometimes known, can be more beneficial to people with SIBO. This means, of course, not snacking on biscuits, or worse, cereals, but fresh and more nutritious foods. As with most things SIBO there is no hard and fast rules: what suits some does not suit everyone because, as we are aware there is no ‘one size fits all.’ 6 .

The opinions regarding fasting and it being possibly beneficial to SIBO sufferers appears to stem from the way Cleaning waves, or Migrating Motor Complex works in the intestinal system. MMC only happens in what is known as the interdigestive state i.e. when you are not eating. This is why it happens more frequently at night. The MMC moves digested matter along the intestine. It also now seems to be frequently quoted that this process sweeps the intestines clean of all bacteria. Clearly this does not happen. Our intestines are not swept clean of all bacteria every 90 to 120 minutes and then repopulated with bacteria in between times. However the conclusion seems to have been drawn that if you don’t eat, then the cleaning waves, because they only work when you are not eating, will sweep more frequently and effectively.

Can I Experience Rosacea or a Rash with SIBO?

There have been strong links between gut dysbiosis in general and not only rosacea but also other conditions skin conditions including acne and psoriasis, for well over 100 years. The good news for people with rosacea is that the antibiotic treatment which is provided for SIBO sufferers, namely Xifaxan, actually does clear up the skin condition and this situation continues for at least 10 months. The research findings relating to this particular symptom are not only significant but conclusive. One study found that out of 28 patients, the treatment either reduced substantially or eradicated the lesions associated with rosacea in 26 out the 28. This was compared to the control group in which none of the patients given a placebo improved and some actually deteriorated. The control group was then given the antibiotic and 17 of the 20 patients involved saw their roseacea eradicated 7 Pretty impressive stuff and good news for those suffering from this particular condition when associated with SIBO. However it should also be made clear that the response of rosacea with regard to other treatments, for example oil of oregano, has not been clinically tested. It may well be that such treatments provide equal benefits and the research has yet to be undertaken.

Can I Have Wine with SIBO?

Alcohol consumption in general is probably one of the most controversial topics in respect of SIBO. There are those who say symptoms are temporarily relieved by a glass of wine and others who avoid alcohol in all forms because they have developed an intolerance to it. Research undertaken in 2011 was published indicating a strong association between even moderate intake of alcohol and SIBO 8 The headline in this article even suggests that moderate alcohol consumption could be a causation of SIBO. That’s probably taking the word ‘associated’ a little too far but it seems that people who drink alcohol do have a high incidence of SIBO if this study is anything to go by. Wines, beers and spirits also contain sugar, which as we are already aware, feed gut bacteria. Which could be another reason why some people find an increase in symptoms after consuming alcohol.

Is SIBO Connected to Candida?

SIBO, like Candida is a bacterial overgrowth. However one is an overgrowth of a specific yeast and the other is an overgrowth of bacteria which are in the wrong part of the intestine. They are both considered to be conditions of dysbiosis i.e. Conditions where the gut microflora has become unbalanced. There is little doubt that the conditions are connected and in many cases treatments are similar and suggested causations are the same. However many treatments designed specifically to treat Candida such as Canxida Remove, contain elements which naturally boost the restorative microflora while containing antifungal treatments to target the Candida specifically.

Can I Eat Rice?

Some people with SIBO can tolerate rice and others can not. Some types of rice, by specific manufacturers, tend to cause problems which is thought to be due to the higher amounts of resistant starch. This is also sometimes attributed to wild rice. However many people can tolerate rice and they tolerate it better than they tolerate pasta. Some SIBO diets actually recommend eating rice, while others limit it and others still consider it to be off-limits. Which simply goes to show once again that when it comes to SIBO one size does not fit all.

Can SIBO Go Away On Its Own?

It is unlikely that SIBO will go away on its own without some kind of intervention. Some people may find that, without really trying, they may small adjustments to their diet and lifestyle and, luckily, their SIBO is treated, but otherwise most people have to embark on a blend of interventions incorporating orthodox medicine, dietary regimes, traditional medicine and lifestyle changes.

Can I Eat Honey?

Because sugars in general cause problems for people suffering from SIBO, IBS and other disorders linked to dysbiosis, and because those sugars are carbohydrates which feed bacteria, then they are generally best to be avoided where possible. However honey is not a naturally occurring sugar in the same sense as plant sugars are and, in general, it has many micronutrients which benefit the body in different ways other than providing energy. That said, all honey is not alike, and most of the store bought honey is little more than sugar itself. Natural honey provides antibacterial and, in some cases, antibiotic properties. Manuka honey has been proven to be effective against even the bacterial strain Clostridium difficile which is the same bacteria that can arise after a course of Xifaxan 9 .

Some SIBO diets recommend excluding honey in the same way they exclude other sugars. Some say honey can be tolerated. In most cases it comes down to not only the way individuals react to honey but also to which honey they use. If you do wish to try honey then make sure you get a good quality one and preferably direct from the producer.

Is Coconut a Good Option?

Although information about coconut oil on the internet abounds, its primary beneficial properties do not appear to be focused on restoring the imbalance of microflora but in repairing and healing the damage to the gut which has been caused. In this respect it could prove that coconut oil is also a possible good preventative of SIBO in addition to be restorative. However, it should be noted that most of this information is anecdotal rather than scientifically verified. Of course that does not mean coconut oil is not beneficial for many of the conditions it is suggested to help, it simply means that, for whatever reasons, science hasn’t got around to testing it yet. Much of the scientific research which has been done is in respect of how the fats in coconut oil can lower cholesterol levels. The primary agent in coconut oil is lauric acid, a medium chain fatty acid which is easily digested – more so than most other fats. This aspect of the oil is also said to be why you feel more full more quickly and so it can reduce appetite and, indirectly, act as a weight loss aid. Despite the fact that science has done little research in respect of coconut oil beneficially aiding the symptoms of dysbiosis, there are many people who, anecdotally, report that it has helped them. And anecdotal evidence, prior to the development of modern medicine (which was only initiated less than 100 years ago) was once the only thing that mattered. In short, if it works for you, then it works.

Is a Stool Test Effective for SIBO?

In general, although stool tests can identify bacterial counts the bacteria they identify are, obviously, those which come at the end of the digestive process. Since SIBO is said to be a condition where bacteria are multiplying in the small intestine, much further up than where stools are produced, then although such tests may identify an excess of specific bacteria, they can’t specify where in the digestive tract this problem is occurring. This is the reason that many people are dissuaded from having a stool test to diagnose SIBO. However the breath tests which are used also have numerous ways of returning inaccurate results. Since both SIBO and IBS are becoming more recognized as diagnosed illnesses many laboratories are busy designing tests which are non-invasive and accurate. Hopefully it will not be long before a stool test which can identify SIBO accurately is found.

