SIBO-An Overview

The last year of my life was a learning experience with my health in regards to my IBS symptoms. Several times I felt like a living science experiment learning what foods I can eat, which I could not; which supplements work and which ones didn’t.  Like I said in my “In the beginning” post, I had been to a nutritionist and a gastroenterologist in search of answers.  Fortunately they were similar in their procedures and advice.

It wasn’t, however, until they both recommended the test for SIBO  (Small Intestine Bacterial Overgrowth) did things start making sense.  (Not everyone that has IBS has SIBO but it’s worth checking out.)  And just because things were starting to make sense (I finally had a “diagnosis” for the symptoms “in my head”) didn’t mean the road was going to be easy from there on out.

I had a diagnosis. Check.  Now what?  As my gastroenterologist, Dr. William Salt (he has his own book on IBS), explained, “the small intestine is still the black box of medicine.”  So that means there are still, to this day, unanswered questions to the inner workings of our gut. It wasn’t until the last few years that discoveries were made in regards to our overall health and our intestine and colon health. Discoveries like mind, gut connection, immune system and hormone function and leaky gut-leading to so many other disorders in the body. So the journey others have taken before me had paved the way for me to find the solution to a problem unknown until just a few years prior.  And my mission?  To make that path a little easier for YOU to maneuver.

So, where do we start?  Let’s go through this step by step.

Step 1. Find a doctor.  Go your GP only IF you need a referral to see a gastroenterologist.  OR find a gastro in your area, but research FIRST.  If possible, find someone who specializes in IBS and other gut issues.  You may have to go off the beaten path to find someone but it will be worth it, even if you have to file your own insurance or pay out of pocket.

Step 2.  Take the SIBO Breath Test. If guided to do so by the doctor of your choice, obtain a SIBO breath test from them and take at home.  The directions are fairly simple: limited diet the day before the test and fasting 12 hours prior to and during the test.  Just make sure you have no where to go till late afternoon until after the test.  The test involves a serious of 10 test tubes that you will breathe into deep from the gut every 20 minutes.  The first 7 tubes test the small intestine and after that it moves into the colon.

Below I have a copy of the test I took last August.  You can see that my levels were fine until I reached 120 minutes where my ppm CH4 (or Methane)  at 7ppm level exceeded the  3 ppm levels.  (See the orange highlighted area.)IMG_0597

Now if you test high in methane as I did that will mean you have IBS-C (constipation), if you test high in hydrogen (H2) then most likely you have IBS-D (diarrhea) AND if you test high in both then you most likely experience IBS-M or both constipation and diarrhea. (Lucky you…)

And according to my test, even though my methane levels weren’t extremely high, it was just enough to cause my symptoms of gut distress and constipation.

Finally I was getting somewhere!  And now that I had this diagnosis of an overgrowth of bacteria in my gut, what was I going to do about it??

Step 3:  The Treatment.

If you are like me you tend to overthink EVERYTHING, which can be good in some cases but not good if you want a fast treatment.  I have learned over the years to take what my doctors say with a grain of salt and research further.  Unfortunately in this case, it did bite me in the butt.  I ended up coming full circle around to what my gastroenterologist recommended.  I was just so used to getting non-specific answers that I couldn’t give up doing it on my own.

Here are the options: (Disclaimer: Please seek the advice and treatment from a medical professional.)

If you have been diagnosed with SIBO, here are your options:

  1. Oral antibiotics.  These include Rifaximin (Xifaxan), Nemycin (and/or Metronidazole).  I was not convinced at first if I wanted to take antibiotics because I ONLY want to use them when entirely necessary.  These, however, are NOT broad spectrum, meaning they will be limited and work only in the gut.
  2. Natural Antibiotics.  Oregano essential oil and other products such as Candibactin AR and Candibactin BR made by Metagenics. ( Please go to for instructions on use.)
  3. The Elemental Diet.  This is a method only for the extremely strong willed and those that may have a few pounds to shed.  It involves a fast with a very unpleasing tasting drink formulated with predigested carbohydrates, fats and proteins. (Sounds good, right?)  This is taken in place of meals for 2-3 weeks, depending on the severity of the SIBO. The idea is to give the body nutrients while not giving the gut any substance to feed on, therefore starving the bacteria.
  4. The SIBO fast.  This is the option I chose based on the fact that I was looking to HEAL the gut naturally, as well as starve and kill off the bacteria that had overgrown.  I liked the idea of the elemental diet but I wanted to keep the cost (and duration) to a minimum. There are different fasts you can try out there but I used the North Laguna Wellness Center’s instructions-just because someone I knew had them available for me step by step.  For this fast you will need 3 things.  Beef or chicken bones-minus the cartilage (organic grass-fed or free-range if possible), purified water and apple cider vinegar to make a bone broth. Put them in a crockpot, cover them with water, add a tablespoon of apple cider vinegar and cook on low for at least 24 hours.  If you go much longer than that the apple cider vinegar will start to break down the bones and cause a sandy sediment in the broth that you will have (or want) to strain out later.  Then drink up to 15 mugs a day for 2-5 days.  Yum!  (I lasted 4 days.) After the fast you begin to implement foods back in slowly as to not repopulate with too much bacteria. (More on this to come.)

Maintenance Keep in mind the levels of bacteria in your gut can fluctuate but here’s how to maintain that great gut feeling for the long term.

  1. Spread out your meals to every 4-5 hours.  Snacking in between meals hinders the full digestive process, causing an overgrowth of bacteria.
  2. For a while, cook down highly fibrous foods such as fruits and veggies.  Our guts employ bacteria to break down highly fibrous foods, therefore causing an overgrowth. (Ah, ha! and all that time I was told to EAT MORE FIBER!)
  3. Eliminate grains.  Oats, rice, breads, corn, quinoa, pasta-you know, all the yummy stuff. This includes while potatoes.  These foods ferment into sugar-some even seconds after placing them into the mouth!  Sugar feeds bacteria in the gut! I eat a lot of squash and cooked veggies. Get used to eating salads for breakfast!
  4. If you didn’t hate me for the last one you will hate me for this one! Keep SUGAR to minimum, especially right after treatment, then later keep them to a minimum.   (Ever have uncomfortable gut distention after eating ice cream or other desserts). Later stick to monosaccharides such as honey and fructose. (NOT high fructose corn syrup-that doesn’t count;)
  5. Use maintenance supplements like Motilpro (Pure Encapsulations) to help keep gut essentially cleaned out.
  6. If you HAVE to eat any of the above foods take Digestive Enzymes with a full glass of water BEFORE eating to help break down the food so it doesn’t linger in the gut.  It will also help you to feel better. You can find them at any health food store.
  7. TRY to NOT get overwhelmed. Take it step by step.

For more information on SIBO please visit by Allison Siebecker.

Thank you for joining me again today and wishing you happy health!  Join me on my next post where I will talk a little more about diet and food.








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