Have you ever had bloating so bad you literally couldn’t fit into your pants? Or had abdominal pain so severe that you’ve had to cancel plans? If so, you could have a condition known as small intestinal bacterial overgrowth or SIBO.

Today, we’re going to dive into exactly what small intestinal bacterial overgrowth is, the different types of SIBO, what causes this unpleasant condition, and most importantly – we’ll go over some scientifically-proven, and all-natural ways to heal the root cause of this overgrowth.

What Is Small Intestinal Bacterial Overgrowth? SIBO Explained 

Your digestive tract is home to trillions of different microorganisms that collectively make up what is known as your gut microbiome. The vast majority of this microscopic ecosystem is designed to reside within your large intestine (the final segment of your digestive tract) where they work in harmony with your own cells to break down nutrients, manufacture certain vitamins, and help your body eliminate waste.

But sometimes, these microbes can begin overpopulating and sneak their way into your small intestine – the uppermost segment of your intestines that serves as the connection between your stomach and your large intestine. You see, normally, your small intestine contains small populations of gram-positive bacteria which are generally considered beneficial or friendly bacteria. But in SIBO, there’s a shift from a small population of gram-positive bacteria to an excessive overgrowth of what’s known as gram-negative bacteria. 

Gram-negative bacteria are species of bacteria that contain compounds known as lipopolysaccharides or LPS – a powerful inflammation-stoking toxin. And it’s the influx of these gram-negative bacteria within your small intestine that causes the unpleasant symptoms seen in small intestinal bacterial overgrowth.

What Are the Symptoms of Small Intestinal Bacterial Overgrowth?

Symptoms of SIBO often show up in the form of:¹

• Abdominal pain and/or discomfort
• Bloating and abdominal distention
• Constipation
• Diarrhea
• Excessive gas – flatulence and/or belching
• Feelings of fullness or loss of appetite
• Indigestion and heartburn
• Nausea

Over time, SIBO’s impact on your digestive system can escalate – hindering your ability to digest food and absorb nutrients which can lead to more serious issues such as:¹

• Kidney stones
• Leaky gut syndrome
• Malabsorption 
• Vitamin and mineral deficiencies
• Weakened bones
• Weight loss

So what on earth causes these microbes to migrate into your small intestine in the first place?

SIBO Causes: What Is the Root Cause of Small Intestinal Bacterial Overgrowth?

SIBO is likely caused by a combination of underlying factors that creates dysfunction in your gut. You see, SIBO itself is really just the downstream manifestation of an upstream issue. Some underlying factors that may come together to trigger the development of SIBO include:^2,3,4,5,6

• Insufficient stomach acid: The acidic environment within your stomach is designed to kill off any microbes before they can make it to your small intestine. If you’re not producing enough stomach acid, some microbes may survive the passage through your stomach and make themselves at home within your small intestines.
• Decreased bile flow: Your bile is a natural antimicrobial that is designed to neutralize any microbes that might have survived your stomach. If the flow of bile is slowed or stopped, it can allow harmful gram-negative bacteria to begin invading your small intestines.
• Impaired gastric movement: Your digestive tract is constantly moving – ushering food and undigested materials through your digestive process until it can be excreted. If gastric movement is slowed or impaired, it gives bad bacteria more time to grow and proliferate.
• Gut dysbiosis: The ecosystem of microbes in your gut is designed to maintain a very delicate balance. If this balance becomes disrupted, bad bacteria can begin overpopulating your gut and crowd their way into your small intestines. 

The underlying dysfunction within your gut can allow a few distinct types of bacteria to invade your small intestine. And each of these organisms causes a specific subset or type of SIBO.

What Are the Different Types of Small Intestinal Bacterial Overgrowth?

There are three distinct types of SIBO, which include:

• Hydrogen dominant SIBO: The most prevalent form of SIBO, hydrogen dominant SIBO is characterized by an overgrowth of bacteria that produce hydrogen gas. This form of SIBO is often associated with looser stools and diarrhea.
• Methane dominant SIBO: Methane dominant SIBO occurs when the bacteria that invade your small intestines are primarily methane-producing strains. This SIBO type is usually associated with constipation and is sometimes also referred to as intestinal methanogen overgrowth. 
• Hydrogen sulfide dominant SIBO: Hydrogen sulfide dominant SIBO is characterized by the presence of hydrogen sulfide gas– which is produced when certain strains of bacteria in the small intestine consume the hydrogen gas made by other bacteria – subsequently generating hydrogen sulfide. This form of SIBO is typically associated with diarrhea, but can sometimes manifest as constipation as well.