Is a Urine Test a Good Option?

Urine testing suffers from similar problems to the stool test in that it may identify an overgrowth but it cannot tell you were the overgrowth is in relation to the digestive tract and therefore is not much use in pinning down a diagnosis of SIBO specifically. However what it can tell you is if the overgrowth you suffer from has developed into Leaky Gut Syndrome. For those whose symptoms have developed into something more than the usual digestive problems which define SIBO, it may well be worth investigating urine tests for intestinal permeability to find out if you have developed Leaky Gut.

How to Live and Deal with SIBO?

A diagnosis of SIBO is achieved by patients meeting several basic criteria and, usually, a breath test. Even though the basic criteria which are primarily related to digestive issues are distressing and somewhat uncomfortable to live with, the symptoms can extend far beyond these basics. Technically speaking once a patient acquires additional symptoms then they no longer suffer from SIBO but from whatever the next diagnosis achieved actually is. This makes the cause and effect of such conditions quite difficult to define. Most people initially will turn to orthodox medicine for a solution. Yet, we are now clearly aware the treatments provided by orthodox medicine, at least those provided in isolation, do not result in a permanent resolution. We also know that many people are reacting negatively to certain foodstuffs – and although there are some foodstuffs in common which cause problems, many others are not consistent. If you are aware that you have problems after eating a certain food, then the answer, at least initially, is to stop eating it. Also try and include as a possible symptom foods that don’t make you feel full after eating. This is a good clue that these foods simply aren’t for your digestive system at the current time. The next important step is to establish what you can eat. As I mentioned previously there are numerous diets out there at the moment. Go through them and pick out foods you can and can’t eat whether they are suggested as recommended or to be avoided – in the case of SIBO one size does not fit all. Don’t make drastic changes to your diet wherever possible. You wouldn’t completely change the food you feed your pet overnight so don’t do it to your own body. If you either don’t want to go the orthodox medicine route or have already tried it, seek out foods which might help to:

  • aid your digestion
  • reduce inflammation
  • leave you feeling full but not bloated
  • leave you feeling energized rather than fatigued

Also investigate the possibilities of including fresh garlic to your diet – negative reports about this particular foodstuff are as scarce as hen’s teeth but positive reports abound. If you can get a breath test done, then do so. It may return a false negative but if it returns a positive you will have some idea of the strain of bacteria causing you problems and be able to avoid it. You may also be able to find a probiotic which contains strains of bacteria which are not responsible for the overgrowth and which will give the beneficial strains a helping hand. As I’ve previously mentioned there exists other natural foodstuffs which provide, or at least are suggested to provide, antimicrobial and antibiotic effects – why not give them a try and see if they improve your overall condition. Other foodstuffs, like raw honey, are said to have anti-inflammatory effects and this may also contribute to resolving the damage already caused.

What Should I do If My Test Comes Back Positive?

Most people, if they have had a test performed will have had it taken via a clinician or natural practitioner. The results, at least if they are positive, will provide you with conclusive evidence that you have a problem which needs to be resolved. At this point you will need to discuss the matter further with your referrer. It may be that you elect to at least try the orthodox treatment route – but be aware it is unlikely to work for an extended period of time, or you may wish to consult a natural practitioner who can advise you accordingly.

How to Treat SIBO Without Antibiotics?

There are many ways and alternative methods to treating SIBO without resorting to antibiotics. If you feel this route is not correct for you then discuss it with your clinician or naturopath and start to examine the other options.
Most people will look, at the very least toward:

  • Making dietary adjustments
  • Making lifestyle adjustments
  • Sourcing possible alternatives in respect of probiotics

Looking into natural sources of:

  • Antibiotics
  • Anti-inflammatories
  • Anti-microbials

Other possible changes include examining the effects of increasing or decreasing your exercise routine and looking to support digestive function with supplementary enzymes.

If I Do Yoga Will That Help?

The digestive system is affected by both mental and physical stress because it is governed by the enteric nervous system. This part of the nervous system is sometimes known as the ‘second brain’ because it functions independently of both the sympathetic and parasympathetic nervous system. Relaxation and gentle physical stimulation all help the gut perform more efficiently. This is thought to be one reason why yoga and other gentle exercises and relaxation techniques can actually assist beneficial digestive function. It would seem that such gentle exercise can be more beneficial than most strenuous workouts which, in themselves, can result in detrimental effects on the junctions within the intestinal wall of which leaky gut syndrome can be an outcome.

Can SIBO Cause Yellow Diarrhea?

When it comes to stool color it is important to differentiate between those which are pale in color and those which are distinctly yellow. However this is made quite a lot easier because usually pale looking stools are associated with constipation and yellow stools are associated with diarrhea.

Constipation is usually caused by stools hanging around too long in the digestive tract and in effect, drying out. Yellow diarrhea is usually associated with a lack of bile salts. Problems with numerous organs can cause this, including the liver, pancreas or gallbladder. If you have diarrhea which is a more normal shade of brown then this is associated with SIBO. If you have diarrhea which is distinctly yellow in color then mention it to your clinician.

Can I Drink Whey Protein Powder?

Whey is normally found in the domain of bodybuilders and Little Miss Muffet (Curds & Whey) and it is the fluid which is produced in cheese making when the cheese is pressed. Whey is high in protein and it has been suggested that for those suffering weight loss due to SIBO that it can be beneficial in aiding weight gain. However at the moment the information that is available is purely anecdotal. Some paleo dietitians do suggest it but whether it conflicts with SIBO is, as yet, unknown.

How Much Does a SIBO Test Cost?

When discussing SIBO tests patients usually are referring to the hydrogen breath test. Prices depend obviously on the laboratory doing the testing, where you are located in the world, and the charge your practitioner makes for submitting it. Generally speaking laboratories charge from around $160 up to $350. Insurance companies rarely cover these costs. You can, of course, apply for the tests directly now from some laboratories which will eliminate the practitioner fees but if the test results are returned as positive it is recommended you approach a professional for advice on how to proceed.

How to take peppermint oil for sibo and how much?

Much of the popularity of peppermint oil as a treatment for SIBO rests on the results found when one case was studied. In other studies peppermint oil was provided in the form of enteric coated tablets rather than the drops themselves. The suggested dosage of these capsules is usually between 2 and 3 per day in between meals.

