SIBO – or small intestinal bacterial overgrowth

In the last weeks, I have managed to somewhat controlled my symptoms following a very restrictive diet avoiding most FODMAPs and food with high food chemicals (salicylates, amines and glutamates).

I was inspired by a post from Melissa McEwen at Hunt.Gather.Love to try white rice, which is both low in FODMAP and in food chemicals. I did and suffered…! Within an hour or two, I looked pregnant and had abdominal pain… and it lasted for a couple of days. But the good thing about it is that it got me thinking! If white rice, which should be one of the safe food I should be able to eat, causes me problem, it means that maybe I haven’t completely figured out what my problem really is yet.

I had heard of SIBO, or small intestinal bacterial overgrowth, before and started researching it more. Bacteria thrives on carbs and it seems that any types of carbs have triggered my symptoms in the past. One of the best resources on the subject is Dr. Siebecker at siboinfo.com. I then decided to go for a hydrogen/methane breath test and just received my results: I have a SIBO infection.

I am happy to know what is contributing to my post-infectious IBS because knowing what the problem is will help me adapt my diet accordingly. Antibiotics and elemental diet formulas can be used to kill the excess of bacteria that should not be in my small intestines, although it seems that recurrence rates can be relatively high.

Another treatment option for SIBO is following either the SCD diet (specific carbohydrate diet) or GAPS diet. Both of these diets are grain-free, sugar-free and very low-carb diets that can easily be made paleo. Following one of these diets for one to two year can work at eliminating my SIBO and allow me to heal and seal my gut (SIBO causes leaky gut), diversify my diet, get rid of my newly developed food intolerances and hopefully, some day, tolerate small amounts of carbs from fruits or tubers.

I have ordered Dr. Mark Pimentel‘s book “The New IBS Solution” which discuss the role of SIBO in IBS as well as the book “Gut and Psychology Syndrome” from Dr. Natasha Cambell-McBride.

More info on my new dietary approach to come soon… :)



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20 thoughts on “SIBO – or small intestinal bacterial overgrowth

  1. We are on similar paths as always! I have found a few products helpful, as I refuse to take antibiotics. You know the enzymes, but the other is Peppermint PLUS by enzymatic. It’s a special coated softgel with Peppermint, Rosemary, and Thyme. :) I have seen improvement, but I fear my idea of letting my body heal itself is sooo slow.

    I eat (almost) no grains and sugars now except for some probiotic Kefir – it’s such a treat…and IF i do eat carbs of ANY type I try to keep them under 40 grams a day. If I cure this stuff of COURSE I’ll let u know.

    BEST of luck to you! You are NOT alone.

    • Thanks Mcoffeesnob! It is interesting to see that the most extreme cases, like us, in the fructmal group seems to have SIBO. It makes sense now that we would react to ANY type of carbohydrates! Like you, I find that I do best when I keep my carbs very low… I overdid pureed carrots once and had symptoms, although not as bad as with white rice.

      I also want to treat my SIBO without antibiotics… I have already had 2 courses for my parasites and think that it probably contributed to completely screwing my gut flora! I’ll look into the natural antibiotic you recommend!

      Good luck to you too! ;)

  2. Keep in mind too that the DS we always talk about can help us digest food we might otherwise malabsorb. Keeps it from being food for bad guys.

  3. This has me wondering whether I should get checked for SIBO too. My IBS-D issues are gone as long as I get rid of FODMAPs, and although I eat paleo/primal I seem to be able to handle some starchy carbs, although I still generally feel better if keep them to 100g or less. Perhaps the next time I go to the doctor I will ask if he will order the test.

    • Hi JKC -
      It could be worth a try but remember that testing is still not 100 percent accurate and reliable and even if you test negative, it doesn’t eliminate the possibility of a small intestinal bacterial overgrowth and definitely does not eliminate the possibility of gut dysbiosis. The more I am reading and the more I believe that all gastrointestinal problems are due to an imbalance in the gut flora and that the GAPS diet may be the best way to correct it… Let me know what happens with you! ;)

  4. Have you ever tried fecal transplantation? (aka: Fecal bacteriotherapy). I have severe candida, extreme SIBO and hypochlohydria (low stomach acid) for which I take HCL acid supplement to help with digesting my food quickly and so it doesn’t sit in the the small intestine and ferment. Dr Pimental’s book is interesting but I don’t think the drug Rifaximin which he is trying to push through is the answer. Many people get relief but then their symptoms return. He is currently trying to mix Rifaximin with Metronidazole with which they are seeing some success. However, Dr Borody in Australia treats Chrons, Colitis, C-Dificle and IBS with fecal Bacteriotherapy. He has a 99% success rate with C-Dificile and somewhere around a 60% cure rate with Colitis. Which goes to show that it’s all gut flora related. By replacing the bad bacteria in your gut with that of a healthy donor’s it seems to re-set the balance and the gut flora once again flourishes in the right quantities with the correct strands. He also starts the treatment with antibiotics with which he tries to reduce the amount of bacteria before starting the process. However, he uses Vancomycin as his choice of antibiotic.

