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Written By: Dr. Janine Mackenzie, Naturopathic Doctor

Digestive issues! It’s one of the most common health concerns patients have.

SIBO, which stands for Small Intestinal Bacterial Overgrowth, is defined as an overgrowth of bacteria in the small intestine of the digestive tract.

But wait! Aren’t we supposed to have bacteria in our intestine?

The answer is yes!

Bacteria in our intestines do us all kinds of favours from enhancing our immune system, helping us digest our foods, providing us with nutrients and vitamins, and many more. Bacteria can become a problem when there is too many in the wrong spot. We call this dysbiosis. The majority of our bacteria in our gut is found in the large intestine. This is the area of our digestive tract that absorbs water from our foods and creates formed stool from the foods we’ve digested. This is normal. We want lots and lots of good bacteria in this location. This is where probiotics have their action.

When these bacteria end up in the wrong spot, into the small intestine, that is when problems may arise. This area of our gut is meant for further digestion of foods and nutrient absorb into our blood stream. When bacteria get into our small intestine they use your partially digested food as nutrition which can lead to symptoms like gas, bloating, diarrhea, constipation, and pain. When you have SIBO, you may also have malabsorption of nutrients, fat soluble vitamins like vitamin A, B vitamins, and minerals including iron and calcium.

What are the symptoms of SIBO?

SIBO symptoms can be varied among people. The following list are the more common symptoms noted by patients with SIBO. You may have only one or several of the following:

  • Diarrhea

  • Nausea with or without vomiting

  • Constipation

  • Alternating diarrhea and constipation

  • Bloating

  • Pain

  • Weight loss

  • Skin issues such as eczema, rosacea, and other rashes

  • Fatigue

  • Malnutrition

  • Anemia

  • Mood issues such as depression and anxiety

How is SIBO diagnosed?

If the above symptoms sound familiar you may be wondering how you can be tested for it. The SIBO test is actually quite simple. It involves a 24 hour preparation diet which works to starve the bacteria of nutrition, then you fast over-night and in the morning you drink a lactulose solution and then perform an 3 hour breath test.

The prep diet and the fast ensure that the bacteria in your gut are hungry and will use the lactulose as a food source. When the bacteria eat the lactulose they produce gas. This gas is absorbed by your body and expelled via the lungs. This is why we can use a breath test to assess a gut condition. Diagnosis of SIBO is based on noting the concentration of methane and hydrogen gas in your expelled breath.

What are causes and complications of SIBO?

There are many reasons why someone may have SIBO. History of food poisoning, stress, surgery, anti-biotic use, stomach acid-blockers like proton pump inhibitors, and Celiac disease are some of the more common reasons that can lead to excessive bacteria in the small intestine.

The complications of long term SIBO may be severe. Chronic long-term malnutrition can contribute to osteoporosis, kidney stones, damage to the intestinal lining, anemia, and hormonal imbalances. SIBO contributes to chronic low-grade inflammation that continually depletes the body of its resources and increases the likelihood of developing auto-immune conditions and even cancer.

How is SIBO Treated?

SIBO treatment is divided into 3 treatment phases. The eradication phase where we work to get rid of the overgrowth in bacteria using either a series of special antibiotics, anti-microbial herbs or a combination of both herbs and pharmaceuticals. Depending on the types of bacteria you have in your small intestine will determine which medicines and herbs are used.

The next phase is a 6-8 week diet plan that helps heal up the digestive tract by reducing inflammation and keeping the bacteria out of the small intestine. You may need additional supplements to help treat any deficiencies that SIBO has caused, but these are prescribed and recommended on a case by case basis.

The final phase is prevention. In this phase we optimize your digestive system and work to prevent future relapse.

If you think that you may have SIBO or would like to speak with one of our Naturopathic Doctors feel free to book in for a complimentary consult! We can discuss your symptoms evaluate whether testing for SIBO would be right for you. Call 604-776-2432 or book online at

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