What Is SIBO, and How Can You Detect, Treat, and Recover From It?

Have you ever wondered why your gut seems to misbehave no matter what you eat? If you’re dealing with bloating, gas, or other digestive discomfort, you might have come across the term SIBO—short for Small Intestinal Bacterial Overgrowth. But what exactly is SIBO? How do you know if you have it? And more importantly, how do you recover from it and feel like yourself again?

In this article, we’ll cover everything you need to know about SIBO, including its types, symptoms, causes, how to detect it, and how diets like FODMAP can play a role in your recovery. Let’s figure it out together so you can take back control of your gut health.

What Is SIBO?

SIBO, or Small Intestinal Bacterial Overgrowth, happens when there’s an abnormal growth of bacteria in your small intestine. While your large intestine (colon) naturally contains bacteria to help with digestion, your small intestine shouldn’t have too many. When bacteria take over this space, they interfere with digestion and nutrient absorption, leading to a host of uncomfortable symptoms.

There are two primary types of SIBO, based on the byproducts these bacteria produce:

1. Hydrogen-Dominant SIBO: Bacteria in your gut ferment carbohydrates, releasing hydrogen gas. This type is often linked to diarrhea.

2. Methane-Dominant SIBO: Certain gut microbes release methane gas, which slows digestion and is typically associated with constipation.

Some people may even experience a mix of both types, leading to fluctuating symptoms.

How Do You Detect SIBO?

Detecting SIBO isn’t always straightforward, as its symptoms can overlap with food intolerances. However, there are a few key ways to pinpoint whether SIBO is the culprit:

1. Breath Test: The most common way to detect SIBO is through a hydrogen-methane breath test. Here’s how it works:

   • You’ll consume a sugary solution (like glucose or lactulose).

   • If you have SIBO, the bacteria in your small intestine will ferment the sugar, releasing gases like hydrogen or methane. These gases can be measured in your breath over time.

2. Small Intestinal Aspirate: This test involves taking a sample of fluid from your small intestine and analyzing it for bacteria. While it’s the most accurate method, it’s invasive and not commonly used unless necessary.

3. Symptom Review: Doctors may also diagnose SIBO based on your symptoms and medical history, especially if you have risk factors like a history of IBS, diabetes, or surgeries involving your digestive tract. However, you should always always test youself first.

What Causes SIBO?

There’s no single cause of SIBO—it often occurs when something disrupts the natural balance in your gut. Here are some common triggers:

1. Slow Gut Motility: If your digestive system moves too slowly, it allows bacteria to linger and grow in the small intestine. This can happen due to conditions like gastroparesis or hypothyroidism.

2. Structural Issues: Scar tissue, adhesions, or anatomical abnormalities in the gut can trap bacteria in the small intestine.

3. Immune System Problems: If your immune system isn’t functioning well, it may struggle to keep bacteria in check.

4. Use of Antibiotics or PPIs: Long-term use of antibiotics or proton pump inhibitors can disrupt your gut’s bacterial balance.

5. Other Conditions: IBS, celiac disease, diabetes, and Crohn’s disease all increase the risk of SIBO.

What Are the Symptoms of SIBO?

SIBO symptoms can vary depending on the type you have, but here are some of the most common ones:

• Digestive Issues: Bloating, gas, diarrhea, constipation, or a mix of both.

• Abdominal Pain: Cramping or discomfort, especially after eating.

• Food Intolerances: Difficulty digesting high-FODMAP foods like garlic, onions, or beans.

• Nutritional Deficiencies: SIBO can interfere with nutrient absorption, leading to deficiencies in vitamins like B12 or fat-soluble vitamins (A, D, E, and K).

• Weight Changes: Unexplained weight loss or, in some cases, weight gain.

• Fatigue and Brain Fog: Due to poor nutrient absorption and gut-brain axis disruption.

If these symptoms sound familiar, it might be worth exploring whether SIBO is the root cause.

How to Treat and Recover From SIBO

Recovering from SIBO often involves a multi-step approach that targets the overgrowth, repairs the gut, and prevents recurrence. Here’s what treatment typically looks like:

1. Antibiotics or Antimicrobials: Your doctor may prescribe antibiotics like rifaximin (for hydrogen SIBO) or rifaximin combined with neomycin (for methane SIBO). These target the overgrown bacteria directly. Alternatively, herbal antimicrobials like oregano oil, allicin, or berberine can be effective for some people. However, from my experience I recommend you a psychoneuroimmunology that will give you antobiotics (not very powerful to avoid destroying your gut flora) and herbs.

2. Dietary Changes: Diet plays a huge role in managing SIBO symptoms and supporting recovery. Many people benefit from a low-FODMAP diet, which reduces fermentable carbohydrates that feed gut bacteria.

3. The FODMAP diet involves three phases:

   • Elimination: Temporarily remove high-FODMAP foods to reduce symptoms.

   • Reintroduction: Gradually test individual foods to identify your triggers.

   • Maintenance: Follow a long-term eating plan based on your triggers and tolerance.

4. Prokinetics: Prokinetics are medications or supplements that help improve gut motility, ensuring food and bacteria move through the digestive system properly. These can be essential for preventing relapse after treatment.

5. Lifestyle Adjustments: 

   • Eat at once, don´t eat several times a day to help you gut clean itself.

   • Chew your food thoroughly.

   • Avoid snacking late at night to give your gut time to reset.

SIBO treatment is not just about eliminating bacteria—it’s also about restoring gut health. Discover how Gut Vita might help support digestion and microbiome balance

Using the FODMAP Diet for SIBO Recovery

The FODMAP diet isn’t a cure for SIBO, but it’s an effective tool for managing symptoms during and after treatment. By temporarily reducing foods that ferment in the gut, you can ease bloating, gas, and discomfort while your treatment takes effect.

Here’s an example of low-FODMAP swaps:

• Replace onions and garlic with garlic-infused oil.

• Swap apples and pears for bananas or oranges.

• Choose lactose-free yogurt over regular yogurt.

• Opt for rice or quinoa instead of wheat-based products.

Emily’s Journey to SIBO Recovery

Emily, a 29-year-old graphic designer, struggled with severe bloating and alternating diarrhea and constipation for years. After a hydrogen-methane breath test confirmed SIBO, her doctor prescribed rifaximin and recommended a low-FODMAP diet.

During the elimination phase, Emily avoided high-FODMAP foods like garlic, onions, and beans. Within a few weeks, her symptoms significantly improved. After finishing her antibiotics, she slowly reintroduced foods and identified her main triggers. Today, Emily manages her gut health with a balanced diet, regular use of a prokinetic, and an occasional low-FODMAP reset when needed.

Reclaiming Your Gut Health

Living with SIBO can feel like a constant battle, but understanding the root of the condition is a powerful first step toward healing. Recovery often involves a mix of dietary adjustments, working with your doctor to address underlying causes, and incorporating tools like the FODMAP diet to manage symptoms. From my experience, people with H. pylori infections often struggle with imbalances that can lead to complications like fungus, parasites, or SIBO. That’s why it’s so important to work with a PNI dietitian who can create a personalized, long-term plan to help you recover fully and regain your quality of life.

If you suspect SIBO might be causing your symptoms, don’t hesitate to take action. Reach out to your healthcare provider and start making small, manageable changes that can lead to big improvements in your gut health. You’ve got this—better days are ahead!