While SIBO can indeed be caused by a mix of different microorganisms, each type is classified by the predominant strain or strains of bacteria that are triggering symptoms and thus producing a specific type of gas. So how exactly do we diagnose SIBO and determine which type of bacteria is the underlying culprit?

How Is SIBO Diagnosed? 

By far the best, most accurate way of detecting SIBO is through a breath test – during which you’re given a drink containing either glucose or lactulose. After consuming this drink, you’ll breathe into a balloon several times over the next few hours to test for the presence of the different forms of gas. But when it comes to SIBO breath tests, they are not all created equally.

You see, there is currently only one breath test available that can accurately detect all three forms of SIBO. Many traditional breath tests are only capable of detecting hydrogen and methane gas – making it impossible to ascertain whether or not hydrogen sulfide dominant SIBO is present. So, if you’re concerned about SIBO, it’s crucial to utilize a test known as Trio-Smart – the only breath test that can detect all forms of SIBO.

It’s important to note though, that even with accurate breath testing, SIBO can be tricky to diagnose. So it’s crucial to work with an experienced Integrative and Functional Medicine Doctor to be sure no stone is left unturned when it comes to identifying the root cause of your symptoms. And more importantly, working with a “root-cause” practitioner will help ensure that your SIBO is treated effectively.

So, What Is the Best Treatment for SIBO?

Conventional medicine often treats SIBO with a round of antibiotics to kill off the bacteria that are invading your small intestine. While this may work in the short term, the problem with antibiotics is two-fold – it doesn’t address the root of the problem and it can also wipe out your good bacteria and exacerbate imbalances in your gut. 

So while antibiotic treatment certainly has a time and a place, there is a better, gentler, all-natural, and equally effective protocol that can work wonders in treating all three types of SIBO. Here’s what I recommend:

Hydrogen and Hydrogen Sulfide SIBO Treatment

A clinically-proven 8 week protocol for both hydrogen dominant SIBO and hydrogen sulfide dominant SIBO includes:

Dr. Jill SB Oregano (3 Capsule Twice Daily): 

This patented formulation of oil of oregano extract contains a concentrated dose of antioxidants that supports gut health while aiding in eliminating undesirable microbes. By using micro-emulsion technology, this unique formula has unmatched bioavailability and absorption levels as well as a sustained release mechanism – creating a gradual release throughout the digestive tract to optimize exposure.

Dr. Jill SB Dysbio (2 Capsules Twice Daily):

This proprietary formula combines a carefully concocted blend of Eastern and Western herbs designed to provide synergistic, comprehensive support for a healthy gut. By supporting a thriving and diverse microbial ecosystem full of friendly bacteria and enhancing the the integrity of your gut barrier, SB Dysbio helps to restore balance and strengthen your defense against the harmful microbes that can trigger SIBO.

Dr. Jill SB Fungo (2 Capsules Twice Daily):

SB Fungo contains a fusion of herbal extracts that includes french tarragon, stinging nettle extract, olive, thyme, and more. Together, the unique constituents in this blend are clinically proven to:

• Have antimicrobial properties – helping to eliminate harmful microbes
• Break down and prevent the formation of pathogen-harboring biofilms
• Combat inflammation and promote healing
• Support a healthy, balanced, and diverse microbiome
• Serve as a potent antioxidant 

When combined, this trifecta of herbal formulations serves as a powerful weapon against hydrogen dominant and hydrogen sulfide dominant SIBO. And it’s equally effective at addressing methane dominant SIBO – which can be a little more challenging to treat.

Methane SIBO Treatment

For trickier methane SIBO, I recommend the above protocol with a slight addition:

• Dr. Jill SB Oregano: 2-3 capsules twice daily
• Dr. Jill SB Dysbio: 2 capsules twice daily
• Dr. Jill SB Fungo: 2 capsules twice daily
• Allimax Pro: 2 capsules twice daily (This extracted component of garlic has significant antimicrobial and immune boosting effects) 
• And/or Black Cumin Seed: 2 capsules twice daily (Black cumin seed oil is especially effective at balancing both immune and inflammatory responses)

Studies have found that this specific herbal protocol is equally as effective as rifaximin (the standard antibiotic used for SIBO) in the treatment of small intestinal bacterial overgrowth.⁷ While this botanical protocol is an excellent starting place when it comes to treating SIBO, it’s also important to address the root cause and restore balance to whatever dysfunction may have contributed to the development of SIBO in the first place. 