How much glutamine for sibo?

Glutamine is an amino acid and a deficiency of it can result in intestinal permeability. Clinical trials and research have been performed and are currently on-going which examine how some patients, primarily those diagnosed with IBS, have low levels of glutamine which is apparent in some tissue samples. It should though be noted that this deficiency appears in the tissue samples of patients with diarrhea predominant IBS. Currently glutamine is used as a restorative treatment in respect of intestinal permeability and many patients purchases over-the-counter products in an effort to remedy symptoms of digestive dysfunction relating to dysbiosis. Glutamine is produced by the body but it is considered in some people that production is inhibited nd this may be a genetic issue.

Glutamine can also be obtained through dietary means and the primary sources are meat and dairy products. Bodybuilders have known about the benefits of glutamine (usually referred to as L-glutamine) for a long time and noticed how it reduced recovery time and aided muscle mass. This has resulted in many products being available which target this market directly and dosage guidelines generally exceed those provided for patients taking the supplement for health issues. Even then the dosage may appear quite high and they tend to average out at 5gms 6 times daily for adults.

How long does sibo last?

SIBO in itself is limited by clinical description to a number of primarily digestive symptoms which are defined by a patient having an overgrowth of bacteria which normally reside in the colon being found in the small intestine. Because many patients either fail to respond to treatment, whether orthodox or traditional, or they fail to get any treatment at all, the illness can progress to other diagnoses, for instance leaky gut syndrome. In itself the name of the diagnosis may change however the SIBO issue has simply developed into another condition. Hence although you might get a different title ascribed to your symptoms SIBO itself can last indefinitely unless treated promptly and correctly. Even then very few cases are resolved totally and permanently.

How to know if i have sibo?

The symptoms of SIBO correspond with several other similar diagnoses including IBS. Initially patients usually start to suffer from digestive issues generally including excess gas, feeling bloated after eating even small meals, diarrhea and/or constipation, excess gas and bloating and stomach cramps. Many people attending a clinician with these symptoms will automatically get a diagnosis of IBS and it is true to say that few will be referred for tests to establish whether or not the problem is related to a general overgrowth or to establish whether the overgrowth is specific to the small intestine by bacteria which normally reside in the small intestine. If you do want to differentiate ask your clinician to provide you with the option of a hydrogen breath test so you can get a more accurate diagnosis.

How to prevent sibo recurrence?

As most people now realize there is not a single solution to the problem of SIBO. Many people manage to reduce the symptoms of it by methods incorporating orthodox medicine, dietary controls and alternative treatments. During the course of their investigations many people realize not only that certain foods trigger SIBO but also begin to understand what may have at least contributed to their symptoms in the first place or what makes them worse. This can include certain stressful situations and even levels of exercise. Some people manage to mitigate their symptoms by applying what they have learned and therefore can prevent their symptoms increasing again. However whether this can be considered a cure, and therefore a recurrence, is a matter of opinion. A real cure would involve symptoms being completely resolved and the patient returning to a normal lifestyle, or at least one resembling the lifestyle they had prior to becoming ill. Few people manage to make this transition, so it is expected that many people prevent a recurrence of SIBO symptoms by avoiding the things which contributed to it in the first place. In short the symptoms are managed rather than cured.

How long to be on sibo diet?

If you choose to embark on a dietary method for treating SIBO the long term outcomes are simply not known. This is because these diets really haven’t been in existence long enough for anyone to provide an absolute answer. What we do know is that where these diets are tried, if patients find they improve symptoms then it takes around 18 months for a significant change to be apparent in their quality of life. They may notice improvements almost immediately but the full benefits are not felt for a substantial length of time. Whether symptoms will remain in remission permanently remains to be seen.

How does someone get sibo?

The direct causes of SIBO are actually unknown however there are many opinions based on causes of dysbiosis and associated problems. The suggestions which have been offered up include previous digestive problems such as food poisoning or diarrhea. This is most certainly seen as an issue which can instigate an imbalance of the microflora directly. Other people are said to contract SIBO after they have undergone surgery particular in the stomach or intestinal region. We are also strongly aware that antibiotics can adversely affect digestive flora. Because most antibiotics kill bacteria indiscriminately and when the gut repopulates it doesn’t repopulate in the same ratios as before. Yet there are other possible or even likely influences. These include the ingestion of NSAIDs, excessive alcohol consumption and even stress. Currently the implications of genetic issues are being investigated and they revolve around glutamine deficiency or depletion. The problems which arise in defining causes of SIBO are primarily related to the fact that although many other conditions are ‘associated’ with SIBO it is unknown if these are an actual cause or if they are simply an effect or result of the overgrowth.

How long does sibo die off last?

Die off is said to be the side-effects of bacteria being killed and producing toxins, and thus side-effects, after treatment. The correct term is actually Jarisch-Herxheimer reaction and is so-called because the scientists concerned discovered a response in patients suffering from syphilis when they were given mercury. This response produced flu-like symptoms which was attributed to be a reaction by the body as its inability to cope with dying microorganisms. The symptoms are those of flu and they start within a few hours of the treatment being taken. So, in short, die-off is a term used when the patient is given a treatment causing the death of pathogens which overwhelms the body. It is said to last up to 7 days and has been investigated in respect of several conditions and treatments. At this time I am unaware of any research which has been performed in respect of dietary changes, die-off and SIBO and patients should be aware that their symptoms may actually be a side-effect of the treatment they are taking rather than simply attributing any adverse reactions to die-off.

How does sibo cause acid reflux?

Many people with SIBO have acid reflux and similar symptoms. This is said to be caused when the bacteria which are too numerous in the small intestine produce excess gas after feeding on sugar and starch. The intestine is distended and believed to push upward contributing to a shift in the stomach, and its contents, and resulting in reflux.

Does sibo make you hungry?

Generally speaking although SIBO produces symptoms which are related to excessive eating, it does make you feel hungry. This is because the food which you are putting into your body is actually feeding your excess bacteria rather than your cells. Many people find that this problem is worse after they have eaten processed foods which contain fewer nutrients anyway and it results in feeling hungry again shortly after a meal.

Does sibo make you tired?

Fatigue is certainly an indication of SIBO and other conditions associated with dysbiosis in general. The reasons for this can be multiple and suggestions include the fact that SIBO results in nutritional deficiencies which in themselves can cause patients to feel fatigued simply because they are not getting the fuel to their cells which is required for them to function at an optimal level. It is also suggested that the bacteria produce toxins which in themselves can cause overwhelming tiredness.

