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Functional Medicine Sibo

Functional Medicine Sibo

By Dr. Patrick Lovegrove Medically Reviewed by Lindsay Langley, BSN, RN, CHT
Posted Wednesday, January 31st, 2024
Functional Medicine Sibo

Introduction to SIBO (Small Intestinal Bacterial Overgrowth)

If you’ve been experiencing digestive issues such as bloating, abdominal pain, and diarrhea, you may have heard of SIBO (Small Intestinal Bacterial Overgrowth). Understanding what SIBO is, its causes, and how it is diagnosed can help you take control of your health and find relief from your symptoms.

Definition and Causes of SIBO

If too many bacteria are in the small gut, SIBO will happen. Usually, the small intestine has a relatively low number of bacteria compared to the large intestine. But some things can throw this balance off, which can cause too many germs to grow. These factors include:

  1. Impaired Motility: Conditions that slow food movement through the digestive system, such as intestinal adhesions or certain medications, can contribute to SIBO.
  2. Structural Abnormalities: Structural abnormalities in the small intestine, such as strictures or diverticula, can create pockets where bacteria can accumulate and grow.
  3. Low Stomach Acid: Insufficient stomach acid can allow bacteria to survive in the small intestine instead of being killed off.
  4. Dysfunction of the Ileocecal Valve: The ileocecal valve typically prevents the backflow of bacteria from the large intestine into the small intestine. If this valve is not functioning correctly, it can contribute to SIBO.

Symptoms and Diagnosis of SIBO

The symptoms of SIBO can vary but commonly include bloating, abdominal pain or discomfort, diarrhea or constipation (or both), and excessive gas. These symptoms may worsen after eating certain types of carbohydrates.

To diagnose SIBO, your healthcare provider may perform a breath test to measure your breath’s hydrogen and methane gas levels. Elevated levels of these gases can indicate the presence of SIBO. Other diagnostic tests may also be used, such as small intestine aspirate and culture.

By understanding the definition, causes, and symptoms of SIBO, you can work with your healthcare provider to develop an appropriate treatment plan and find relief from your digestive issues.

Understanding Functional Medicine Approach

Functional medicine and its role in treating SIBO

Suppose you are struggling with SIBO (Small Intestinal Bacterial Overgrowth). You may have tried various treatment options with limited success in that case. That is where functional medicine comes in.

The idea behind functional medicine is that health problems should be treated at their root, rather than just treating the signs. Regarding SIBO, functional medicine practitioners aim to identify and address the root causes contributing to the overgrowth of bacteria in the small intestine.

Unlike conventional medicine, which often relies on antibiotics to treat SIBO, functional medicine takes a more comprehensive approach. It involves personalized treatment plans that may include dietary changes, supplementation, lifestyle modifications, and addressing other factors contributing to the condition.

The Importance of Identifying Underlying Causes

Finding and treating the root causes of a health problem is one of the most essential ideas in functional medicine. Many things can cause too many bacteria to grow in the small intestine in SIBO.

These underlying causes can include impaired gut motility, low stomach acid production, structural abnormalities in the digestive system, food intolerances, and imbalances in gut microbiota. Functional medicine tries to eliminate the signs of SIBO and restore balance in the gut by finding and treating these underlying issues.

In addition to treating the underlying causes, functional medicine optimizes overall health and well-being. It may involve supporting digestion and nutrient absorption, making the gut flora healthier, and lowering inflammation.

By taking a personalized and comprehensive approach, functional medicine offers a promising alternative for individuals struggling with SIBO who have not found relief through conventional treatments. If you are dealing with SIBO, talking to a functional medicine practitioner could help you take a more complete and personalized approach to your health.

Diet and Nutrition for SIBO

Specific Carbohydrate Diet (SCD)

If you are dealing with Small Intestinal Bacterial Overgrowth (SIBO), following a specific diet can help manage your symptoms and promote healing. One popular diet for SIBO is the Specific Carbohydrate Diet (SCD). This diet focuses on eliminating complex carbohydrates that can feed the bacteria in your small intestine. Instead, it emphasizes simple carbohydrates that are easier to digest.

