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Small Intestinal Bacterial Overgrowth (SIBO)

SIBO is a leading cause of IBS symptoms. Learn more about this condition and how we approach it.

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Your SIBO Symptoms

If you suffer from IBS it’s possible that SIBO (Small Intestinal Bacterial Overgrowth) is the underlying issue.

What causes SIBO?

A range of factors can lead to SIBO. This includes food poisoning, certain medications and abdominal surgery.

Is there a test for SIBO?

The SIBO breath test is used to assess for levels of hydrogen and methane to assess for SIBO.

Foods and meal plan for SIBO

What is SIBO?

If you suffer from IBS you may have come across a condition called SIBO (Small Intestinal Bacterial Overgrowth)

This occurs when an elevated number of bacteria are found in the small intestine. Since the small intestine is meant to contain a low number of bacteria, an overgrowth of organisms can lead to symptoms of IBS.

Are there different types of SIBO?

The SIBO tests measure 2 types of gas, hydrogen and methane. If there are elevations in 1 of these gases, we can name that hydrogen or methane SIBO. It’s also possible to have elevations in both gases.

If you experience constipation as a main symptoms, it can be more likely that the elevation is in methane gas. The type of gas that is elevated helps to guide supplement protocols to target the specific organisms that produce that type of gas.

The SIBO subtypes are:

  • Hydrogen SIBO
  • Methane SIBO (referred to as IMO/intestinal methane overgrowth)
  • Hydrogen sulphide SIBO
SIBO stomach symptoms

Common Symptoms of SIBO

SIBO symptoms are very similar to those seen in IBS. This is due to most people with IBS actually having SIBO as the underlying issue.

Bloating and distention

Gas and bloating often occur within 1 hour of eating.

Food reactions

Common reactions are to high FODMAP foods such as garlic, onions and beans.

Bowel patterns

As with IBS, bowel patterns can be diarrhoea, constipation or a combination of both. 

Abdominal pain

Increased sensitivity, nerve pain as well as abdominal cramps are common SIBO symptoms.

Additional SIBO Symptoms

Digestive symptoms are the most common SIBO symptoms.

However, SIBO can also lead to symptoms elsewhere in the body.

These include:

  • An increasing amount of food sensitivities
  • Impaired vitamin absorption
  • Maldigestion of fats
  • Histamine intolerance
  • Brain fog
  • Restless leg syndrome
  • Acne rosacea
  • Fibromyalgia
IBS stomach treatment

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Underlying Causes of SIBO

Understanding and addressing the underlying reason for the bacterial overgrowth in the small intestine is important for a successful SIBO treatment.

These underlying causes of SIBO include:


Opiates, proton pump inhibitors, tricyclic antidepressants.

Impaired Flow Through the Intestines

Ileocecal valve dysfunction, endometriosis, abdominal surgeries/adhesions, EDS.

Impaired Digestion

Microbiome dysfunction, chronic stress, sIgA deficiency, poor bile flow, low stomach acid.

Altered Motility

Hypothyroidism, diabetes, chronic infection, MMC damage, scleroderma, traumatic brain injury.
Underlying Causes

SIBO can lead to the symptoms of IBS. While symptom management strategies can be important, our aim is to resolve the underlying issue of the bacterial overgrowth and help you get back to your life.

Personalised Treatment

Our comprehensive intake process assesses the underlying factors that are contributing to your symptoms. From this, we create a personalised treatment plan for you to follow.

Ongoing Support

Our consultations also include regular support and monitoring of your symptoms. This allows us to review your response and make relevant adjustments to the treatment plan.

How is SIBO diagnosed?

If you have been diagnosed with IBS or experience many of the symptoms listed on this page, a SIBO test may be an important step to understanding the cause of your symptoms.

The small intestine is a particularly tricky place to get to.  However, one test we can use for diagnosis is the SIBO breath test.

This assess for the 2 gases already mentioned, hydrogen and methane which are used to diagnose SIBO.

Breath Testing for SIBO

The SIBO breath test is used to assess for levels of hydrogen and methane in order to diagnose SIBO.

  • The test is performed by drinking a sugar solution which acts as a food source for the bacteria in the digestive system.  When the bacteria come into contact with this sugar solution, fermentation takes place.
  • The gases produced during the fermentation process are then absorbed into general circulation, transferred into the lungs, and then exhaled.
  • Elevated levels of these gases found in breath samples can indicate the presence of SIBO which can then help guide your protocol.
  • These tests can be carried out in your own home with results typically back from the lab within 10 working days.
SIBO Breath Test

Frequently asked questions

How is SIBO diagnosed?

SIBO breath testing is the most common test used to test for SIBO. The 2 main test solutions used are glucose and lactulose.

In research settings, an aspirate and culture test is often used.

Can SIBO be cured?

SIBO is a bacterial overgrowth in the small intestine with several possible underlying causes. If we address the underlying cause we are aiming to fully resolve symptoms.

Are supplements needed to address SIBO?

We consider the use of a range of evidence-based supplements to address the root causes of symptoms which include:

  • Antimicrobials
  • Probiotics
  • Prebiotics
  • Prokinetics

Are antibiotics needed for SIBO?

Research has found that antimicrobial herbs are as effective as pharmaceutical antibiotics in the treatment of SIBO. Alongside these probiotics and prebiotics are also considered.

What diet is needed for SIBO treatment?

Removing foods will not treat SIBO but short-term elimination diets may help to identify triggers and reduce symptoms.  Once the underlying issue is addressed, the aim is for the diet to be diverse and relaxed.

IBS and SIBO specialist

Martin Cohen – Dip CNM, CNHC, BANT
Registered Nutritional Therapist, Clinic Director

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Client Conversations

Conversations with those we’ve already helped.


Rebecca’s symptoms of IBS started after taking antibiotics for tonsillitis. She cut out foods and introduced supplements by herself, but her symptoms continued.

With our support, Rebecca is now symptom-free.


Geri’s gut issues started decades ago. After several trips to her GP, treatment for H Pylori and even the removal of her gallbladder she was still experiencing symptoms.

Since working with us, Geri’s symptoms have stopped.


Stella’s digestive problems started gradually. This led her to cut foods one at a time and survive on an increasingly restrictive and bland diet. Even with doing this, she was still experiencing symptoms.

Stella can now eat a varied diet without experiencing gut issues.
IBS nutrition consultation

Martin Cohen Dip CNM, mBANT, mCNHC
Registered Nutritional Therapist

What treatments are available for SIBO?

The approach to SIBO is divided into 2 categories. The first is short-term symptom management strategies to help improve symptoms to provide more comfort and stability. This can include short-term elimination diets and digestive support, such as enzymes.

The second part of SIBO treatment is to address the bacterial overgrowth as well as take into consideration the underlying issue.

Common elements of a treatment plan include:

  • Antimicrobial herbs
  • Probiotics
  • Prebiotics
  • Prokinetics
  • Gut lining support
  • Gut-brain support

Your Next Step

Learn about our consultations

Follow the link to learn more about our consultations and how we can support you.


Read more about symptoms and causes

Understand the symptoms and causes of SIBO and how we can help you.

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