Will sibo kill me?

There are no recorded cases of anyone dying as a direct result of SIBO. However little or no investigation has been undertaken with regard to what happens to patients as a direct result of malabsorption of essential nutrients and trace elements. Another factor which is rarely considered is the impact that illnesses related to dysbiosis can have on a patient psychologically. Since the condition often becomes chronic many people find their quality of life seriously diminished and a study into the psychological effects on patients found that 38% of sufferers involved in the research and who had been diagnosed with IBS, had either contemplated or actually attempted suicide as a direct result of the affect it had on their lives. Clearly this is not an acceptable number of people who, for the most part, are considered by orthodox medicine to have nothing more than an illness which is an inconvenience 11 .

Does sibo get worse?

By definition SIBO does get worse in most people, particularly when they don’t take effective action to mitigate it, because the overgrowth which causes the initial problems continues to populate. The bacteria themselves result in damage to the intestinal wall which can result in intestinal permeability more commonly known as leaky gut syndrome. Additionally, even if the bacterial overgrowth remained static, the sufferer would continue to be robbed of nutrients and vitamins which are either being ‘stolen’ by the bacteria themselves or are simply not being degraded effectively and allowing them to be absorbed adequately. So, yes, the result is that sufferers are in a state of progressive deterioration from a variety of factors.

Can sibo ever be cured?

What must be remembered is that SIBO is really only an illness which has been partially recognized in recent years. As such research into it, both from the perspective of orthodox medicine, dietary controls and alternative medicine, has had little time to evaluate the result of treatments in the long-term. We now recognize that orthodox treatments can only provide limited effects in resolving symptoms in the short-term and that they are likely to return, quite possibly with more resilience, when the effects of the drugs have worn off. Anecdotally patients report that they have better effects by embarking on either dietary measures or by using alternative preparations or a combination of the two. Many people also try the orthodox treatments prior to moving on to the other alternatives. It would seem, that although the benefits which occur when a patient uses the correct treatment and dietary measures, which can differ from person to person, that although the benefits take longer to materialize, the patient does in fact go into remission substantially. Because these courses of action are relatively new, as yet no one really knows if the beneficial effects will be permanent and most people actively avoid the things which make them worse.

Does sibo cause nausea?

Nausea is a symptom which indicates SIBO however it is not quite as common as other symptoms which include diarrhea, constipation, bloating, cramps and abdominal discomfort.

Does sibo cause inflammation?

SIBO is generally thought to cause inflammation by two pathways: Firstly the bacteria themselves and the toxins they release can inflame the intestinal wall as they become persistent aggravators. Secondly, if the intestinal wall starts to break down at the tight junctions further inflammatory responses can be triggered when molecules enter the blood stream which are simply not supposed to be there.

Does sibo cause fatigue?

There are many factors which may contribute to the fatigue felt by patients suffering all forms of dysbiosis and the associated conditions. For example the nutritional deficiencies themselves may lead to fatigue. Additionally the bacterial overgrowth may be producing toxins and gases which also contribute toward it. The body is also generally being overworked internally because it is having to fight the toxins and deficiencies and absorption issues which it would not normally have to contend with if the body was functioning normally. Inflammation of the intestine for instance will result in the body using energy which would normally be redirected to general daily activities.

Does sibo cause body odor?

Many people with illnesses related to dysbiosis find they have an increased, and unpleasant, body odor. The reasons behind this have not been investigated but several theories have been put forward. These include increased toxins being either released or produced on the skin and, particularly in the case of patients suffering constipation based IBS or SIBO, degrading materials staying within the intestine for too long. Excess bacteria result in the production of high levels of methane which can be responsible for the foul smelling gases evacuated in feces and breath, however there is little evidence this gas is omitted via the skin.

Does sibo cause hair loss?

Many patients report hair loss as a symptom of SIBO. It should be noted that the term hair loss does not restrict itself to that of head hair only but can also include body hair. Neither should loss be interpreted as total, it can be a thinning of hair or simply increased loss without resulting in bald patches. It is thought to arise due to hair follicles being damaged due to nutritional deficiencies.

Can sibo be contagious?

No. SIBO is not thought to be contagious. The causes of SIBO may be multiple but, as you can see in my answer to another question, it is not considered to be a contractible illness.

Is sibo the same as H. Pylori?

No. SIBO is not the same as H. Pylori. H. Pylori is a type of bacteria which lives in the stomach, not in the intestine. It used to be thought that high levels of stomach acid were the cause of stomach ulcers. However after the discovery of H.pylori it is now considered by some to be the actual cause of this particular problem. Yet this conclusion is not definitive and certainly treatments for H. Pylori, which are usually by antibiotics, although they may see the bacteria go into remission find this is not a permanent solution as they quickly return. It could be that H. Pylori simply co-exist in the stomach without actually interfering in function but this situation needs more monitoring and research studies to establish conclusively the effects of the bacteria, if indeed there are any.

Is sibo the same as ibs?

No, SIBO is not exactly the same as IBS, although many people are diagnosed with IBS and then fail to be tested for SIBO. This results in many people being diagnosed with IBS who could possibly actually have SIBO. Both are thought to result from dysbiosis which means there is an imbalance in the gut flora. However SIBO is currently believed to be a specific situation where bacteria which normally reside in the large intestine, for whatever reason, have migrated and established themselves in large numbers in the small intestine. This is why there is a distinction between SIBO and IBS, however since most people don’t have the tests it is difficult to establish what bacteria are specific to the overgrowth and where they are in the digestive tract.

Is sibo an infection?

Although SIBO is described as an infection it is not typical of an infectious or contagious disease. Yes, it is an overgrowth of bacteria which can cause injury, but it is not an invasion by bacteria which are not normally found in the body. So, although SIBO can be termed an infection, it is not infectious.

Is sibo common?

Although SIBO is now becoming more recognized as a diagnosed illness in its own right, the likelihood is that the number of actual cases is still underestimated. This is simply because many clinicians and national health authorities refuse to acknowledge its existence. However the situation is much improved than it was a decade ago and many clinicians are becoming more aware of the condition and the problems it can result in. Prevalence rates of SIBO in general populations are difficult to establish and appear to vary widely between the nationality of populations and also which tests were used. For example, in Japan a study examining the levels of SIBO in older members of the population (which usually return higher results due to age related lowering of stomach acid) 0% patients returned positive test results 12 . Compare this to a similar study in the UK where the percentage returned a result of 14.5% of the cohort and the difference seems significant 13 .

