What Is SIBO? Symptoms, Causes, Testing & Diagnosis

Table of Contents:

• What Is SIBO?
  • SIBO Symptoms
  • What Causes SIBO?
• How to Know If You Have SIBO
  • SIBO Testing & Diagnosis
• How to Treat SIBO: The 3-Step Protocol
• The Last Word
• FAQs

Do you feel bloated after meals, even when you eat healthy foods? Does your stomach feel tight or uncomfortable by the end of the day? These symptoms are common but are often dismissed or labeled as IBS. In many cases, there is a deeper root cause.

I have worked with thousands of patients who struggled with chronic bloating, gas, and digestive discomfort. Many of them were told their labs were normal or that their symptoms were something they had to live with. I have also experienced gut health challenges in my own journey with autoimmunity. That experience shaped how I approach root-cause medicine today and led me to develop the SIBO Support Protocol.

First, let’s review what SIBO is and the common symptoms associated. Then I’ll walk you through testing and treatment steps.

What Is SIBO?

SIBO stands for small intestinal bacterial overgrowth. It occurs when bacteria from the large intestine move into the small intestine and multiply. This condition is more common than many people realize. It is also frequently missed or misdiagnosed.

I often describe your gut as a rainforest. When balanced, it supports digestion, immune health, and nutrient absorption. When disrupted, this balance shifts.

In a healthy gut, most bacteria live in the large intestine. With SIBO, they migrate into the small intestine, where they do not belong. There, they ferment food too early in digestion. This process creates gas and irritation.

Over time, this overgrowth can damage the gut lining. It may also lead to biofilm formation. Biofilms are protective layers that help bacteria survive. This makes the overgrowth more difficult to address.(1) This is one of the reasons I developed Biofilm Disruptor.

SIBO Symptoms

SIBO symptoms can affect digestion and overall health. Here are the most common signs:

1. Gas, bloating, and diarrhea
   Fermentation in the small intestine produces hydrogen or methane gas.
2. Abdominal pain or cramping
   Inflammation in the gut can cause discomfort.
3. Constipation
   More common with methane-dominant SIBO.
4. IBS or IBD diagnosis
   Many individuals with IBS may also have SIBO.
5. Food intolerances
   Common triggers include gluten, dairy, and high-histamine foods.
   Gut inflammation can contribute to leaky gut, allowing particles into the bloodstream.
6. Chronic illness and autoimmunity
   Increased intestinal permeability may trigger immune responses through molecular mimicry.
7. Vitamin and mineral deficiencies
   Damage to the gut lining can reduce nutrient absorption.
8. Fat malabsorption
   This can lead to pale, bulky stools.
9. Skin concerns such as rosacea
   Inflammation in the gut can appear on the skin.

If probiotics that contain lactobacillus or bifidobacterium worsen your symptoms, this may be a sign of SIBO. That’s why I always recommend a soil-based probiotic such as Primal Earth Probiotic if you have SIBO. 

What Causes SIBO?

Several factors can contribute to bacterial overgrowth:

• Impaired gut motility
  Conditions that slow digestion can allow bacteria to remain in the small intestine.
• Structural changes
  Scar tissue or diverticula can trap bacteria.
• Medications
  Antibiotics, acid blockers, and steroids can disrupt gut balance.(2)
• Diet high in sugar and refined carbohydrates
  These foods feed bacterial growth.

Hydrogen and Methane SIBO

Bacteria produce gases during fermentation:

• Hydrogen is often linked to diarrhea
• Methane is often linked to constipation

Both forms can cause bloating and discomfort.

How to Know If You Have SIBO

You may wonder how to know if you have SIBO. Start with your symptoms and health history.

You may suspect SIBO if:

• You have ongoing bloating or gas
• You were diagnosed with IBS and did not improve
• You have multiple food sensitivities
• Probiotics worsen your symptoms
• You have unexplained nutrient deficiencies

Testing can help confirm the diagnosis.

SIBO Testing & Diagnosis

Here are four common testing methods to help determine if you have SIBO or not:

1. Breath Test
   This is the gold standard. It measures hydrogen and methane gas levels after a sugar solution. I recommend the Lactulose Breath Test from Aerodiagnostics.
2. Organix Dysbiosis Test
   A urine test that detects byproducts of bacteria or yeast.
3. Comprehensive Stool Test
   Evaluates overall gut health and bacterial balance.
4. Clinical Assessment
   A detailed symptom review can provide strong insight.

How to Treat SIBO: The 3-Step Protocol

I use a three-step approach to support gut balance, which can also be found as part of the SIBO Support Protocol.

Step 1: Starve the Bacteria

Remove foods that feed bacterial overgrowth:

• Sugar and alcohol
• Refined carbohydrates
• Grains and legumes
• Dairy
• Fermented foods

Focus on AIP-compliant foods such as:

• Grass-fed meats
• Wild-caught fish
• Non-starchy vegetables
• Healthy fats such as olive oil and coconut oil

Step 2: Support Microbial Balance

This step focuses on supporting a healthy microbial environment.

Targeted supplements such as Microb-Clear® and a Biofilm Disruptor are designed to support microbial balance and gut health. Charcoal Binder Complete can support the body’s natural detox pathways.

Step 3: Restore the Gut

Rebuilding the microbiome is essential. Many probiotics can aggravate symptoms in individuals with SIBO. Soil-based probiotics are often better tolerated than Lactobacillus-based probiotics.(3) Primal Earth Probiotic supports a healthy gut environment without adding to bacterial overgrowth. This type of probiotic also survives stomach acid and actually reaches your intestines.

You can find Primal Earth Probiotic, Microb-Clear®, Biofilm Disruptor, and Charcoal Binder Complete included in the SIBO Support Protocol, which provides overall guidance, supplements, and support throughout each phase of eliminating SIBO.

The Last Word

SIBO can affect your digestion, energy, and overall health, often going unrecognized. When you understand what SIBO is and address the root cause, improvement is possible.

With the right nutrition, targeted support, and a clear plan, you can restore balance in your gut. Following the SIBO Support Protocol provides the specific guidance you need to get back on track with your gut health. 

FAQs

• What is SIBO, and what causes it?
  SIBO is small intestinal bacterial overgrowth. It occurs when bacteria grow in the small intestine. Common causes include poor gut motility, medications, structural issues, and diet.
• What are the most common SIBO symptoms?
  Common SIBO symptoms include bloating, gas, abdominal pain, diarrhea or constipation, food sensitivities, and nutrient deficiencies.
• How do I know if I have SIBO vs. IBS?
  SIBO and IBS share many symptoms. If your symptoms persist or worsen with standard care, SIBO may be the underlying cause. Testing can help to confirm.