Overview
SIBO occurs when bacteria that normally live in the large intestine colonize the small intestine in excessive numbers. This interferes with normal digestion and nutrient absorption. SIBO is increasingly recognized as an underlying cause of IBS-like symptoms and nutritional deficiencies.
Symptoms
Bloating and abdominal distension
Excessive gas and flatulence
Diarrhea or alternating diarrhea and constipation
Abdominal cramps
Deficiencies of B12, iron, or fat-soluble vitamins (A, D, E, K)
Unexplained weight loss
Common Causes
Slow intestinal motility (gastroparesis, hypothyroidism)
Structural abnormalities (adhesions, diverticula)
Low stomach acid (proton-pump inhibitor use)
Immune deficiency
Prior intestinal surgery
Celiac disease or Crohn's disease
Self-Care Tips
Take the full course of prescribed antibiotics (rifaximin is commonly used)
Address the underlying cause — treat motility disorders or structural issues
Follow a low-FODMAP or specific carbohydrate diet during treatment
Correct nutritional deficiencies with appropriate supplements
Probiotics may help maintain remission — discuss with your doctor
Minimize long-term PPI use if not medically necessary
When to See a Doctor
SIBO can mimic IBS exactly — if you've been told you have IBS but respond poorly to standard treatment, ask about SIBO breath testing. Treatment requires prescription antibiotics and management of the underlying cause.
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