Yet in the Japanese group a glucose breath test was used and in the UK a lactulose test, which could account for the difference in returns. Most of the research undertaken however is usually to assess how common SIBO may be in respect of already diagnosed conditions which can range from IBS through to spina bifida. The prevalence rates are however quite high particularly in the case where IBS has already been identified.

Is sibo candida?

No, SIBO is not Candida. SIBO is an overgrowth of bacteria whereas Candida is an overgrowth of yeasts. However in many cases Candida can appear either with or without SIBO. The problem in answering this particular question with any level of accuracy though is quite difficult since many people are tested for Candida and few are tested for SIBO. In some countries, the UK for example, SIBO as a condition is simply not recognized. Until such countries do recognize this illness and start testing for it accordingly then it is impossible to provide definitive answers. It is however recommended by many practitioners that if a patient has tested positive for Candida then they should go on to test for SIBO.

Is sibo an autoimmune disease?

There is no evidence that SIBO is an autoimmune condition however there is suggestion it can result in autoimmune issues. This occurs when the illness develops into leaky gut syndrome (intestinal permeability) and the immune defenses of the body start to attack the molecules coming through the intestinal wall when tight junctions break down.

Is the paleo diet good for sibo?

The Paleo Diet is, generally speaking, a suggested healthy eating plan rather than it being designed to deal with the symptoms of specific illnesses. In some ways it may conflict directly with what sufferers of SIBO find actually aggravates their condition such as certain nuts, fruits and vegetables. In particular the direction to avoid dairy products directly contradicts what is known to be a significant factor in many people suffering from intestinal permeability which is a lack of glutamine. When I was initially diagnosed several years ago it was suggested to me by a natural practitioner that I embark on the Paleo Diet. One glimpse at the list of foodstuffs to be included and excluded, convinced me simply by my own previous experiences as to which food relieved my symptoms and which foods exaggerated them, that the Paleo Diet was not for me. Like most healthy eating plans it can though be adjusted to incorporate or exclude foods which are known to relieve or worsen symptoms of SIBO. Paleo recommendations to avoid processed foods which are manufactured as meals at least, is a common-sense way to at least start eating more healthily.

Is sibo hereditary?

It must be remembered that SIBO is only now becoming recognized as an illness in its own right and as a possible cause, and therefore probable misdiagnosis, of many cases of IBS. Although I am unaware of any research which has been undertaken with regard to SIBO in particular, there has been research into the hereditary incidences of IBS. It would seem that, as this research paper suggests 14 someone with IBS is two to three times more likely to have relatives with the same condition. There are also possible genetic links because glutamine deficiency and genetic defects and this research is currently underway.

Is coffee bad for sibo?

Although coffee is well known as an antioxidant, when it comes to SIBO, IBS and other gastrointestinal problems, it can aggravate the symptoms quite dramatically. Until quite recently it was thought that the caffeine in coffee was the primary culprit for adverse responses however now it has been shown that decaffinated coffee can also produce the effects. Not only does coffee act as a stimulator to the motility of the gut but it also elevates stress hormones (which are also involved in regulating gut motility), increases acidity and can interfere with GABA (Gamma aminobutyric acid) which is a neurotransmitter that also indirectly affects gut motility 15 The adverse effects of coffee have been researched relative to IBS rather than SIBO however the indications are that responses are similar. In respect of individual reactions to coffee they can vary greatly but, if possible, it is best to at least cut down coffee intake and the benefits should speak for themselves.

Is chocolate bad for sibo?

Chocolate is usually highlighted as being one of the main triggers of both SIBO and IBS symptoms. However some people find there is a distinct difference between either dark or milk chocolate reporting that one or the other produces more severe effects. In some cases chocolate is suggested to be a possible cause of SIBO but there is little research supporting this. Again it is thought to be the caffeine in chocolate which is the problem – however with coffee it has now been shown that decaffinated can cause more severe symptoms than non-decaffinated brands. Conversely cocoa is not thought to bring on symptoms of digestive issues and many people use this as an alternative to make cakes, cookies and other chocolate products.

Is belching a symptom of sibo?

Yes, excessive belching is a symptom of SIBO. Again this is thought to be as a result of the gases which bacteria produce being raised substantially because the bacteria are residing in the small intestine rather than the colon. The human body is accustomed to coping with gases under normal circumstances and this is not usually a problem – belching is normal. However the gases produced when there is an overgrowth of bacteria is excessive and many people have a problem voiding the gases effectively. This is another reason why many people suggest sugars and starches should be restricted from the diet to deny the bacteria their food-source and limit the troublesome gas which can result.

Can stress cause sibo?

Yes. The digestive system is governed by both the sympathetic nervous system and the enteric nervous system. The sympathetic nervous system is the one which governs our ‘fight or flight’ responses. Although much research is still to be done into SIBO itself and also the causes of it, we know that anxiety can result in the disruption to the digestive tract. A simple example of this is to recall what happens for example if we are nervous about attending a job interview – your stomach will start to grumble, you get ‘butterflies’ and, usually, have to make a few trips to the rest-room! This is because the motility, the movements your intestines perform to move waste along, are disrupted, and, if you are in a permanent state of anxiety or stress it can result in disruption to the balance of the microflora. Hence, yes, stress can cause SIBO.

Can parasites cause sibo?

Most of the research undertaken investigating parasites as a possible causation of illnesses linked to gut dysbiosis have been done with regard to IBS. As it currently stands the majority of the research suggests that someone with IBS has similar parasitic counts to those of a healthy person. However there are conflicting research studies and it has to be remembered that there are over 500 strains of bacteria within the human digestive tract and not all of those have even been identified much less tested. Two strains in particular, B. hominis and D. fragi are prevalent in cases of IBS and one study claimed IBS symptoms were resolved when D. fragi was eliminated 16 .

Can prednisone cause sibo?

Prednisone is a corticosteriod which is sometimes prescribed to treat inflammatory conditions because it suppresses the immune system. Some doctors may prescribe this drug to treat inflammatory reactions related to IBS and dysbiosis whether they are related to rashes or in an effort to treat the intestinal response. However I cannot find any research which suggests either prednisone or other steriodal anti-inflammatories resolve the issues of gut dysbiosis and, although there is suggestion of it, there is no actual evidence which suggests prednisone can cause SIBO either. Prednisone should not be used if the patient has a fungal infection of any kind.

Can PPIs cause sibo?

