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What You Need To Know About SIBO + How To Fix It

William Cole, IFMCP, DNM, D.C.
Functional Medicine Practitioner By William Cole, IFMCP, DNM, D.C.
Functional Medicine Practitioner
Will Cole, IFMCP, DNM, D.C., is a leading functional medicine practitioner with a certification in natural medicine and a doctor of chiropractic degree.
What You Need To Know About SIBO + How To Fix It

SIBO, an acronym for Small Intestinal Bacterial Overgrowth, has been a term increasingly on people's radar, especially in the health blogosphere. But like the terms adrenal fatigue or leaky gut, what is SIBO, and why should you care?

What is SIBO?

With the exciting research coming out about gut health and the microbiome, SIBO has become better understood. Your gut is comprised of the small and large intestines. During the night and in between meals, your gut normally has a function called the migrating motor complex (MMC), which pushes gut bacteria down into the large intestines.

Typically, when there is a decreased function of the MMC, the bacteria can grow up into the small intestines where it doesn't belong; here comes SIBO.

The bacteria will eat what you eat, fermenting the food in the wrong area, causing gas, swelling and, eventually, "leaky gut syndrome," which is linked to many chronic and autoimmune conditions. Now you can see why SIBO is a big deal to your health!

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Common SIBO Gut Symptoms:

  • Constipation
  • Diarrhea
  • Irritable Bowel Syndrome (IBS)
  • Cramping
  • Gas
  • Nausea
  • Acid Reflux/Heartburn/GERD

Because your gut controls 80% of your immune system and can regulate your mood and genetic expression, we're just beginning to see the far reaching associations between SIBO and autoimmune conditions like autoimmune thyroiditis (Hashimoto's), skin conditions like rosacea, chronic conditions like diabetes and seemingly unrelated conditions like fibromyalgia.

Six steps to help manage SIBO:


1. Compile a complete health history.

NSAID use and SIBO appear to be associated, though the relationship is not totally clear; past food poisonings, chronic gut infections and prior intestinal surgeries can also disturb the gut and could be of interest to a medical professional. Getting a complete health history can help rule determine whether SIBO may be a factor.

2. Seek out comprehensive diagnostic testing.

Functional medicine is concerned with the underlying mechanisms of the health condition. The lab I run on my patients is a fasting lactulose breath test which measures the gases (methane and hydrogen) released by the bacterial overgrowth.


3. Try an intermittent fasting protocol.

Sometimes I will design a specific intermittent fasting protocol, where the patient limits food intake for a short period of time to starve out the bacterial overgrowth. There is no one-size-fits all approach, and this doesn't work for everyone.

4. Avoid high-FODMAP foods.

FODMAP stands for Fermentable Oligo-, Di-, Monosaccharides And Polyols. Some foods that are high in FODMAPS are onions, cabbage, beans, apples and rye. These foods can aggravate SIBO. Monash University, a leader in research on this topic, has a great app to help you stick to low FODMAPs. Again, a customized approach is very helpful.


5. Avoid snacking.

Allowing time between meals is a small modification that can allow the migrating motor complex to work more efficiently.

6. Take probiotics.

A combination of Bifidobacteria, Enterococcus and Lactobacillus has been shown to have a positive effect on irritable bowel syndrome. Avoid probiotics that contain prebiotics, which can feed the bacterial overgrowth.

As always, seek help from a medical professional to treat any symptoms you experience.

William Cole, IFMCP, DNM, D.C.
William Cole, IFMCP, DNM, D.C.
Will Cole, IFMCP, DNM, D.C., is a leading functional medicine expert who consults people around the...
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