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Small Intestinal Bacterial Overgrowth: the New Gut Problem

Small intestinal bacterial overgrowth (SIBO) is a digestive imbalance where bacteria is present in the small intestine. The problem with SIBO isn’t that the bacteria is pathogenic. Rather, it’s the accumulation of bacteria in the wrong place.

In a healthy scenario, the majority of your gut flora and bacteria populates the large intestines. For several reasons that I talk about in the video, bacteria migrate to the small intestine, ferment food (causing gas, bloating, etc..), compete with your body for nutrients, inflame the gut, disrupt digestion and absorption, and result in nutrient deficiencies, especially vitamins, minerals, and antioxidants.

SIBO: Symptoms, Why Fix it, and Treatment Options

Watch the video for full details about SIBO symptoms, the problems it creates, why it’s important to fix it, and treatment options. If you prefer to read, I listed the key information below.

When you’re ready to dive deeper into your health, get tested for SIBO, get a full gut assessment, and get a customized food and supplement plan to treat SIBO and any other condition or imbalance that could be happening and you don’t know it, let’s talk. Book a strategy session HERE.

SIBO Symptoms

These symptoms are often common in people with SIBO:

  • IBS (irritable bowel syndrome). Research shows that 60-80% of IBS cases are caused by SIBO
  • Gas and bloating
  • Excessive burping and belching
  • Nausea, vomiting, stomach pain
  • Diarrhea or constipation, or both
  • Heartburn, acid reflux
  • Indigestion, feeling that food is stuck in your stomach, feeling too full even with a small amount of food
  • Fatigue
  • Anemia (both iron or vitamin B12)
  • Food sensitivity symptoms like muscle and joint pain, headaches, migraines, brain fog, eczema (read more about food sensitivities)

Why is it important to fix SIBO?

SIBO will keep your gut in a state of inflammation, which will lead to a cascade of side effects and disturbances long-term. Here is why you must address SIBO so the problem doesn’t get any worse:

  1. Bacteria in the small intestine ferment food, especially carbohydrates and fibers, releasing hydrogen and methane gases that cause your pain and discomfort. The result is bloating, gas, belching, and burping. The gases can push the stomach content up and cause acid reflux and heartburn.
  2. Bacteria in the small intestine will compete with your body for nutrients. The result is iron and/or vitamin B12 deficiency.
  3. Bacteria in the small intestine causes damage to the lining of your gut. This means that the cells of your small intestine can’t produce adequate enzymes to digest food, which means that you will be stuck in a circle where bacteria is better at fermenting food than you at digesting and absorbing it.
  4. Bacteria in the small intestine can enter the bloodstream and cause toxicity. The bacteria become an endotoxin and trigger an immune system attack that can cause fatigue, muscle pain, increased detoxification load on the liver, and neurological issues like mood fluctuations, anxiety, and depression.
  5. When you don’t digest food properly and have an inflamed and damaged gut, you’re going to develop food sensitivities. Read more about food sensitivity symptoms and testing here.

How to Treat SIBO

These are the common treatment options for SIBO:

  1. Antibiotics. That’s typically the route that a GI doctor will take. However, the antibiotics may wipe out the good and bad bacteria for up to 2 years. Botanical and herbal products are as successful at eliminating symptoms, evidenced by negative follow-up breath tests, with fewer side effects.
  2. Diet: there are several plans that help with SIBO. They all agree on removing carbohydrates that are fermentable by bacteria, as well as sugars and processed foods. Some eliminate all grains while others don’t. You may need a FODMAPs diet, SCD diet, or SIBO-specific diet. Keep in mind that the diet does not kill bacteria. It’s just starving it and reducing your discomfort.
  3. Botanical and herbal antimicrobials. I have used multiple products and protocols and I definitely have my favorites because they tend to cause fewer side effects. If your SIBO is stubborn or if your hydrogen or methane levels are very high, you may need to rotate antimicrobials.
  4. An elemental diet. This option is great if you can’t tolerate any foods and the botanical protocol is still not helping. However, this option has side effects as it’s not recommended for people with yeast overgrowth. You should not try to do an elemental diet on your own without supervision from a medical provider or dietitian who’s familiar with it.
  5. Probiotics. Many protocols discourage probiotics, and I agree that traditional probiotics may make things worse. However, I find that using one or a combination of certain probiotics, depending on the rest of your medical issues, is actually very important.


SIBO can be a very stubborn and complicated condition, and it’s always a good idea to work with a provider who knows how to help you. It can come back, so addressing the root causes and having a long-term prevention plan will spare you the frustration from dealing with it again. Fix it once, and fix it right!

If you’re ready to dive deeper into your health, get tested for SIBO, get a full gut assessment, and get a customized food and supplement plan to treat SIBO and any other condition or imbalance that could be happening and you don’t know it, let’s talk. Book a strategy session HERE.

Nour’s guidance and expertise was the key to dramatically halting our son’s [Crohn’s] disease progression! His pediatric gastroenterologist is now in agreement of our choice to treat solely with diet and supplements. All his labs have improved and his inflammatory markers are so low they are practically nonexistent.

Before working with Nour, I experienced intestinal pain off and on for for 54 years with minimal success on medications. I have benefited 100% from Nour’s program as I am now pain free!

A lot of time and money was wasted on foods that I thought would help my digestive struggles [diarrhea, bloating, hunger], but in fact I was making it worse. The main benefit is getting a handle on what negatively affects my digestive symptom. Doing a total 180 to my eating habits has been pretty amazing.