Because proton pump inhibitors stop or severely restrict the production of stomach acid and this results in a low pH or more alkaline stomach acid levels, then this is an indication that PPIs will result in an accumulation of unwanted bacteria. However test results relating to bacterial levels relative to breath test counts differ in their findings. Some clinicians argue that PPIs are not associated with SIBO or other conditions caused by dysbiosis, whereas others maintain they are significant causative factors 7 . Commonly used proton pump inhibitors include Prilosec and Nexium. If you have the symptoms of SIBO and also use these products, ones which are similar or even over-the-counter antacids, it may be worth discussing the possible links with your clinician.

Can opiates cause sibo?

Although opiates are generally associated with substance abuse and illegal drugs they can also be prescribed medications which are used to depress the activity of the central nervous system and generally have a relaxing effect. Some people are concerned that opiates, whether illegal or prescribed, can result in SIBO because of the indirect connection between the effects they have on the CNS and how the CNS is involved in regulating intestinal motility. It is now believed that because opiate usage slows down motility this results in dysbiosis as the digestive microflora are disrupted. One of the main indicators that a patient may have developed SIBO as a direct result of opiates is said to be when they present with chronic constipation. Although there is little in the research to suggest the same, there are widespread reports among clinicians that opiate usage is now being considered as predisposing patients toward conditions associated with dysbiosis in general.

Can mold cause sibo?

It has recently been hypothesized that mold can either cause SIBO or immune systems can be affected by it as a direct result of antibiotic preparations 18 .

But first, if you are thinking of checking out mold in respect of its links to any illness you must get the spelling right to ensure things don’t get too confused. In the US the word ‘mold’ is used and the UK English spelling is ‘mould.’ Searching using both spellings tends to reveal a lot more than just using one.

Toxic mold exposure is suggested to be either a direct cause of IBS or that it is being misdiagnosed as IBS but to date there is no strong evidence to support the hypotheses. Either way living with toxic, or black mold as it is sometimes known, is not good for your health as the spores can trigger a variety of reactions. Certainly the implications of toxic mold on health in general need to be investigated in more depth.

Can manuka honey treat sibo?

Manuka honey is not renown for curing SIBO however it has been tested with regard to its effects on intestinal inflammation – in rats. The study did though show that manuka honey had significantly beneficial effects compared to controls and suggested that further research be conducted – but next time on human subjects 19

Can sibo cause malabsorption?

Yes. Many people are diagnosed with SIBO or other illnesses associated with dysbiosis simply because of their bodily condition relating to malabsorption. Many people, although they eat relatively well, fail to absorb nutrients and vitamins from their food due to not only the bacterial overgrowth but also the fact that the bacteria ‘steal’ nutrients and also that leaky gut syndrome can develop which causes problems outside of the digestive tract and into the blood. Malabsorption can ultimately affect weight and body condition and result in a malnourished appearance.

Can sibo cause dry mouth?

The links between SIBO and other illnesses related to gut dysbiosis may well be related to the sympathetic and parasympathetic nervous systems. Under normal circumstances the sympathetic nervous system does not kick in unless the person is under threat because this is the nervous system which triggers fight or flight responses. In situations where it is activated then this results in less saliva being released as the body directs its energies into more essential survival mechanisms. Most people will recognize that their mouth becomes dry when they are anxious or afraid and this is the same response people with dysbiosis experience. The indications here are that the sympathetic nervous system is responding even in situations where the individual is not under threat.

Can lactose intolerance cause sibo?

It is likely that lactose intolerance is a symptom or a result of SIBO rather than a causation. Lactose is a dairy sugar which appears not only in dairy products but is also used in food production as a sweetener. Since the bacteria involved in SIBO feed on such sugars then, even when sufferers abstain from dairy products, they are still ingesting lactose in foods such as tinned fruits, salad dressings, snacks and even some processed meats. Lactose is even present in medications including some birth control pills. Avoiding dairy products is obviously a sensible precaution to take but this by no means results in sufferers avoiding lactose completely.

Can low stomach acid cause sibo?

Stomach acid pH affects how bacteria are allowed to enter the body. The higher the stomach acid (more acidic) the more effective it is. It therefore follows that a more alkaline stomach acid is going to be less effective in killing potentially harmful bacteria entering the body.

Can lyme disease cause sibo?

Lyme disease is spread by ticks and can result in arthritic conditions and affects the central nervous system even years after the initial event. However it is not thought that Lyme Disease in itself can cause SIBO or any microflora imbalance directly but that the treatment for Lyme may predispose the patient to one of several conditions associated with it. SIBO is no different in this respect to antifungals prescribed for Lyme predisposing patients to Candida. As the treatments used kill off certain bacterial and yeasts in large numbers it can result in an imbalance of the microflora. Many clinicians are now aware that treatments for Lyme disease can result in patients developing gut dysbiosis and if you suspect you are one of these people it would certainly be worth mentioning to your primary care physician.

How long can you have sibo?

Sibo is what is known as a chronic illness. This means it is not acute, in that it comes and goes quickly, but that it lasts for a long period of time. In some cases chronic illnesses go into remission but then return. In others they simply disappear over time. But in many they simply get worse as time goes on. Many people have SIBO for a long time before even trying to access treatment as they see the initial digestive symptoms as merely an inconvenience. It is usually when other deficiencies and problems arise as a result that they attend doctors to discuss their symptoms.

Can sibo cause leaky gut?

Yes. Leaky gut syndrome is more commonly termed Intestinal Permeability by the medical profession. Debates still rage about this condition because some medical professionals claim it does not exist, others state that it does exist but does not cause any major physical problems and others still maintain that it exists and the problems it causes can result in systemic illness. The condition itself is where the tight junctions in the intestinal wall become damaged. The intestinal wall is made up of cells through which nutrients and other compounds are absorbed into the body. In between these cells are what are known as tight junctions. If you consider that they are the cement holding together a brick wall then you will get some idea of how the system works. In cases of dysbiosis in general, it is thought that these tight junctions become damaged by the toxins which an overgrowth of bacteria can produce. Once these tight junctions are damaged or absent then toxins, bacteria and larger food particles can pass through into the body.

Can kefir cause sibo?

For the uninitiated kefir is a form of fermented milk drink which is considered by many to be a highly effective probiotic. However some people report that their digestive issues started after they ingested kefir. The claims made are however purely anecdotal and no information has been gathered to establish what was taken and how much of it. It would seem that with kefir, as with all probiotics, that the ‘everything in moderation’ analogy applies. No matter what is suggested to be good for your digestion too much can result in digestive imbalances if not taken sensibly.

Can gallbladder cause sibo?

