SIBO:  A common but overlooked cause of IBS

 Have you been diagnosed with Irritable Bowel Syndrome (IBS), but still suffer from it despite treatment?  You may have Small Intestine Bacterial Overgrowth (SIBO).  SIBO is a very common cause of IBS.  SIBO accounts for over half of IBS cases and up to 84% in one study.  Hydrogen breath tests are used for diagnosis.1

What is SIBO? 

SIBO is a condition where bacteria (and other microorganisms) live in the small intestine in abnormally high numbers.   This can be due to a variety of factors:   history of antibiotic, antacid or proton pump inhibitors (PPI’s) usage, low digestive secretions, moderate to heavy alcohol usage,  carbohydrate malabsorption, and/or anything affecting gastrointestinal motility.  Symptoms include:  bloating, belching, gas, abdominal pain, constipation and/or diarrhea, heartburn, nausea, osteoporosis, headache, fatigue, joint/muscle pain, and various skin conditions.2

How is SIBO diagnosed?

The most common method to date for diagnosing SIBO is hydrogen/methane breath testing.  Following a preparatory diet, breath samples may be taken either at home, at a medical setting or at a lab.  Stool analysis, which is widely used for other gastrointestinal conditions, has no diagnostic value.3

How is SIBO treated?

Conventional medical approaches include antibiotics, elemental diet or both.The elemental diet is based on nutrient powders available commercially or homemade.   Natural medicine approaches include specific antibiotics that stay in the intestines and/or herbs and various diets, such as GAPS or CSD, which restrict carbohydrates, as bacteria use carbohydrates for energy.



1Lin HC, et al.  Small intestinal bacterial overgrowth:  a framework for understanding irritable bowel syndrome.  JAMA.  2004 Aug 18; 292(7):852-858.

2Sandberg-Lewis S.  Siebecker A. Townsend Letter.  2015 Feb-Mar 379/380 (2):67.


4Pimental M.  A New IBS Solution.  Sherman Oaks, CA; Health Point Press; 2006.

52Sandberg-Lewis S.  Siebecker A. Townsend Letter.  2015 Feb-Mar 379/380 (2):71.

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