You might have gas and bloating, alternating constipation and diarrhea, or reflux for a number of reasons. These symptoms are hallmarks of many underlying conditions.
But if you feel full after eating just a few bites of food…
If you feel gassy after taking probiotics…
If fiber actually seems to make your constipation worse…
If your gut tends to feel better when you’re on a round of antibiotics…
If you have chronically low levels of iron but you’ve never found a good reason for it…
…Then you might have SIBO.
What SIBO Is
The main difference between SIBO and other forms of dysbiosis is that in SIBO, the overgrown bacteria aren’t “bad,” they’re just in the wrong place (the small intestine instead of the large intestine). This is a problem because most of your nutrient absorption occurs in the small intestine. If you’ve got a lot of bacteria that aren’t supposed to be there also, they’ll compete with you for your nutrients. This can mean nutrient deficiencies, and lots of gas and bloating as by-products of bacterial fermentation.
SIBO seems to occur due to decreased gut motility. This can happen for a number of reasons, including high blood sugar (which can lead to gastroparesis), hypothyroidism, or ileocecal valve dysfunction.
Testing involves a breath test (either lactulose or glucose).
SIBO Treatment: The Herbs Work!
The traditional treatment for SIBO are antibiotics—either Rifaximin or Rifaximin and Neomycin. While I try not to prescribe antibiotics except when absolutely necessary, I have less of an issue with these two because neither are systemically absorbed, cause minimal disruption to gut flora, and have very low side effect profiles. Unfortunately, Rifaximin is still under patent and is quite pricey.
The good news is that there are alternatives—specifically, in this study, a combination of berberine and essential oils are shown to be just as effective as the antibiotics.
Unfortunately, SIBO tends to recur after treatment, whether with herbs or with antibiotics. Prokinetic treatment (medications or herbs that help speed up bowel transit) can help to prevent this, but long-term, it’s also necessary to correct the underlying cause of slow bowel motility.