Gallstones in the gallbladder have recently been linked to SIBO and it is now considered that SIBO itself is actually a possible causation of gallstones rather than the development of gallstones resulting in SIBO. Unfortunately one resolution to gallstones is to remove the gallbladder completely. Because this organ is necessary for releasing an alkaline substance called bile which helps break down fats, removal of it can prevent fats being broken down and absorbed effectively. A clear symptom of fats not being broken down, whether you have had your gallbladder removed or not, are stools which float in the toilet bowl. Recent research suggests that many patients with gallbladder problems actually have a slower gut transit time compared to healthy subjects and were looking not at the relationship between gut motility and SIBO but the effects it has on bile acid production. The research revealed that more acid was produced as a result of the changes.

Can good bacteria cause sibo?

It should be clarified that the bacteria which cause the problems in the small intestine are not necessarily ‘bad’ bacteria. They are ‘good’ or beneficial bacteria when they are in the location they are supposed to be in – the large intestine. It is only when they migrate to the small intestine where they are either not meant to be or are meant to exist in much smaller numbers than they do in the large intestine that there activities become ‘pathogenic’ or harmful. So, in short the problem is location, location, location rather than ‘bad’ and ‘good’ bacteria.

Can fructose malabsorption cause sibo?

Again we are looking at a malabsorption issue in light of cause or effect. Fructose is a sugar which, although understood to aggravate the symptoms of SIBO, has actually been eaten by man since time immemorial. To consider now that so many people have a problem eating fructose seems incompatible with what the human body has considered to be healthy food for thousands of years. Yet there is no doubt that in some people fruit products, such as apples, can cause excessive gas production. Whether this is a cause or effect of SIBO remains to be seen.

Can food poisoning cause sibo?

One of the first indications of SIBO is thought to be cases of food poisoning particularly where the symptoms fail to remedy after treatment or recur after treatment was thought to be effective. This is the reason many people fail to investigate their SIBO symptoms for quite a long period of time because they simply associate the problems they are having with the original case of food-poisoning.

Can endometriosis cause sibo?

Endometriosis is generally considered to be a gynecological condition which is characterized by an excess of tissue outside of the uterus. A study looking into the correlation between IBS and women diagnosed with endometriosis found that women with IBS symptoms or a diagnosis were more likely to suffer with endometriosis 10 , and further investigations actually looking at the correlation between the condition and SIBO in particular, found that there were significant findings in respect of adhesions resulting from endometriosis and SIBO.

Can endoscopy detect sibo?

Endoscopy cannot detect SIBO because of where the bacteria are located in the small intestine – which is a pretty hard place to get to. Not only is this procedure considered to be invasive, because the intestines are so long, it can usually only be performed effectively to reach the upper portion of the small intestine and not penetrate even the lower portions where the bacteria are thought to reside. Although this test, for the above reasons, makes it unreliable when it comes to providing an accurate diagnosis, some clinicians prefer it to the hydrogen breath tests, which, unfortunately also have potential flaws.

Can doxycycline treat sibo?

Doxycycline is another broad spectrum antibiotic which was first used to target overgrowth in respect of IBS. This drug has now been superseded by the non-absorbed antibiotics such as Xifaxan. Tests evaluating effectiveness of such drugs are usually undertaken by hydrogen breath-tests only.

Can diet alone cure sibo?

Many people undertake to treat SIBO, or even a self-diagnosed SIBO condition, due to either failing to get the condition recognized by their clinician or orthodox medicine failing to provide a long-term solution to the symptoms. Some report that their symptoms have gone into full remission by embarking on a specific diet. However it is debatable as to whether this can be determined as a ‘cure.’ By definition if a patient is on a permanently restrictive diet, and if the symptoms return if the diet is not adhered to, then it should be looked at as a treatment or management of the condition only – although, of course, the treatment does actually work. Yet there are obvious problems associated with embarking on a restrictive diet and particularly one which is undertaken without the guidance of a clinician or nutritionist, and that is related to the patient avoiding nutrients which the body actually needs. The suggestions are that although many diets are possible in the short-term, the long-term implications may be detrimental outside of the problems caused by SIBO.

Can diverticulitis cause sibo?

Diverticulitis is where small pouches are formed in the colon which can collect waste and, obviously, bacteria and generally can affect people as they get older. It is possible therefore that this condition can result in illnesses associated with dysbiosis as the bacteria which would normally be moved swiftly from the colon remain trapped and therefore could result in an imbalance of microflora.

Can celiac disease cause sibo?

Once again when it comes to SIBO relative to other conditions it is a case of cause or effect? No one really knows whether such illnesses are as a direct result of a previously undetected microflora imbalance or whether the celiac disease causes SIBO. However what we do know is that there is a relationship or association between the number of people diagnosed as celiac and the number of people with SIBO.

Can birth control cause sibo?

There is debate about whether or not oral contraceptives can result in SIBO. Although there is a direct correlation between IBS and oral contraceptives as this study indicates 21 . However since there appears to be a definite link between SIBO and misdiagnosed IBS, it is quite possible that there is a link between SIBO and oral contraceptives. Again, although it is often stated that there is no direct link, this is not because research has taken place which proves no direct link, but usually because the research has not been undertaken in the first place.

Can bulimia cause sibo?

There are suggestions that eating disorders can result in SIBO, however I am unaware of any which link bulimia and SIBO directly. Yet again this does not mean a causation does not exist, merely that it has not been researched. The majority of research undertaken has been in respect of people with food eating disorders in general and IBS. Here there has been discovered a direct correlation. For example in a study mentioned in this article 22 64% of women with an eating disorder and IBS, although all were not formally diagnosed, actually had the symptoms of IBS relative to the Manning Criteria. If we also consider that most patients with IBS do not go on to be tested for SIBO even though their condition may warrant it, then there is a likely link between eating disorders in general and gut dysbiosis and the related malabsorption problems.

Can sibo cause brain fog?

SIBO and brain fog are synonymous. However there are differing opinions as to why this condition, which seems extremely prevalent at this point in history, should manifest. Some practitioners claim that cognitive problems in general are caused by toxins which are released by the bacteria and undigested food fragments. However it also seems completely plausible that because sufferers of dysbiosis fail to digest the relevant vitamins and nutrients, and that many of these play major parts in brain function and control neurotransmitters, that brain fog actually results due diminished absorption of essential molecules and compounds.

Can sibo cause shortness of breath?

