SIBO – What is it?



SIBO stands for Small Intestinal Bacterial Overgrowth. We all have small amounts of bacteria present in our small intestine. If this bacteria begins to proliferate in the small intestine then they begin to ferment sugar from food and this can lead to many uncomfortable digestive symptoms.


  • abdominal pain & cramps
  • bloating
  • burping
  • gas
  • constipation
  • diarrhoea
  • heartburn


The purpose of the small intestine is digestion and absorption. Your food is mixed with pancreatic enzymes and bile to break down carbohydrates and proteins into smaller pieces and to emulsify fats. Enzymes lining the small intestine (called brush border enzymes) can break down carbs and proteins even further, so that the enterocytes (the cells lining your small intestine) can take in the nutrients from your food and pass them to your blood.

When bacteria are present in the small intestine, they will start fermenting undigested carbohydrates. This leads to the production of gas (like hydrogen or methane) in the small intestine. This can result in visible abdominal distention (Your belly can look pregnant).

The bacteria also produce other byproducts that can damage the enterocytes. Damaged enterocytes means loss of brush border enzymes. This means your food isn’t broken down enough to absorb properly, leading to nutrient deficiencies, fatigue, and blood sugar imbalances. This also means that more food is available for your gut bacteria, which means more fermentation, which means more gas, bloating, changes in bowel movements and other digestive symptoms. Damaged enterocytes also means that you will have a harder time absorbing any food that is properly digested, again leading to the above issues. And if there is enough damage to the enterocytes, gaps can form between enterocytes. This is also known as leaky gut. So now you have undigested food and bacterial byproducts directly entering your blood. This leads to food reactions, immune activations, and whole body inflammation that can set you up for other health problems.


The damage to the small intestine leads to nutrient deficiencies and immune activation that can cause other symptoms and health conditions:

  • Anemia
  • Food sensitivities
  • Headaches
  • Joint pain
  • Fatigue
  • Eczema
  • Asthma & allergies
  • Depression & mood disorders


SIBO is associated with many other diseases, either resulting from that disease or causing that disease. The following conditions also occur with SIBO; IBS, Celiac, Crohn’s disease, Diabetes, Hypothyroidism, Chronic Fatigue Syndrome, Fibromyalgia.


The current standard for testing is a 2-3 hour breath test. You drink a lactulose solution and take breath samples every 20 minutes for 2 hours. This test can be done at home. It measures the production of hydrogen and methane. If bacteria are overgrown in your small intestine, they will ferment the lactulose to produce hydrogen or methane. Once we know if SIBO is the cause of your symptoms we can begin treatment. The test is quite expensive though and often we can determine if you have SIBO by assessing your current symptoms.


SIBO is quite a complicated condition to treat and can take a very long time, depending on how long you have had it and the reasons behind the development. There are several phases of treatment:

  • Eradication of bacteria (antibiotics or herbal antimicrobials)
  • Restoration of motility
  • Restoration of digestive deficiencies (gastric acid, digestive enzymes, bile, GI immunity)
  • Healing gut lining (herbs and nutrients)
  • Repopulating healthy bacteria
  • Preventing recurrence (lifestyle, diet)

Treatment may last 6-12 months. It is also important to note that all SIBO treatments should be individualised. You may have additional conditions, such as leaky gut or an autoimmune condition that also require treatment. You may also have parasites, yeast overgrowth, or a large intestine bacterial imbalance that need to be treated as well. So it is important to find a naturopath who can work with you holistically to fully address your symptoms. Get in touch today if you would like to find out more about treatment options.