Is SIBO the cause of your Bloating?

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What is SIBO and could it be the reason you constantly experience bloating?

SIBO is an acronym standing for Small Intestinal Bacterial Overgrowth.  So an overgrowth of bacteria, not necessarily “bad”, in your small intestine.   It is estimated that 85% of people with IBS (Irritable Bowel Syndrome) have SIBO as their underlying cause.

Magnifying glass showing bacteria or virus cells in the human digestive system, digestive tract or alimentary canal. Possibly good bacteria or gut flora such as that encouraged by pro biotic products

Ideally almost all our bugs should be hanging out in the large intestine, and the small intestine should be relatively sterile.   This displacement can wreak havoc on your health as it can lead to leaky gut syndrome, liver overload, immune issues and potentially brain toxicity.  Cotton wool head anyone?

SIBO often goes on unchecked for years on end as it is still relatively new as a diagnosis in the medical community.  Plus, even though its annoying and uncomfortable, most people are still able to carry on their day to day lives.  I often hear my clients say they have learnt to live with it over the years, “I just have a sensitive stomach”.

Doesn’t have to be that way.

The bloating is often occurring as a result of fermentation.  Fermentation is a metabolic process that converts sugar to acids, gases, or alcohol.  The gas build up leads to the bloat.  Often the six months pregnant bloating when all you are incubating is food, not a baby.  The favourite food that the bacteria like to ferment are certain types of carbohydrates, namely fructose and sorbitol in fruits, lactose in dairy, and fructans in wheat or onions.

What are the main symptoms of SIBO?

(Could be one or all)

  • Bloating, especially if gets progressively worse throughout the day
  • Food intolerances
  • Constipation and/or diarrhoea
  • Abdominal pain
  • Reflux or indigestion
  • Excessive gas or belching
  • Fatigue
  • Morning stiffness
  • Out of control cravings
  • Eczema and other skin conditions
  • Worse for taking probiotics and prebiotics

Risk Factors for getting SIBO?

So many, main ones include:

  • Irritable bowel syndrome or other digestive diseases like Coeliac’s, Crohn’s, or Ulcerative colitis
  • History of antibiotics (even as long ago as when you were two years old)
  • Any episode of food poisoning
  • Period of high stress
  • Low levels of stomach acid
  • Pancreatic insufficiency
  • Drugs, such as opiates
  • Any disease that slows functioning of the digestive system, i.e. Diabetes, Hypothyroidism

How to Diagnose SIBO?  

Currently, the best form of diagnosis is the Lactulose Hydrogen Breath Test.  Certain countries require a prescription from your GP, but anyone can order it through SIBO Test.  SIBO Test is the company I use for testing, they send kits out world-wide.

Diagnosis of SIBO is really important as it will determine your most appropriate treatment protocol.  Treating bloating without SIBO has so many more options, treating bloating with SIBO is very specific and targeted.

How to Treat SIBO?

Dietary modifications

(These are as a treatment adjunct, diet alone is almost never enough to clear SIBO completely) 
It is also important to note that many of these recommendations are quite restrictive and aren’t designed to be followed long term.  Clear the SIBO, then begin re-introducing.  

  • FODMAP DietSIBO Food list
  • SCD Diet
  • SIBO Specific Food Guide
  • GAPS Diet
  • Dr Siebeckers Home Made Elemental Diet
  • Avoid alcohol – if you must your best choices would be clear spirits and no more than 30ml 2x weekly
  • Caution with pre and probiotics
  • Caution with fermented foods such as sauerkraut and kimchi
  • Aim to space meals 4 – 5 hours apart.  This helps with your Migrating Motor Complex (sweeping wave that goes through your small intestine every 90 minutes – but stopped by eating).
  • Avoid drinking with meals.  This can dilute your stomach acid levels and digestive enzymes.  Great to “flush” your body with one litre of water on rising – digestive system is at its emptiest and can help to clear your digestive tract.

Antibacterial and Antimicrobial herbs

This depends on the type of SIBO you may have, i.e. Hydrogen or methane dominant.  Another reason why testing is a great idea.

Some of my favourites include:




Oregano – enteric coated

Iberogast for motility and improving digestion.

A “round” of herbals would usually be 4 to 6 weeks.   High doses are often needed to smash  SIBO, so check in with your practitioner.


This wouldn’t be my first recommendation as they nuke everything, good and bad, and the relapse rate tends to be quite high after antibiotics.
Knowledge is power though and can help you to make informed decisions, so here you go:

H2 (hydrogen) Predominant SIBO: Xifaxan
Methane Predominant SIBO Xifaxan plus neomycin or tindamax


What then?

Once you’ve cleared your SIBO it is important to figure out how you might’ve got it in the first place, so that you can prevent it from coming back. Unfortunately “relapses” can occur if not addressed correctly.

Parting piece of advice would be to begin your own food journal. Noting down foods eaten and any symptoms which may be occurring. So much easier to make connections when it’s noted down. The one I have available for download on my website can help you get an idea of what to look out for. Sometimes food intolerances can take 2-3 days to show up so bear this in mind.

If your bloating is not resolving or comes back as soon as you deviate from your “safe foods”, it would be a great idea to book yourself in to see your health care practitioner. From there you can investigate further to come up with a personalised treatment protocol for you and your specific needs…don’t be scared to look for a second opinion if your current practitioner has not yet heard of SIBO. It’ll be worth your time and effort to connect with one that has.

While I have been busy clearing my own SIBO, I have also been busy taking Urban Remedies online. I now do the majority of my consultations via Skype, helping clients world wide with their health. If you would like to work with me you can book yourself in anytime through my online booking system and we can get started straight away!

Life is so much better when your digestive system is happy.


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Kirsten Swales

Director and Naturopath at Urban Remedies
Kirsten is a qualified Naturopath, Nutritionist, Medical Herbalist and Yoga Instructor passionate about health. Kirsten loves to help people from all over the world so she is now operating as an Online Naturopath and consultant. It makes her incredibly happy to share her knowledge and help her clients to do all the nourishing things necessary for themselves. Kirsten's areas of expertise include all things Digestive System, such as SIBO, (Small Intestinal Bacterial Overgrowth), IBS, Bloating, Food Intolerances, Crohns, Celiacs, Candida and Parasites. Bookings can be scheduled through her website (including a complimentary 30 minute Discovery Call).

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