What is SIBO?

Small intestinal bacterial overgrowth (SIBO) is a clinical condition characterized by a malabsorption syndrome due to an increase in microorganisms within the small intestine.


SIBO symptoms mainly affect the gut. They may include:

  • pain in the stomach, especially after eating
  • bloating
  • cramps
  • diarrhea
  • constipation
  • indigestion
  • regular feeling of fullness
  • flatulence
  • weight loss


The main mechanisms restricting bacterial colonization in the upper gut are the gastric acid barrier, mucosal and systemic immunity and intestinal clearance. When these mechanisms fail, bacterial overgrowth develops.

When to see a doctor?

Bloating, nausea and diarrhea are signs and symptoms of many intestinal problems. See your doctor for a full evaluation — especially if you’ve had abdominal surgery — if you have:

  • Persistent diarrhea
  • Rapid, unintentional weight loss
  • Abdominal pain lasting more than a few days


SIBO is not yet well understood. It can occur when:

  • your small bowel has anatomic abnormalities
  • the pH changes in your small bowel
  • your immune system isn’t working properly
  • the muscular activity of the small intestine malfunctions, which means that food and bacteria aren’t removed from the organ

Risk factors

Having a chronic condition or surgery that affects the gastrointestinal (GI) tract can put you at risk of SIBO. Certain diseases and chronic conditions can also increase your risk, including:

  • Crohn’s disease
  • diabetes
  • scleroderma
  • HIV
  • Parkinson’s disease
  • hypothyroidism
  • medications that slow down the gut, such as narcotics


Small intestinal bacterial overgrowth (SIBO) can cause escalating problems, including:

  • Poor absorption of fats, carbohydrates and proteins
  • Vitamin deficiency
  • Weakened bones (osteoporosis)
  • Kidney stones

Tests and Diagnosis

  • Breath test

A breath test is a common test for diagnosing SIBO. Excess bacteria in the small intestine can lead to the release of the gases hydrogen and methane, which can be identified through a breath test. This test is noninvasive and can be performed at home or in a doctor’s office. You’ll need to fast overnight before having a breath test. During the test, you’ll breathe into a tube. You’ll then drink a special sweet drink provided by your doctor. You’ll breathe into a series of additional tubes at regular intervals for 2 to 3 hours after consuming the drink.

  • Aspiration and direct culture of the jejunal aspirate


  • Antibiotics Therapy
  • Diet changes


  1. Fruit Salad with Cilantro Lime Dressing


  • 2 cups organic blueberries
  • 1 cup organic raspberries
  • 1 cup halved organic green grapes
  • 1 cup cantaloupe
  • ¼ cup lime juice
  • ¼ cup honey
  • ¼ cup finely chopped cilantro (mint may be substituted)


  • Cut fruit into bite sized pieces and add to a large bowl.
  • In a separate bowl, mix the lime juice with honey until incorporated. Stir in the cilantro.
  • Before serving, add dressing to the fruit and stir.

  1. Tangy Red Cabbage


  • 4 pieces bacon, chopped
  • 1 small head cabbage, cored and thinly sliced
  • Tablespoon garlic oil
  • 7 Tablespoons red wine vinegar
  • 3 Tablespoons honey
  • ½ teaspoon cinnamon
  • 3 Tablespoons water or chicken stock
  • ¾ cup toasted walnuts


  • Chop bacon into small pieces and fry at medium high heat in medium pan until crispy.
  • Remove bacon and set aside.
  • Add garlic oil to the bacon fat.
  • When oil is hot, add cabbage. Sauté for 10 minutes until wilted.
  • Add vinegar, honey and cinnamon and stir to incorporate.
  • Add 3 tablespoons of water, stir and cover for 15 minutes until soft.
  • Remove cover, add bacon and cook for about 5 more minutes until soft and relatively dry.
  • Top with toasted walnuts.

Call Us to Book a Free Consultation

Ask a Question
Book An Appointment