    • Hi Scooby,
      Yes I have heard of it but will give the GAPS diet + probiotics a go first. I know antibiotics have a high recurrence rate but the GAPS/SCD diet seems very effective, although they may take longer, and I am willing to go this route for now since it seems to be working very well for me. Thanks!

  5. About SIBO testing, my doc said I have it…and ordered the test. She said that there was a good chance it would ‘blow’ negative for many reasons, but that I have SIBO. She (sort of) apologized for not telling me earlier, but said she has a process she had to follow. (WTH!?) and that she also had to eliminate worse possibilities. So when the office called me TEN DAYS later to schedule the test, I declined. The substance I need to drink will surely cause inflammation – i’ve read the posts on SIBOnation – and if it’s going to give me a possible false negative, i’d just rather NOT drink something for HOURS that makes me sicker and feeds the very bad guys i’m trying so hard to get rid of. She also said that it might take at LEAST two rounds of antibiotics to cure it. Thank you doc, i’ll pass. I suspected SIBO two years ago and you didn’t even seem to know what it was. I’ll handle this from here. *am a bit bitter – thanks for the vent.

    • WhaT???! Sorry about your struggles finding a good doctor to help you out and glad to know that you are also going the antibiotic-free way. It may take longer but I think it is the best choice in the long term..! :)

  6. The best information I found so far on SIBO was at siboibs.org, which seems to be down now. Luckily I was able to save most of the website, it was still in google’s cache. One of the most interesting things I learnt was about D-Lactic-Acidosis caused by common probiotics like L. Acidophilus.

    I’ve had much better energy and was quite active on a strict VLC paleo diet recently. I’m trying to improve SIBO with natural antibiotics, and it seems like a slow and unpredictable process. One of the main areas to figure out is which substance and amounts to use for them to really kill the overgrowth. The things I use now are nattokinase on an empty stomach against biofilms, enteric coated peppermint oil, propolis, pressed garlic (hoping the FODMAPs aren’t in the juice), NAC, high dose vitamin C, coconut oil.
    I tried eating fresh a few herbs (sage and peppermint) and got bloated and run-down… which felt strange because I expected a good reaction.

    I have both books you mentioned. I don’t really think the GAPS diet is optimal for SIBO, you can find my thoughts about it here: http://paleohacks.com/questions/62525/is-there-any-downside-or-danger-to-gaps/62542#62542
    Adding more bacteria to SIBO can be like putting gasoline in fire, as my own experience confirms.
    I would probably try Pimentel’s regimen if I knew a decent doctor.

  7. Regarding the white rice- I have found that I can tolerate the short grain, Japanese/glutenous/sushi/sticky rice, but not the longer grain rices like basmati. I think it may have something to do with amylose content, as there is more in the longer-grain varieties.

  8. I struggle tremendously from symptoms of SIBO, candida, and IBS, I was wondering if you had an update on how these diets have helped your symptoms since starting it? I am on the hunt trying to find a diet that works. Some days I can eat without suffering but mostly, I won’t be able to eat at all. I am at my wits end and am so desperate to be able to eat again (I’ve lost 25lbs) and be healthy. I’m just starting the paleo diet and trying to find out the best foods to eat and avoid for SIBO (candida and IBS also!). I’ve read so many different websites that say its okay to eat one thing and another that says its off limits. Please let me know or email me if anyone has ANY suggestions. I’m very very desperate! Thanks so much!

  9. hi guys, I am gonna take the sibo test soon and no because any doctor told me to, but because of all the posts I found, so thanks. I don’t understand why doctors are not aware of SIBO :( do you have any tips or suggestions for me? I have booked an appointment with Doctor Borody in November as well… $400 is how much it costs :( thanks you.. :)

  10. Sorry one last thing, my dietician (from Italy) told me that there is no other diet she knows for SIBO then FODMAPS… is the SIBO diet you mentioned much better? thanks you :)

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