SIBO: The Hidden Gut Problem That Will Wreck Your Health

Coconut Oil and MCTs: Unhealthy or Boost Health? Dr. Will Cole

There are many conditions that mainstream medicine has disregarded while the holistic community has worked to find solutions. Issues like leaky gut, adrenal fatigue, candida overgrowth, gluten intolerance, and fibromyalgia are finally gaining legitimacy as research uncovers more information about them.

Another one of these conditions is SIBO, an acronym for Small Intestinal Bacterial Overgrowth. Once questioned as a legitimate condition, science is now discovering that SIBO really can be a serious health issue for many people. So what is it, and what can you do about it if you think it affects you? Let’s explore.

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SIBO Defined

With the exciting research coming out about gut health and the microbiome, SIBO has become better understood. Your gut is comprised of the small and large intestines, and when you are not eating (during the night and in between meals), the migrating motor complex (MMC) pushes gut bacteria down into the large intestines, where most of it lives. However, sometimes this process can fail. In cases of decreased MMC function, bacteria meant to migrate grows up into the small intestines where it doesn’t belong. This is SIBO fatigue.

This wayward bacteria will eat what you eat, fermenting the food in the wrong area, causing gas, swelling, and eventually, “leaky gut syndrome,” which is linked to many chronic and autoimmune conditions. Nobody wants that!

SIBO Gut Symptoms:

  • Constipation
  • Diarrhea
  • Irritable bowel syndrome (IBS)
  • Cramping
  • Gas
  • Nausea
  • Acid Reflux/heartburn/GERD

Because your gut controls 80% of your immune system (1) and can regulate your mood and genetic expression, we’re just beginning to see the far reaching associations between SIBO and autoimmune conditions like autoimmune thyroiditis (Hashimoto’s), skin conditions like rosacea, (2) chronic conditions like diabetes, and seemingly unrelated conditions like fibromyalgia. Fortunately, you can take steps to avoid SIBO fatigue, or even reverse it.

The Seven-Step Plan to Reverse SIBO:

1. Get your health history compiled

NSAID use and SIBO appear to be associated, (3) though the relationship is not totally clear; past food poisonings, chronic gut infections, and prior intestinal surgeries can also disturb the gut and could be of interest to a medical professional.

2. Get diagnostic testing

The lab I run on my patients is a fasting lactulose breath test which measures the gases (methane and hydrogen) released by the bacterial overgrowth. This can determine whether you have those bacteria growing in the wrong place.

3. Fast intermittently

An intermittent fasting protocol, where the patient limits food intake for a short period of time to starve out the bacterial overgrowth, can be an effective attack on SIBO. There is no one-size-fits all approach, and this doesn’t work for everyone, so I advise working with an experienced health professional if you want to try this.

4. Avoid high-FODMAP foods

FODMAP stands for Fermentable Oligo-, Di-, Monosaccharides And Polyols, and these specific carbohydrates can be a problem for some people because they feed gut bacteria and encourage them to proliferate.

Some foods that are high in FODMAPS are onions, cabbage, beans, apples, and rye. Monach University, a leader in research on this topic, has a great app to help you stick to low FODMAPs. Again, a customized approach is very helpful because you may only have a problem with some of these foods and not others.

5. Quit snacking

If you eat all the time, you may not be giving your migrating motor complex a chance to kick in. Allowing more time between meals is an easy way to encourage the MMC to work more efficiently.

6. Try herbal antibiotics

My favorite herbal antibiotics include extracts form oregano, goldenseal, uva ursi, and garlic, among others. This is an anecdotal gut overgrowth bomb that can be a powerful piece of the SIBO solution.

7. Take probiotics

Probiotics containing a combination of Bifidobacteria, Enterococcus, and Lactobacillus have been shown (4) to positively affect irritable bowel syndrome, and may aid in rebalancing your microbiome population. Avoid probiotics that contain prebiotics, which can feed the bacterial overgrowth.

As always seek help from a medical professional to treat any symptoms you experience.

If you want to learn more about your own health case please check out our free health evaluation. We offer webcam as well as in-person consultations for people across the country and around the world.

Photo: Stocksy


  1. Furness JB, Kunze WA, Clerc N. Nutrient tasting and signaling mechanisms in the gut. II. The intestine as a sensory organ: neural, endocrine, and immune responses. Am J Physiol. 1999;277(5):G922‐G928. doi:10.1152/ajpgi.1999.277.5.G922
  2. Parodi A, Paolino S, Greco A, et al. Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication. Clin Gastroenterol Hepatol. 2008;6(7):759‐764. doi:10.1016/j.cgh.2008.02.054
  3. Muraki M, Fujiwara Y, Machida H, et al. Role of small intestinal bacterial overgrowth in severe small intestinal damage in chronic non-steroidal anti-inflammatory drug users. Scand J Gastroenterol. 2014;49(3):267‐273. doi:10.3109/00365521.2014.880182
  4. Fan YJ, Chen SJ, Yu YC, Si JM, Liu B. A probiotic treatment containing Lactobacillus, Bifidobacterium and Enterococcus improves IBS symptoms in an open label trial. J Zhejiang Univ Sci B. 2006;7(12):987‐991. doi:10.1631/jzus.2006.B0987

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Dr. Will Cole, IFMCP, DNM, DC, leading functional medicine expert, consults people around the world via webcam and locally in Pittsburgh. He received his doctorate from Southern California University of Health Sciences and post doctorate education and training in functional medicine and clinical nutrition. He specializes in clinically researching underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Dr. Cole was named one of the top 50 functional medicine and integrative doctors in the nation and is the best selling author of Ketotarian and The Inflammation Spectrum.

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