How to Treat SIBO (small intestine bacterial overgrowth)?

What is SIBO (small intestinal bacterial overgrowth)?

Small intestinal bacterial overgrowth is referred to as SIBO. It indicates that your small intestinal bacteria are out of control and that the mechanisms that usually keep the flora in your gut in balance aren’t functioning. Although having bacteria in your small intestine is natural and healthy, having too many of the wrong kinds might interfere with digestion. By consuming foods that aren’t intended for them, the incorrect bacteria can disturb your digestive system by outnumbering the helpful bacteria that you need to have there.

How does SIBO occur?

Your body uses a sophisticated network of chemical and mechanical processes to keep the bacteria in your gut in balance. One or more of these processes must be malfunctioning for SIBO to take place. Some of the substances that regulate bacteria in the small intestine include gastric acid, bile, enzymes, and immunoglobulins. These chemical processes can be inhibited by many circumstances. Another significant cleansing mechanism is the passage of food particles from the small intestine into the large intestine. The small intestinal bacteria have more time to multiply and the big intestine bacteria may start to migrate upward if this mechanism is slowed down or compromised.

What are the symptoms of SIBO?

SIBO symptoms can mirror a number of different gastrointestinal disorders, and frequently, another disorder has influenced the development of SIBO. Depending on how severe your disease is, you might encounter a few or all of them:

  • Abdominal pain.
  • Nausea.
  • Abdominal distension.
  • Bloating.
  • Gas.
  • Diarrhea.
  • Indigestion.
  • Unintentional weight loss.
  • Constipation.
  • Fatigue.


You might undergo tests to look for bacterial overgrowth in your small intestine, inadequate fat absorption, or other issues that may be causing or contributing to your symptoms in order to identify small intestinal bacterial overgrowth (SIBO). Common tests consist of:

  • Breath analysis. This noninvasive test gauges how much hydrogen or methane you exhale after consuming a glucose and water solution. Your small intestine may have bacterial overgrowth if your exhaled hydrogen or methane levels suddenly increase. Breath testing, despite being readily accessible, is less accurate than other kinds of tests for identifying bacterial overgrowth.
  • Small intestine aspirate and fluid culture. The gold standard test for bacterial overgrowth right now is this one. Doctors insert an endoscope, a long, flexible tube, down your throat, past your upper digestive tract, and into your small intestine to collect a fluid sample. A sample of intestinal fluid is taken, and the presence of bacteria is then examined in a lab.

Your doctor might also advise blood tests to check for vitamin deficiencies or stool tests to check for fat malabsorption in addition to these procedures. In some circumstances, your doctor can advise imaging tests to look for structural abnormalities of the intestine, such as X-rays, CT scanning, or magnetic resonance imaging (MRI).

SIBO Treatment

You must restore balance to your gut flora in order to treat SIBO. It should help your body absorb more nutrients from your food and lessen your symptoms.

The outcome of your breath test might affect the course of treatment. The antibiotic rifaximin is the principal treatment if your sample had a lot of hydrogen (Xifaxin). If your test revealed elevated methane levels, you’ll likely take rifaximin together with the antibiotic neomycin (Mycifradin).

Other antibiotics that treat SIBO include:

  • Amoxicillin-clavulanic acid (Augmentin)
  • Ciprofloxacin (Cipro)
  • Metronizadole (Flagyl)
  • Norfloxacin (Noroxin)
  • Trimethoprim-sulfamethoxazole (Bactrim)

Soil-based probiotics for SIBO

In a small trial with 60 participants, it was found that probiotic bacillus clausii containing all four strains helped reduce SIBO. Its effects on SIBO patients were compared to those of taking an antibiotic in a 2007 research.

  • Reducing side-effects of antibiotics
  • Diversifying your microbiome
  • Preventing and treating diarrhea

Bacillus Coagulans

Due to its beneficial effects on gut health, including preventing the growth of pathogenic bacteria, facilitating excretion and digestion through the secretion of enzymes, and restoring normal immune function, probiotic bacillus coagulans is regarded as one of the best probiotics for SIBO and a hot topic in the medical community.

It’s possible that you’ll need to take antibiotics for longer than a week or two. Additionally, your doctor may alternate between various types.

Your body may not be able to absorb enough iron, vitamin B12, thiamine, or niacin as a result of SIBO. Supplements could be useful.

If a physical issue with the intestine is the cause of the SIBO in certain people, surgery may be necessary. If so, you should visit your doctor frequently following the procedure to monitor your gut health.

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