And accomplishing that requires incorporating some other all natural treatments and lifestyle adjustments. 

Other Ways to Treat SIBO Naturally

Addressing SIBO at the source requires a big-picture approach that helps restore optimal gut function. Some natural, easy-to-implement strategies that can provide relief and work together to heal the root cause of SIBO might include things like:

• Supporting stomach acid production: Avoid acid-suppressing medications and add in stomach acid-supporting supplements (like Digestzyme Complete) if needed.  
• Promoting bile production and flow: Support your production and flow of bile by giving your liver the support it needs to function optimally.
• Balancing your microbiome: Reset your microbiome by combining traditional probiotics with spore-based probiotics and support the integrity of  your gut lining with supplements like Gut Shield and Collagen Boost.
• Minimizing exposure to environmental toxins: Reduce the toxins in your life by making the switch to low-tox products and enhance your detoxification pathways with things like infrared sauna therapy, dry brushing, and detox binders.
• Prioritizing rest and relaxation: Prioritize logging plenty of high-quality sleep and be sure to take time to rest, have fun, and connect with others. 
• Focusing on a healthy, gut-friendly diet: Your diet can dramatically impact your gut health. So try building most of your meals around non-inflammatory, whole foods while avoiding processed foods. If you’re working with a practitioner they may recommend following a specific dietary protocol (like the low-FODMAP diet or the SCD diet) for a period of time as well.

By following a clinically proven herbal protocol and making some simple lifestyle tweaks, it’s absolutely possible to manage and heal the root cause of SIBO.

Are You Concerned About SIBO?

If you’ve been diagnosed with SIBO or are grappling with unexplained, ongoing digestive woes, it might be time to dig a little deeper into what’s going on. While the steps outlined in this article are an excellent place to start, I cannot overemphasize the importance of working with an Integrative and Functional Medicine Practitioner. They will work to pinpoint an accurate diagnosis and help you come up with a comprehensive, personalized plan for healing – shortcutting your path to relief and a happy, healthy gut.

While working with a practitioner is invaluable, at the end of the day, you are your own best advocate – and knowledge is your most powerful tool in defending your health. This is why I’m so dedicated to providing you – my patients and readers – with science-backed, easy-to-understand information. So if you’re looking for more ways to stay educated and empowered, be sure to browse through my blog, check out my YouTube Channel, and sign up for my weekly newsletter (all you have to do is enter your name and email address in the form below). 

And if you’re looking to dive a little deeper, need a little nudge of encouragement, or need a reminder that you’re never alone in this journey, be sure to check out a copy of my brand new book Unexpected: Finding Resilience Through Functional Medicine, Science, and Faith. My hope is that this book not only provides a practical roadmap for a vibrantly healthy life, but also inspires you to create an extraordinary life full of love, resilience, and adventure. Because a truly healthy life means you’re thriving body, mind, and soul.

Now it’s time to hear from you. Were you surprised to learn about some of the underlying factors that can contribute to the development of SIBO? If you’ve healed from SIBO, what strategies do you feel helped you the most? Leave your questions and thoughts in the comments below!

Resources:

1. Small Intestinal Bacterial Overgrowth – PMC (nih.gov)
2. The Effect of Ursodeoxycholic Acid on Small Intestinal Bacterial Overgrowth in Patients with Functional Dyspepsia: A Pilot Randomized Controlled Trial – PMC (nih.gov)
3. Low Stomach Acid – Fact or Fiction? – The Functional Gut Clinic
4. Small Intestinal Bacterial Overgrowth – PMC (nih.gov)
5. Small intestinal microbial dysbiosis underlies symptoms associated with functional gastrointestinal disorders – PMC (nih.gov)
6. SIBO (Small Intestinal Bacterial Overgrowth): Symptoms, Diet, Causes & What it Is (clevelandclinic.org)
7. Herbal Therapy Is Equivalent to Rifaximin for the Treatment of Small Intestinal Bacterial Overgrowth – PMC (nih.gov)