WTF Is SIBO? Digesting The Details: Unpacking SIBO From Diagnosis to Healing
Gut health has been a hot topic for a while now—and for good reason! I firmly believe that our gut is the guardian of our overall health and well-being. Often called our "second brain," it plays a crucial role in everything from digestion to mood, influencing countless bodily functions in ways you likely don’t even realize.
At the end of 2022, after numerous visits to gastroenterologists and months of battling chronic digestive issues, extreme fatigue, brain fog, mood swings, and anxiety—not to mention an overwhelming sense of helplessness—I finally discovered the culprit: Small Intestinal Bacterial Overgrowth, better known as SIBO. Now, you might be wondering, what on earth is that? Trust me, I was asking the exact same thing. So let’s break it down:
Small Intestinal Bacterial Overgrowth, or SIBO, occurs when bacteria that typically thrive in other parts of the gut (like the large intestine) take up residence in the small intestine, where they don’t belong. This bacterial overgrowth throws digestion off balance and interferes with proper nutrient absorption, triggering a cascade of debilitating symptoms. These can range from mild to severe bloating (and trust me, I’m talking SEVERE), abdominal pain, diarrhea, constipation, excessive gas, and even unexplained weight fluctuations. In my case, the nutrient malabsorption caused noticeable weight loss. But SIBO’s effects go beyond the digestive system—it can lead to systemic issues like extreme fatigue, brain fog, skin conditions (think eczema, rosacea, and acne), hair thinning or loss from malnutrition, and mood disturbances, all thanks to the intricate gut-brain connection. Unfortunately, SIBO is often misunderstood and misdiagnosed, leaving many people feeling lost and desperate for answers.
So, how do you know if you have SIBO? Here’s the deal: diagnosing SIBO starts with understanding your symptoms and working with a healthcare provider who really gets it – personally, I recommend working with a functional/integrative practitioner.
I had the privilege of working with an incredible practitioner through Parsley Health, and let me tell you—it was a game-changer. The good news is functional and integrative precision healthcare is a rapidly growing field of medicine and there are plenty of forward-thinking practices out there now. Think Function Health (co-founded and led by Dr. Mark Hyman), The Lanby, and Wild Health, just to name a few. These practices take a holistic, cutting-edge approach to getting to the root of your health issues and guiding you to an optimal state of total body wellbeing.
Depending on your symptoms, your practitioner will suggest a range of tests to get to the root of the issue. For diagnosing SIBO, breath testing is the go-to, but don’t sleep on the power of a stool test for a more comprehensive gut health picture. My personal favorite? The GI-MAP stool test—it’s like a full-on report card for your gut, breaking down all the bacteria (good and bad) so you can pinpoint exactly what's out of balance. This level of detail is crucial because there are different types of SIBO to consider: hydrogen-dominant (the more common variety) and methane-dominant (less common but trickier to spot since most traditional GIs rely solely on breath testing). Knowing which type you’re dealing with is the key to getting the right treatment plan.
Treatment plans for SIBO can vary widely, depending on your symptoms and personal preferences. A popular option is the antibiotic Rifaximin, which effectively targets and eliminates bad bacteria in the small intestine. However, like any antibiotic, it can also wipe out some of the good bacteria, so it’s crucial to use it as part of a broader strategy: 1) eliminate the overgrowth, and 2) rebuild and support a healthy, thriving microbiome with probiotics, prebiotics, and gut-friendly foods.
But antibiotics aren’t your only option! Many people find success with a low-FODMAP diet, which limits fermentable carbohydrates that feed bacteria in the small intestine. It’s a temporary and structured eating plan designed to starve out the overgrowth while reducing symptoms like bloating and gas. The key here is that it’s temporary and it’s essential to work with a knowledgeable practitioner and/or nutritionist who can guide you throughout the elimination and reintroduction phases. There are also herbal antimicrobials like oregano oil, berberine, and allicin (from garlic), which can be just as effective as antibiotics for some people, without the risk of wiping out beneficial bacteria. These herbal options are often paired with dietary adjustments and gut-supporting supplements to optimize healing.
In my own experience, I found that Rifaximin caused more digestive distress than relief. After a rough time with it, I decided to pivot to a more holistic approach: using herbal antimicrobials, focusing on a nutrient-rich diet, incorporating supplements where needed, and, most importantly, working to regulate my nervous system and reduce stress. This multi-pronged approach not only addressed the root cause but also helped me support my body’s overall healing process. Ultimately, the best treatment plan is the one tailored to your body and guided by a knowledgeable practitioner who can help you navigate the options and restore balance to your gut.
SIBO might seem overwhelming at first, but trust me—it’s manageable once you understand what you’re dealing with and have the right support system in place. The journey to healing isn’t one-size-fits-all, and that’s okay. Whether you opt for antibiotics, herbal antimicrobials, dietary changes, or a combination of these approaches, the key is finding what works for you and giving your body the time and tools it needs to heal. Addressing SIBO isn’t just about eliminating the overgrowth—it’s about restoring balance, building a resilient gut microbiome, and supporting your overall well-being. With the right plan, a great practitioner by your side, and a little patience, you’ll be on your way to better health. Better yet, you’ll gain an even deeper appreciation for the role your gut plays in your overall health AND you’ll learn just how capable your body is of healing if given the chance.
Lots of love,
Rach
