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Emily Wolbers, ND

All About SIBO


SIBO, small intestinal bacterial overgrowth, is one of my specialties in terms of what I treat. SIBO occurs when there is too much bacteria in the small intestine. Today's post will highligh symptoms of SIBO, Risk Factors for Developing SIBO, and Naturopathic Treatment Options.

Bacterial overgrowth can cause symptoms such as:

  • Bloating

  • Gas

  • Abdominal pain

  • Constipation and/or diarrhea

  • Nausea

  • Heartburn

SIBO is a common cause of IBS, and they often present with the same symptoms. SIBO can also cause symptoms outside of the GI tract, such as:

  • Headaches

  • Fatigue

  • Joint pain

  • Depression

  • Anxiety

  • Skin disorders

SIBO can occur from a variety of causes. It's important find the root cause of SIBO, which helps prevent it from coming back. Risk factors for developing SIBO include:

  • Food poisoning or traveler's diarrhea

  • Traumatic Brain Injury or Spinal Injury

  • Past use of antibiotics

  • Past alcohol & drug abuse

  • Autoimmune disorders, such as, Ehler's-Danlos syndrome, scleroderma, Hashimoto's/hypothyroid

  • Pelvic disorders - Endometriosis, Pelvic Inflammatory Disease, pelvic or abdominal surgery and/or radiation treatment

  • Perforated appendix

  • Not being breast fed

  • Past use of Proton Pump Inhibitors (and a long list of other drugs!)

This list is long, which is why a thorough medical history is important to find and treat the root cause of symptoms. SIBO is diagnosed with a breath test, called a lactulose breath test. Lactulose is a sugar that humans can't digest, but bacteria can. When bacteria eat this sugar, they produce gas, either methane or hydrogen. The breath test measures these gases and helps diagnose bacteria in the small intestine.

If a breath test shows you have SIBO, there are LOTS of options for treatment.

  • Herbs - my favorite treatment option: treatment takes 4-8 weeks with very little side effect potential

  • Antibiotics - a 2 week protocol with pharmaceuticals

  • Elemental Diet - a fasting protocol with a powdered drink as your main source of calories for 2-4 weeks

  • Dietary recommendations - helps prevent SIBO from recurring

  • Prokinetic - a supplement that keeps things moving in the GI tract to further prevent bacterial overgrowth

If you think you may have SIBO, or at least want my doctorly opinion, please reach out. I'd love to help!​

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