Shortness of breath is one symptom that regularly arises as a result of SIBO. This particular symptom was overlooked for quite a long period of time because initially, when the criteria for diagnosing IBS was devised, it was based on what is known as the Rome Criteria and this looked at digestive and bowel symptoms only. The Rome Criteria has been revised several times and is now known as Rome III Criteria but many still feel it falls short of specifying the many symptoms related to gastrointestinal disorders of which shortness of breath is one.

Can sibo cause high blood pressure?

Obviously high blood pressure or hypertension as it is sometimes known can be indicative of many illnesses and it is essential any problems are thoroughly investigated by your clinician. However many people with illnesses arising from dysbiosis find that they suffer from hypertension. The relationship between the nervous system, gut and resulting symptoms, although they may initially appear distinct, is closely connected and blood pressure rises as a response to the fight or flight mechanism. This is given as being one of the reasons hypertension can manifest when the motility of the digestive tract is disrupted.

Can acupuncture help sibo?

Acupuncture is said to help SIBO because it reduces tension which acts on the sympathetic and enteric nervous systems. These systems affect digestion which are thought to be at least partial contributory factors to SIBO and other conditions related to dysbiosis. By relaxing these systems and reducing their responsive effects to stress, then the patient is considered to have the opportunity to support resolving SIBO and bacterial overgrowth in general. Many practitioners, and particularly those from orthodox medicine, consider acupuncture to be effective simply because of the ‘placebo’ effect. The placebo effect revolves around the situation where patients, suffering from many conditions, are given a non-drug treatment to establish if the effects are real. Yet in many cases, and this includes most conditions, some patients symptoms go into remission when given a placebo. The implications of this are broad and varied – were the patients not really ill in the first place for example? Of course this simply isn’t true and placebo pills are given to people even with serious tangible illnesses such as cancer – and the placebo still ‘works.’ So really the term ‘placebo’ relates to something within the human metabolism which works but science hasn’t yet figured out how or why. Since acupuncture in respect of digestive function and relaxation ‘works’ even if some ascribe it to the placebo effect, the bottom line is that for some people it still works. In this particular case, since scientific causes cannot currently identify why it may be, in the same way that some forms of hypnosis work, that if the patient is told they are going feel more relaxed then they are actually more relaxed – and this all helps aid effective digestive function.

Can a hernia cause sibo?

There are common links or associations between SIBO and hernias. Some schools of thought consider that a hernia is possibly a direct causation of SIBO but other consider that hernias are as a result of SIBO already existing. The way this is believed to happen is that as the bacteria in the intestine feed on sugars and starches they produce excess build up of methane and hydrogen. This excess of gas is thought to distend the intestine and subsequently to put pressure on the stomach and distort it upward to contribute toward not only hernia but also heartburn, indigestion and nausea.

Can anyone get sibo?

Yes, most certainly anyone can, and indeed does, get SIBO. No matter how healthy you are there exists currently a list of possible causations ranging from surgery to stress which may adversely influence gut microflora and which may result in dysbiosis of the same: SIBO is merely a specific description of gut dysbiosis when bacteria which are normally found I the colon have, for whatever reason, been found in large numbers in the small intestine.

Can amoxicillin treat sibo?

Amoxicillin is a broad spectrum antibiotic and was one of the first used in the treatment of SIBO and IBS. Broad spectrum means that it kills a wide range of bacteria and as such use was generally discouraged when other, targeting antibiotics such as Xifixan, were developed. There is actually no recorded evidence that amoxicillin is effective for treating either SIBO or IBS.

How to prepare for sibo breath test?

Currently most breath tests require the same preparations and in this also includes fasting. For people who feel hungry most of the time anyway, it is usually no simple task. The test itself is performed in the consulting room, or if you prefer, you can order it as a home test. However, there is a rigid protocol to be followed and I give details of this further down this page.

What is stool test for sibo?

The stool test for SIBO counts the bacteria in the samples. However it is considered to be unreliable for SIBO in particular since the test counts the bacteria after they have passed through the small intestine and after they have passed through the large intestine. Since SIBO is thought to be specifically concerned with the strains and numbers of bacteria colonizing the small intestine then the stool test simply cannot measure the level of bacteria at this point.

What is blood test for sibo?

At the present time I am not aware of any blood tests which are available to identify SIBO. Indirectly the current breath tests measure the amount of hydrogen or methane which has been produced by bacteria, then transferred to the blood and then through to the lungs prior to be exhaled. This is a more accurate measurement than testing the blood only.

What to eat before sibo test?

Most laboratories provide guidelines for SIBO testing that are very similiar. I have taken the guidance here from the SIBO Center to give you some idea of what to expect 23 . For 2 weeks prior to the test cease to take any antibiotics or antifungals. In some cases this may have to be done under consultation with your clinician. If you are on any other prescription medications you must also discuss this with your clinician so he can assess the situation. Neither, for the 2 weeks prior to the test should you have a colonoscopy or a barium enema.

For 7 days prior to the test being taken stop taking all PPIs (Proton Pump Inhibitors) again some of these will be prescribed medications and the situation will have to be discussed with your clinician.

The preparation diet for the 2 days prior to the test may depend on your condition and also the laboratory performing the test, however it is suggested that for those suffering slow digestion reflected by constipation, the diet should be started 2 days prior and for those with a normal digestion for the 24 hours prior. Foodstuffs allowed usually follow similar guidelines. What you can eat is:

Meat, fish and seafood, and poultry.
Lactose free dairy.
Steamed white rice – but not for those who are currently on a grain-free diet.
Clear meat broth but not bouillon, bone or cartilige or vegetable.
Fats and oils including coconut, oliver oil, vegetable oil, butter and lard.
Salt and pepper but no other seasoning
Weak black tea or coffee but with no sweetener or cream.

What you cannot eat is anything not included on this list and this also means any vitamins, minerals, herbs or supplements that you would normally take. However most prescription medications can be taken but if you are uncertain speak with your clinician.

For 12 hours prior to the test all patients are required to go on a water fast diet.

Remember that if you ‘cheat’ on your preparation diet then this will only have the effect of skewing your own test results!

How reliable are sibo tests?

SIBO tests are not 100% accurate. There are many reasons why a test may not return an accurate result and a major one is where the preparation diet for the test is not adhered to. However the test itself may have several flaws and, to be fair, most laboratories are quick to point these out to clinicians and explain that the test itself is not a gold standard.

Sibo test side effects?

Because breath tests for SIBO actually involve giving the patient sugar, albeit a small amount, and the bacteria which cause the problems feed on sugar, then most sufferers which experience side-effects. These side-effects are the same as those they would normally experience and include diarrhea, stomach cramps, constipation, and gas.

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