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Women suffering from SIBO, causing digestive discomfort.

Understanding SIBO


Irritable Bowel Syndrome (IBS) is a common disorder of the digestive tract that can cause gas, bloating, abdominal cramping, diarrhea and/or constipation. Naturopathic doctors have always been great at treating this common problem and now the understanding of a common condition called SIBO (pronounced see-bow) is providing more relief for many people.

What is it?

SIBO stands for “small intestinal bacterial overgrowth”. Science is learning more and more about the importance of the bacteria in our digestive tract. We now know that the amount and types of beneficial bacteria in our large intestines play a hugely important role in our health. We are also learning that when it comes to the small intestine, it is possible to have too much of a good thing. SIBO is the result of having an abnormally large amount of bacteria present in the small intestine.

What are the symptoms?

Some of the main symptoms of SIBO include: abdominal bloating – especially after meals or at the end of the day, excessive burping or flatulence, a sensation of fullness and slow digestion, nausea, heartburn, chronic diarrhea (or loose stools) and/or constipation.

What other conditions is SIBO related to?

There are many health conditions that have been connected to SIBO. Here are just a few: inflammatory bowel disease, leaky gut, B12 and iron deficiency, chronic fatigue syndrome, celiac disease, acne rosacea, fibromyalgia, hypothyroidism, and interstitial cystitis.

How do we test for SIBO?

SIBO is diagnosed using a breath test. The patient is asked to eat a special diet for the day before the test and then fasts for 12 hours (overnight). The next day, breath sample is taken and then the patient drinks a liquid sugar called lactulose. Breath samples are then taken every 20 minutes for 3 hours. Using the presence of different gases we can understand the types and amounts of bacteria in the small intestine.

How is SIBO treated?

There are a few steps to SIBO treatment. The first step is to decrease the numbers of bacteria in the small intestine. We do this by using herbs that kill bacteria and sometimes a short course of a specific antibiotic known for its use in treating SIBO. Usually patients feel much better almost immediately when we put them on this treatment. This treatment is followed by many strategies to help the root cause of the SIBO in the first place so that the problem does not return. Usually, there are dietary suggestions to discourage regrowth of the bacteria. We also look at many ways to help support proper digestion including proper movement in the digestive tract.


Dr. Alexis Blanks is a naturopathic doctor who would be happy to help you with any digestive issue you may have, including SIBO. She is co-owner of Flourish Naturopathic at Moss Healthcare.

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