What is SIBO? 6 FAQs You Should Read Today!

September 1, 2020

We’ve talked about the importance of healthy gut bacteria, and how there’s good bacteria and bad bacteria. But what happens if you have too much bad bacteria, particularly in your small intestine, known as small intestinal bacterial overgrowth (SIBO)?

The scary truth of the matter is that SIBO is grossly under diagnosed, yet it’s responsible for many of the common digestive complaints we see today.

Let’s discuss some of the top questions about SIBO and uncover some of the reasons why it’s so under diagnosed, review the top symptoms, and more!



Here are six of the most frequently asked questions about SIBO.

1. What is SIBO?

SIBO, or small intestinal bacterial overgrowth, is simply having an excessive amount of bacteria in your small intestine. It occurs where there’s a disruption to the mechanisms that control the amount of bacterial allowed in your small intestine.

You see, your small intestine is highly regulated, so it’s sensitive to any changes such as bacterial overgrowth, which, in turn, produces symptoms.

2. What Causes SIBO?

Now, any disturbance in your gut immune function or any abnormality in your GI tract can increase your likelihood of developing SIBO. [1] These include:

  • Low stomach acid.
  • GI motility disorders.
  • Poor immune function.
  • Irritable bowel syndrome (IBS).
  • Antibiotic overuse.
  • Stress.
  • Certain diseases, such as celiac, Crohn’s, lupus, and/or diabetes (types 1 and 2).

As you can see, anything that impacts your GI system can also impact your small intestine and potentially cause SIBO.

3. What Are the Top Symptoms of SIBO?

At this point, you’re likely wondering how to spot signs of SIBO, especially if you have any of the potential causes listed above.

Here are the most common symptoms: [2]

  • Diarrhea or constipation
  • Bloating/distention
  • Increased flatulence
  • Abdominal discomfort
  • Fatigue
  • Nausea
  • Unexplained/unintended weight loss

4. Why is SIBO So Under diagnosed?

SIBO was originally believed to impact only a limited number of people. But more recent findings have shown that this condition is far more prevalent.

In fact, scientific studies have found that up to 20 percent of healthy, asymptomatic people may actually have SIBO! [3] But the lack of symptoms isn’t the only reason it's under diagnosed.

SIBO symptoms are very closely related to another very common condition: IBS. In fact, studies have found that many IBS symptoms actually mimic the symptoms of SIBO.

For example, one study found that out of 202 patients, almost 80 percent met the criteria for an IBS diagnosis but also showed test results suggesting they actually had SIBO! [4]

Meanwhile, another double-blind study confirmed this finding. The researchers revealed that while only 20 percent of healthy volunteers showed test results indicating they had SIBO, that number jumped to 84 percent for those who also met the criteria for IBS! [5]

With IBS affecting 11 percent of the world’s population, it’s easy to see how the similar symptoms of SIBO could easily be mistaken for it. Between this factor and the fact that up to 20 percent of those with SIBO display no symptoms, it's easy to see why it's under diagnosed.


SIBO - Dr. Pingel


5. How is SIBO Diagnosed?

SIBO is officially diagnosed by a breath test in your doctor’s office. This test is known as the Lactulose Breath Test and assess the function of bacteria in your gastrointestinal (GI) system.

When the bacteria in your GI system digest food, a gas is produced. And this gas travels through your blood stream and into your lungs. Specifically, the Lactulose Breath Test assesses the levels of hydrogen and methane you exhale. The higher these gasses, the more likely you have SIBO. [6]

6. What Can I Do to Help Improve SIBO?

Due to the facts that IBS and SIBO symptoms are so closely related and IBS is a well-known stress-induced syndrome, focusing on a diet that supports your body’s stress response may very well support the health of your small intestine.

Fortunately, this type of diet is full of anti-inflammatory foods, which have been shown to support overall gut health.

I recommend consuming a plant-based diet of nutrient-rich whole foods in a predictable pattern. This not only helps to reduce cortisol levels, which helps to support your body’s stress response, but also helps to fight inflammation.

In fact, studies have shown that consuming plant-based diets produces predictable positive shifts in gut bacteria and lower the amount of harmful bacteria in your gut! [7]

To learn more about how to get started, click here.

Key Takeaways

  • SIBO, or small intestinal bacterial overgrowth, is grossly under diagnosed, yet it’s responsible for many of the common digestive complaints we see today.
  • It's often caused by GI conditions such as low stomach acid, poor GI motility, or IBS. It's also been linked to stress, poor immune function, antibiotic overuse and certain diseases such as celiac, Crohn's, lupus, diabetes, and more.
  • Some of the top reported symptoms include diarrhea and/or constipation, bloating, gas, stomach pain, fatigue, nausea, and unexplained weight loss.
  • If you're looking to improve SIBO, consuming a diet full of plant-based foods that support you body's stress response.
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