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SIBO Tongue: What Is It & What Does It Mean?

By 4th December 2023SIBO
Sibo Tongue


SIBO is a digestive condition that presents with similar symptoms to IBS. In fact, for many people with IBS, SIBO may be the underlying cause of symptoms, possibly including tongue issues or changes. [Source: PubMed]

SIBO is a gut condition that involves and higher level of bacteria in the small intestine than should normally be seen in this part of the digestive tract. This overgrowth of bacteria can lead to malabsorption, gas, and fermentation, which leads to the symptoms seen in SIBO.

While the specific symptoms and their severity can vary from person to person, common symptoms of SIBO include:

  • abdominal pain
  • bloating
  • flatulence
  • diarrhoea
  • constipation
  • fatigue [Source: PubMed]

It may also be possible for SIBO (or similar gut issues) to impact the colour or texture of the tongue. [Source: PubMed]

It’s not possible to diagnose SIBO based on symptoms or via a blood test. However, a SIBO breath test is often used in clinical practice as a diagnostic tool. [Source: PubMed]

What is SIBO?

SIBO is an overgrowth of bacteria in the small intestine. This can cause a variety of symptoms, including bloating, gas, and pain. As mentioned, it can also be difficult to diagnose because it doesn’t show up on standard tests like blood tests or stool samples.

The overgrowth of bacteria seen in SIBO is not an infection as such, but a change in the small intestinal ecosystem has allowed more bacteria to grow.

This change in the ecosystem can be considered a root cause. For example, SIBO can be common following food poisoning or an event of gastroenteritis. In this situation, an overgrowth can be due to a low-grade inflammatory response.

This is due to how inflammation can alter the motility of certain sections of the gut as well as alter levels of oxygen within the bowel. These 2 factors can create a more favourable environment for bacteria to overgrow. [Source: PubMed]

Can SIBO cause a white tongue?

The most common symptoms of SIBO are gas, bloating, pain, food reactions, and diarrhoea. However, these symptoms are not required to be diagnosed with SIBO.

Along with bacterial changes or overgrowths in the gut, it’s also possible for there to be imbalances or overgrowth in fungal species such as candida. This can be referred to as a SIFO (small intestinal fungal overgrowth), which may contribute to a white tongue. [Source: PubMed]

Testing for SIBO

The small intestine is a challenging place to test. However, SIBO can be diagnosed using a SIBO breath test. The breath test measures the amount of hydrogen and methane in the breath, which can be produced from the bacteria in your gut. [Source: PubMed]

The gold standard for testing for SIBO is an aspirate and culture. This is an invasive procedure that involves a sample of fluid being removed from the small intestine and then assessed via culturing in a lab. Due to the invasive nature of this test, this test is not used routinely in clinical practice to test for SIBO. [Source: PubMed]

What are the weird symptoms of SIBO?

While digestive issues and a white tongue may be present in SIBO (small intestinal bacterial overgrowth) or SIFO (small intestinal fungal overgrowth), it’s also possible for other symptoms to be present.

These symptoms include:

While IBS is diagnosed based on a specific set of symptoms, SIBO is only diagnosed following relevant tests.

What colour is SIBO poop?

SIBO poop is not a specific shape or colour, but it can often be foul or strong smelling. Additionally, due to malabsorption issues, the colour may vary from brown to green or even yellow. [Source: PubMed]

The amount of SIBO poop you have can vary from person to person but with hydrogen SIBO, it’s often looser. While if someone has methane SIBO, stools can be harder to pass. [Source: PubMed]

Does SIBO give you a lot of wind?

SIBO can lead to lots of wind, which is also referred to as gas, flatulence or farting. 

The small intestine is home to hundreds of species of bacteria that help us digest our food and absorb nutrients from it. With SIBO, these bacteria can grow out of control, causing symptoms like diarrhoea, constipation, or even issues on the tongue.

Another result of these changes is that there can be an increase in certain bacteria that are better able to digest sugars or dietary fibres. A short-term approach to reducing this gas is a low-FODMAP diet. However, this will not address the underlying issue in the gut that is leading to SIBO in the first place. [Source: PubMed]

Natural Treatments for SIBO

Diet and lifestyle changes can be considered a foundational step in addressing SIBO. While certain foods may trigger SIBO symptoms, these foods do not cause SIBO. [Source: PubMed]

For example, a low FODMAP diet can be used for SIBO and IBS; however, removing highly fermentable foods may reduce symptoms, but it does not address the underlying issue. This is why many people who have addressed the bacteria overgrowth find that symptoms return when FODMAP foods are reintroduced. [Source: PubMed]

Probiotic supplements can also be used to address bacterial overgrowths. Rather than requiring antimicrobial herbs to antibiotics, probiotics can stimulate the bodies natural production of antimicrobial peptides in the gut lining. [Source: PubMed]

Herbal antimicrobials have been used to address SIBO. There are herbal extracts or concentrated herbal capsules that have antimicrobial properties. These can be seen as natural or herbal antibiotics which have a comparable level of efficacy when compared to antibiotics (such as Rifaximin/ Xifaxan) [Source: PubMed]

A white coating on your tongue may be an indication of candida or SIBO

If you have a white coating on your tongue, it could be an indication of candida or SIFO (small intestine fungal overgrowth). Candida is an opportunistic fungal infection that occurs in certain situations. [Source: PubMed]

A way to consider this is that the mouth and tongue are the first sections of the digestive tract. Therefore, changes to imbalance in the small intestine may also lead to symptoms of microbial imbalances elsewhere such as the mouth or tongue.

What does your breath smell like if you have SIBO?

It’s been reported that up to 90% of cases of bad breath (halitosis) are caused by microbial changes in the gut. Cases report that this symptom can be treated with probiotics. [Source: PubMed]

The smell of bad breath in SIBO can vary between individuals and can vary depending on the types of organisms in the gut that are producing gas. Some find that these smells can be sulphurous like rotten eggs, while others may be more like onions. [Source: NIH]

It’s also possible for the gut microbiome to produce metabolites such as cadaverine and putrescine, both of which have strong smells which can lead to bad breath. [Source: PubMed]

Does SIBO cause a big belly?

As well as possible tongue changes, if you have SIBO, it’s possible that your belly is bigger than it should be.

This may be due to increased gas leading to distention. This is where the belly looks bigger due to the accumulation of gas in the small intestine. [Source: PubMed]

As well as gas production, it’s also possible to have a change in the muscle reflexed in the gut. This is where a change in muscle coordination can lead to abnormal viscerosomatic reflex activity. This leads to alterations in how the muscles contract, leading to the belly distending. [Source: PubMed]

Also Read: Can SIBO Cause Acid Reflux?

What does stool look like with SIBO?

Changes in the tongue may indicate a gut issue if you are experiencing symptoms associated with SIBO such as bloating, pain or flatulence.

One step in confirming SIBO performing a test called a hydrogen breath test (LHBT). This test checks for elevated levels of hydrogen in your breath, which indicates bacterial overgrowth in the small intestine. [Source: PubMed]

Other considerations are loose bowel movements (diarrhoea) that may occur after eating high-FODMAP fruits or vegetables. Other individuals with SIBO may also have problems digesting fats. This can lead to a greasy or oily-looking stool. [Source: PubMed]


SIBO can lead to a wide range of symptoms. These can include gut symptoms such as bloating as well as symptoms such as bad breath and changes in the tongue.

Working to address the underlying issues can be crucial to fully resolve this digestive condition.