The SCD encourages the consumption of fresh fruits, vegetables, meats, and certain dairy products. It restricts the intake of grains, processed foods, sugars, and dairy products. By following the SCD, you can reduce the food sources available to the bacteria in your small intestine, helping to alleviate symptoms like bloating, gas, and diarrhea.


Another dietary approach for managing SIBO is the Low FODMAP diet. FODMAPs are a group of carbs that some people have trouble absorbing. They can contribute to symptoms such as bloating and abdominal pain. The Low FODMAP diet avoids high FODMAP foods like certain fruits, vegetables, grains, and dairy products.

By eliminating these high-FODMAP foods from your diet, you can reduce the fermentation and gas production in your gut, which can help alleviate SIBO symptoms. To ensure you follow the Low FODMAP diet correctly and get all the nutrients you need, you must work with a doctor or registered dietitian.

Other Dietary Approaches for SIBO

In addition to the SCD and Low FODMAP diets, other dietary approaches may be beneficial for managing SIBO. These include:

  • Probiotics: Consuming probiotic-rich foods or taking probiotic supplements can help bring the bacteria in your gut back into balance.
  • Herbal antimicrobials: Certain herbs like oregano, berberine, and neem have antimicrobial properties that can help reduce bacterial overgrowth in the small intestine.
  • Digestive enzymes: Taking digestive enzyme supplements can aid digestion and absorption of nutrients, reducing the food sources available to the bacteria in your small intestine.

Remember that talking to a doctor or nurse is essential before starting new vitamins or making big changes to your diet. They will be able to give you personalized advice based on your needs and help you develop a complete treatment plan for SIBO.

Herbal Treatments for SIBO

Suppose you’re dealing with Small Intestinal Bacterial Overgrowth (SIBO). In that case, you may be looking for natural remedies to help alleviate your symptoms. One option worth considering is herbal treatments. These can provide relief and support your body’s natural healing process. Here are some common herbal remedies for SIBO that you might find helpful.

Common Herbal Remedies for SIBO

  1. Peppermint Oil: Researchers have found that peppermint oil can help stop the growth of germs that are too much in the small intestine. It can also help relieve symptoms such as bloating and abdominal pain.
  2. Oregano Oil: Oregano oil contains compounds like carvacrol and thymol, which have antimicrobial properties. These compounds can help kill off the small intestine’s excessive bacteria and alleviate SIBO symptoms.
  3. Garlic: People know that garlic can kill germs and it can help keep gut bacteria from growing too much. It can also help soothe inflammation in the gut system because it is an anti-inflammatory.

Effectiveness and Safety of Herbal Treatments

While herbal treatments can effectively manage SIBO symptoms, it’s important to note that they may not completely eradicate the bacterial overgrowth. They are best used with other treatments, such as dietary changes and probiotics.

Additionally, talking to a medical worker before beginning any herbal treatment plan is essential, as they can guide dosage and potential interactions with other medications.

Additionally, it’s important to note that herbal remedies may only suit some. Some people may have allergic responses or stomach problems when they use specific herbs. It’s always best to start with a low dose and monitor your body’s response.

In conclusion, herbal treatments can be valuable to your SIBO management plan. They can help reduce symptoms and support your body’s natural healing process. However, working with a healthcare professional is crucial to ensure safety and effectiveness.

Antibiotic Therapy for SIBO

Types of Antibiotics used for SIBO treatment

Suppose you are struggling with Small Intestinal Bacterial Overgrowth (SIBO). Your healthcare provider may recommend antibiotic therapy as part of your treatment plan. Several antibiotics can effectively target and eliminate the overgrowth of bacteria in your small intestine.

  1. Rifaximin: This is the most commonly prescribed antibiotic for SIBO. It works by selectively targeting the harmful bacteria in your small intestine while leaving the beneficial bacteria in your gut intact. Rifaximin has significantly relieved SIBO symptoms, such as bloating, abdominal pain, and diarrhea.
  2. Neomycin: Neomycin is another antibiotic often used with Rifaximin for more severe cases of SIBO. It has a broader spectrum of activity and can effectively target a more comprehensive range of bacteria.

