SIBO Part I: What is it & How Do I Know if I Have it?

We know that bacteria are essential for a healthy gut biome, performing a number of functions that affect everything from metabolic function to immunity, to how we perceive the world. But there are instances when the same bacteria that help us with digestion and fighting off nasty infections can turn against us in a condition called SIBO.  

Small Intestinal Bacterial Overgrowth (SIBO) is a condition in which there is an increase in the number of bacteria found in the small intestine. The increase in bacteria may be an overgrowth of what is normally found in the small intestine, but more commonly, it is the result of bacteria finding their way from the large intestine into the small intestine.

Sounds harmless? It’s not.

Inhabitants of the large intestine have taken up residence in the small intestine.

SIBO has been shown to cause damage to the small intestine, resulting in nutrient malabsorption, nutrient deficiencies, inflammation, allergies, food sensitivities and leaky gut, which is involved in autoimmune conditions and other chronic disease. Because the bacteria have the ability to inactivate (deconjugate) bile, fat malabsorption and deficiencies in fat soluble vitamins can also occur. So, how do you know if you suffer from SIBO?

Common Symptoms Caused by SIBO:

  • Gas/ Bloating
  • Heartburn/ GERD
  • Constipation
  • Diarrhea
  • Irritable Bowel Syndrome (IBS)
  • Nausea
  • Abdominal Pain/ Cramps
  • Joint Pain
  • Fatigue
  • Anemia-B12 or Iron
  • Fat Malabsorption/ Steatorrhea
  • Weight Loss

It is estimated that upwards of 84% of people diagnosed with IBS test positive for SIBO.

84% of people diagnosed with IBS test positive for SIBO. Click To Tweet

Treating SIBO can be difficult because these bugs are smart.

I have a love-hate relationship with these bacteria. I love how smart they are and have a huge amount of respect for their survival tactics, but when they’re in your small intestine hijacking your food — I hate them.

You see, their objective is to create an environment in which they preferentially absorb important nutrients; for example, B vitamins and amino acids.

But how your gut functions can also make SIBO very difficult to treat.

Most people I see with SIBO have some degree of slow gut motility. What does that mean? Basically, your digestive system is a little slow in moving out waste.

If you have slow gut motility, any antimicrobial therapy, either pharmaceutical or herbal, will only be a temporary fix in symptoms until this underlying issue has been addressed.

I’ve helped many patients achieve permanent resolution of symptoms after having been frustrated with unsuccessful pharmaceutical or herbal antimicrobial therapy prescribed by other practitioners. The difference in my treatment approach is that I not only look to correct the bacteria levels and gut function, but I also look to what may have created the condition in the first place.

Risk Factors for Developing SIBO:

  • Diabetes I & II
  • Low Stomach Acid/ Use of Antacids
  • Pancreatic Insufficiency
  • Repeat Antibiotic Therapy
  • Celiac Disease
  • Bowel Surgery
  • Crohn's Disease
  • Oral Contraceptive Pills
  • Moderate to Heavy Alcohol Use
  • Constipation
  • Unmanaged Hypothyroidism

The test I order to confirm the diagnosis of SIBO is a fasting lactulose breath test. This test measures the amount of methane and hydrogen produced by bacteria. But knowing if you have SIBO is not enough. That is why I will often order blood work and/or other functional lab tests. I believe in a holistic approach and having a thorough understanding of who you are and what created your condition in the first place.

If you think that you or a loved one may be suffering from SIBO, please submit an application to become a patient today.

Follow the link to Learn More About SIBO Natural Treatments and Therapies.

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About The Author


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Dr. Jolene Brighten is a Functional Medicine Naturopathic Medical Doctor and the founder of Rubus Health, a women’s medicine clinic that specializes in women's hormones. She is recognized as a leading expert in Post-Birth Control Syndrome and the long-term side effects associated with hormonal contraceptives. Dr. Brighten is the best selling author, speaker and regular contributor to several online publications including MindBodyGreen. She is a medical advisor for one of the first data-driven apps to offer women personalized birth control recommendations.Read more about me.