SIBO (SMALL INTESTINAL BACTERIAL OVERGROWTH)

Breath Testing (Hydrogen/Methane, Lactulose or Glucose) is a first-line, non-invasive test that detects early fermentation and can differentiate hydrogen- from methane-predominant patterns.

Small-Bowel Aspirate & Culture is the invasive gold standard (limited availability) and reserved for complex or refractory cases.

Supportive Work-up includes assessment for predisposing factors (motility disorders, prior surgery, PPI use) and nutrient deficits (B12, iron, fat-soluble vitamins).

Treatment focuses on reducing excess small-bowel microbes, fixing the driver (motility/anatomy/acid–enzyme issues), and rebuilding a resilient microbiome to prevent relapse.

• Targeted Antibiotics (e.g., rifaximin for hydrogen-predominant; rifaximin + neomycin when methane/constipation features) are first-line for symptomatic SIBO. Course length typically 10–14 days; repeat only if relapse with clear indications.
• Prokinetics & Motility Hygiene (night-time low-dose agents; meal spacing, gentle activity) support the migrating motor complex, lowering recurrence risk.
• Diet (short term): a low-fermentation/low-FODMAP phase can reduce symptoms during treatment; systematic re-introduction is essential to avoid long-term restriction.
• Probiotics & Prebiotics (adjunct, phased) may help symptoms and recolonization after antimicrobial phase; introduce gradually to tolerance.
• Correct Contributors: address hypochlorhydria/PPI overuse, pancreatic or bile insufficiency, adhesions/strictures, and constipation (especially with methane overgrowth).
• Emerging/Selective Options: herbal antimicrobials in supervised protocols; FMT is not standard for SIBO and is generally not recommended outside trials.

1. REPOPULATING YOUR GUT MICROBIOME WITH THE RIGHT GOOD BACTERIA
   Repopulating your gut microbiome with the right good bacteria to improve its function and role within your health will start resolving your symptoms.
   Ensure you only take a probiotic that meets pharmaceutical grade standards to ensure efficacy and that dose delivery for symptom improvement, (uses gold-standard strains backed by clinical evidence for efficacy, with a minimum dose of 10 Billion CFU’s, protects it bacterial dose by ensuring shelf stability and full stomach acid protection with targeted delivery of the bacteria to your intestine, and meets all other quality metrics).The bacteria in your microbiome improves digestion and nutrient absorption, acts at the guts pharmacy – making vitamins, producing SCFA’s and other important metabolites, like serotonin. It is both the boss of and manager of our immune system. They Influence our brain and hormones, improve our mood + how our brain work. The microbiome also influence our Metabolic and Hormonal system/health.
2. HEALING THE WHOLE GUT SYSTEM, IMPROVING THE STRUCTURE, ENVIRONMENT AND FUNCTION
   This condition can affect the gut structure, environment and function, leading to an overall decline in the performance of the whole gut system. This results in gut inflammation, increased oxidative levels altered colonic PH levels. It impairs; immune capabilities, cell function, barrier function, digestion and metabolic health. Which makes it harder for good bacteria to survive in your gut, and easier for pathogens to take over – leading to a negative-cyclical feedback loop that keeps you unhealthy, compromised and struggling with severe symptoms.