Benefits and Risks of Antibiotic Therapy

While antibiotic therapy can be highly effective in treating SIBO, it is essential to consider the benefits and risks before starting this treatment option.


  • Reduction in SIBO symptoms: Antibiotics can help alleviate bloating, gas, abdominal pain, and diarrhea.
  • Improved gut health: Antibiotic therapy can restore a healthier gut flora balance by eliminating the overgrowth of bacteria in the small intestine.
  • Enhanced nutrient absorption: Antibiotics can help the body absorb nutrients better, which is good for general health and well-being.


  • Development of antibiotic resistance: Antibiotic-resistant bacteria can form when drugs are used too much or incorrectly.
  • Disruption of gut microbiome: Antibiotics can also throw off the balance of good bacteria in the gut, which could cause other stomach problems.
  • Side effects: Like any medication, antibiotics can have side effects such as nausea, vomiting, and diarrhea.

Working with your doctor to find the best drug treatment for your SIBO is crucial. They will look at things like how bad your symptoms are, what treatments you’ve had in the past, and any underlying health problems.

Probiotics and SIBO

Probiotics and their role in SIBO treatment

If you’re dealing with Small Intestinal Bacterial Overgrowth (SIBO), you may have heard about the potential benefits of probiotics. Bacteria and yeasts that are still alive and good for you are called probiotics. They can help get the balance of bacteria in your gut back to normal, which is very important for treating SIBO.

When you have SIBO, there is an overgrowth of bacteria in your small intestine, leading to symptoms like bloating, gas, diarrhea, and abdominal pain. Probiotics can help by introducing beneficial bacteria into your gut, crowding out the harmful bacteria causing the overgrowth.

Studies have shown that some probiotics can help lower SIBO symptoms and make the gut healthier. They can help normalize the gut flora and improve digestion, relieving uncomfortable symptoms.

Choosing the Right Probiotics for SIBO

When selecting probiotics for SIBO treatment, choosing strains specifically studied and proven effective for this condition is essential. Look for probiotics that contain strains such as Lactobacillus plantarum, Bifidobacterium infantis, or Saccharomyces boulardii.

It’s also crucial to consider the dosage and formulation of the probiotic. Higher doses may be needed to combat SIBO effectively, so look for products that provide adequate live bacteria per serving.

Additionally, consider the delivery method of the probiotic. Enteric-coated capsules or time-release tablets can be beneficial as they protect the beneficial bacteria from stomach acid, ensuring they reach the small intestine where they are needed most.

Before starting a new supplement plan, you should talk to a doctor or nurse, especially if you already have a health problem or are taking medicine.

In conclusion, probiotics can help a lot with SIBO because they smooth out the bacteria in the gut. Choosing the suitable strains, dosage, and formulation is critical to maximizing their effectiveness.

Lifestyle Changes for SIBO Management

Exercise and SIBO

Suppose you are dealing with SIBO (Small Intestinal Bacterial Overgrowth). So, you might be wondering what changes you can make to your lifestyle to better deal with your problems. Adding regular exercise to your schedule is an important thing to think about.

It has been shown that exercise is good for your gut health and can help ease the signs of SIBO. Here’s how exercise can help:

  1. Improves Gut Motility: Exercise stimulates the muscles in your digestive tract, promoting better food movement through the intestines. It can help prevent bacteria buildup in the small intestine, reducing the risk of SIBO.
  2. Reduces Stress: Stress has been linked to gut issues, including SIBO. Regular exercise is a great way to reduce stress levels, releasing endorphins and promoting relaxation.
  3. Boosts Immune Function: Exercise strengthens your immune system, making it more resilient against bacterial overgrowth. A robust immune system can help prevent the development of SIBO and reduce the severity of symptoms.

