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SIBO Explained


SIBO Explained

March 6, 2015

SIBO, or Small Intestinal Bowel Overgrowth, is a chronic bacterial infection that affects the lining of the small intestine resulting in a “leaky gut”. When our gut is working normally, as we digest food the bacteria gets transported along to our large intestine to be eliminated. If this system is disrupted and bacteria is leftover in the small intestine, we may begin to see these signs.

10 Signs of SIBO

  • Abdominal bloating/gas
  • Abdominal cramps
  • Anemia
  • Constipation or diarrhea
  • GERD/nausea
  • Fatigue
  • Skin rashes
  • Depression
  • Food intolerance
  • Weight gain/loss


There is no perfect test and a diagnosis can often be made from a patient’s history and symptoms. Hydrogen breath test – the gold standard. Breath testing measures hydrogen and methane gases produced by bacteria in the small intestine that have diffused into the blood. Patients drink a sugar solution of lactulose (distal overgrowth) or glucose (proximal overgrowth) after a 1-2 day elimination diet removing likely food triggers like sugar and carbohydrates. Interpretation of the results from doctors vary widely and no universal standard exists. Dysbiosis test – It tests the by-products of yeast and bacteria to determine overgrowth in the small intestine. A simple urine collection is all that is required. Comprehensive stool test – A functional medicine test that determines levels of gut inflammation, diversity of gut bacteria, and pathogenic yeast and/or bacteria.


There is a four-pronged approach to treatment, commonly known as the 4R therapy in functional medicine.

  1. Remove – Avoid common food triggers like gluten, dairy, corn, and sugar which increase inflammation in the gut.
  2. Replace – Add back essential ingredients that have been depleted like digestive enzymes and hydrochloric acid.
  3. Re-inoculate – Reestablish a healthy balance of good bacteria with a high dose, broad spectrum probiotics.
  4. Repair – Heal the leaky gut lining with amino acids like L-glutamine and herbal supplements like aloe vera, berberine, and marshmallow root.

We recommend working closely with a functional medicine doctor to determine your personalized treatment plan if you are suffering from any of the above symptoms.

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