SIBO: What Is It, What Are the Symptoms & What Can You Do About It?

Oct 7

3 min read

If you regularly experience bloating, gas, reflux, constipation or diarrhoea, you may have started to wonder whether there is more going on than simply “a sensitive gut”. One possible contributor is SIBO - Small Intestinal Bacterial Overgrowth. SIBO occurs when bacteria migrate from the large intestine into the small intestine, where they are not normally present in such large quantities. This can contribute to inflammation, impaired digestion and nutrient absorption, and increased fermentation of undigested food.

For some people, investigating SIBO can be an important piece of the puzzle when persistent digestive symptoms aren't improving.

What are the symptoms of SIBO?

SIBO can present differently from person to person, but common symptoms include:

Bloating
Abdominal discomfort
Excessive gas or flatulence
Burping
Reflux
Constipation
Diarrhoea
Fatty stools (steatorrhea)
Food intolerances or sensitivities
FODMAP sensitivity
A history of diagnosed IBS

Because these symptoms can overlap with many other digestive conditions, it's important not to assume that SIBO is automatically the cause. Appropriate investigation can help determine whether it is actually present.

Could SIBO be contributing to your IBS symptoms?

The relationship between SIBO and IBS is an area of growing interest, with the research suggesting SIBO may be associated with a significant proportion of IBS cases. This is one reason that, when someone has ongoing IBS-type symptoms, it can be worthwhile looking beyond simply managing individual symptoms and considering what may be contributing to the underlying digestive dysfunction.

What can you do if you suspect SIBO?

There isn't a single dietary or lifestyle strategy that works for everyone. A naturopathic approach can involve investigating whether SIBO is present, supporting digestion and reducing uncomfortable symptoms while also considering why the overgrowth may have developed in the first place.

1. Consider a temporary low-FODMAP approach

FODMAPs are fermentable carbohydrates that can contribute to digestive symptoms in some people.

A relatively low-FODMAP diet may be used temporarily to help reduce symptoms. However, long-term restriction isn't advisable. The goal isn't to permanently eliminate a wide range of foods from your diet, but to use dietary strategies appropriately as part of a broader approach.

2. Give your digestive system time between meals

Frequent grazing can mean your digestive system is constantly processing food. Allowing around 4–5 hours between meals, where appropriate for the individual, may support the function of the Migrating Motor Complex (MMC) - sometimes described as the digestive tract's “cleansing wave”, which helps move material and bacteria through the small intestine. This doesn't mean everyone needs to follow a rigid eating schedule. Individual circumstances, energy needs and health status all matter.

3. Look at alcohol intake

Alcohol can irritate the gastrointestinal tract and may compromise gut barrier function. It is generally advised to avoid alcohol when addressing SIBO. For someone experiencing ongoing digestive symptoms, reducing or removing alcohol can therefore be a useful part of their overall treatment.

4. Don't underestimate stress

Your gut and nervous system are closely connected. Chronic stress can influence digestive function by shifting the body's priorities away from digestion and towards a stress response. Stress management doesn't have to look like another item on an already overwhelming to-do list. It might be:

Going for a walk or exercising
Reading a book
Meditating
Catching up with a friend
Cooking something you enjoy
Creating more space to rest and switch off (away from your phone!)

The most effective strategy is often the one you can actually maintain.

How is SIBO investigated?

If SIBO is suspected, breath testing may be used as part of the investigation. The test involves consuming a sugar preparation and then measuring gases produced in your breath over time. Elevated gas levels can be associated with bacterial overgrowth in the small intestine. Testing can help provide more information rather than relying solely on symptoms.

A naturopathic approach to SIBO

The aim isn't simply to put a band-aid over digestive symptoms. Once SIBO has been identified, naturopathic care may focus on:

Reducing gut inflammation. Supporting a healthier intestinal environment and addressing factors contributing to digestive discomfort.

Supporting digestion and nutrient absorption. Helping the digestive system function more effectively.

Managing symptoms. Reducing the bloating, gas, reflux, constipation or diarrhoea that can have such a significant impact on day-to-day life.

Understanding why it developed. Identifying potential contributing factors can help inform a longer-term preventative strategy, rather than simply focusing on the overgrowth itself.