Sleep and SIBO

Another meaningful lifestyle change to consider for managing SIBO is improving sleep habits. Quality sleep is crucial in maintaining a healthy gut and overall well-being. Here’s why sleep is essential for managing SIBO:

  1. Restores Gut Health: During sleep, your body repairs and restores various systems, including the digestive system. Getting enough sleep allows your gut to heal and function optimally.
  2. Regulates Hormones: Sleep deprivation can disrupt hormone balance, leading to imbalances in gut bacteria. Adequate sleep helps regulate hormones that affect gut health, reducing the risk of SIBO.
  3. Reduces Inflammation: Lack of sleep has been associated with increased inflammation in the body, including the gut. Chronic inflammation can contribute to the development and persistence of SIBO symptoms.

By incorporating regular exercise and prioritizing quality sleep, you can make significant lifestyle changes that support SIBO management. Remember to consult with a healthcare professional for personalized advice and treatment options.

Other Treatment Options for SIBO

Digestive Enzymes and SIBO

If you’re struggling with SIBO (Small Intestinal Bacterial Overgrowth), you may seek alternative treatment options to complement your current regimen. One potential option to consider is the use of digestive enzymes.

Digestive enzymes are naturally occurring substances in your body that help break down food and aid digestion. They can be taken as supplements to support the digestive process and alleviate symptoms associated with SIBO. These enzymes can help break down carbohydrates, proteins, and fats, reducing the workload on your digestive system.

Regarding SIBO, specific enzymes may be beneficial in targeting the overgrowth of bacteria in the small intestine. For example, proteolytic enzymes can help break down protein-based biofilms that may contribute to SIBO symptoms. Additionally, certain enzymes like amylase and lipase can aid in the breakdown of carbohydrates and fats, respectively.

Supplements for SIBO

In addition to digestive enzymes, various supplements may help manage SIBO symptoms. These supplements are designed to address the underlying causes of SIBO and promote a healthy balance of gut bacteria.

One commonly recommended supplement for SIBO is berberine. Berberine is a natural compound found in certain plants. It has been shown to have antimicrobial properties against bacteria associated with SIBO. Another supplement often used is oregano oil, which also possesses antimicrobial properties.

Probiotics can also play a role in managing SIBO. While it may seem counterintuitive to introduce more bacteria into an already overgrown environment, certain strains of probiotics are beneficial in restoring a healthy balance of gut flora.

It’s important to note that these treatment options should be discussed with a healthcare professional familiar with SIBO. Based on your needs, they can help you determine the right amount to take and how long to take.

Everyone’s experience with SIBO is unique, so finding the right combination of treatments may require trial and error. Along with the help of a medical professional, you can try these other choices to get relief from SIBO symptoms.


So, you’ve learned about the various treatment options for SIBO and the importance of an individualized approach in Functional Medicine. Now, it’s time to take action and find a healthcare provider who can help you on your journey to better gut health.

Summary of SIBO treatment options

When it comes to treating SIBO, there are several options available. These include:

  1. Antibiotics: This is the most common treatment for SIBO. Antibiotics can help reduce the overgrowth of bacteria in the small intestine and alleviate symptoms.
  2. Herbal antimicrobials: Natural herbs with antimicrobial properties can also effectively treat SIBO. They can help kill off the excess bacteria and restore balance in the gut.
  3. Dietary changes: Making dietary changes is crucial in managing SIBO. A low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet can help reduce symptoms and prevent bacterial overgrowth.
  4. Probiotics: Certain strains of probiotics can help restore a healthy balance of bacteria in the gut. However, working with a healthcare provider is essential to determine which strains are best for your case.

Importance of Individualized Approach in Functional Medicine for SIBO

Functional medicine takes a personalized approach to healthcare, focusing on the individual rather than just the disease. It is essential when treating SIBO because everyone’s gut microbiome is unique.

By working with a Functional Medicine practitioner, you can undergo comprehensive testing to identify the root cause of your SIBO and develop a tailored treatment plan that addresses your specific needs. This individualized approach can lead to more effective and sustainable results in managing SIBO.

Finding the right healthcare provider specializing in Functional Medicine is critical to successfully treating SIBO. They will guide you through the process, provide support, and help you achieve optimal gut health.

About the author

Dr. Patrick Lovegrove