You’ve had a bit more acid reflux recently and antacids are your new best friend.

Constipation is becoming worse but nothing that a bit more fiber can’t help, right?

Your stomach is bloated and feels like its twice its size by the
end of the day so you tell yourself it’s time to stop eating so much so quickly.

Or, your stool is so loose lately that you just need to make sure there is a bathroom nearby.

Just common digestive upset?

It actually may be a bit more than that. It may be SIBO.

Never heard of SIBO? That’s okay – it can be a lesser known term when it comes to gut health, but nonetheless, it’s one that’s vitally important to know about.

Small intestinal bacterial overgrowth (also known as SIBO), occurs when bacteria from another part of the digestive system (primarily the large intestine) migrates its way into the small intestine – where it’s not supposed to be.

And no matter if this bacteria is good (think probiotics) or bad, if it’s in the small intestine, it needs to get out.

If it doesn’t, it can result in SIBO which is both a symptom and a diagnosis.

SIBO symptoms can include:

           – mounting digestive pressure throughout the day

           – stomach distension

           – bloating, gas

          – constipation

          – diarrhea

          – heartburn, acid reflux

in which these symptoms can present themselves solely on their own or alternate between a variety of them.

SIBO can be caused by:

        – a previous parasitic infection or infection of the GI tract

        – too much stomach acid

        – not enough stomach acid

        – poor diet

        – inflammation

        – hormone fluctuation

        – a hiatal hernia

in addition to what many of us have been experiencing over the past year…chronic stress.

For the digestive system to work properly, it needs a fair amount of time in parasympathetic mode (calm and restorative). When stress is abundant, the body can get stuck in sympathetic mode (fight or flight response) in which the gut can literally lock up and become stagnant.

So while we may think that we can just take an acid reducer before eating or blend a fiber supplement with our morning smoothie, it may take more than just an over-the-counter band-aid to get your digestion back to normal.


SIBO can be treated in a variety of ways, depending on how severe the symptoms are and how long it has been going on as well as what has already been tried.

The first step lies in testing. It’s important to understand if SIBO is at play and which particular bacteria is overgrowing. Testing is done with a breath test, although stool testing may also be helpful.

Next, it’s crucial to take care of any immediate digestive complaints (for example: supplements for acid reflux, visceral manipulation for constipation, or diet changes for diarrhea) so an individual can begin to function again.

From there, treatment is designed based on an individual’s goals and wishes. This can include naturopathic herbs (such as broad spectrum antimicrobials) as well as, or in place of, pharmaceuticals to kill off the bacteria.

In addition, restrictive food choices such as the FODMAP diet for a brief period of time may support the gut in ridding the bacteria in the small intestine. However, there is also evidence that very strict dietary adherence could prolong a SIBO infection.

Lastly, the root cause must be addressed or it can almost certainly come back. This means that hormones may need to be checked and balanced, stomach acid may need to be boosted, or chronic stress may need to be reduced – whatever the underlying cause for SIBO is needs to be treated accordingly.

If self-remedies, over-the-counters, or even your general practitioner aren’t able to help your worsening digestive distress, you may be suffering from SIBO, and I am here for you.

Together, we can work to discover if this issue is causing your symptoms and create a plan to treat it effectively so you can get your life back.

Please call me at (720) 340-0193 or contact me here to get started.

Harmony Family Medicine provides naturopathic medicine to the Boulder and surrounding Denver metro areas. For support with stress, anxiety, sleep, pain, hormones, fatigue, digestion, and other health issues, please call me at (720) 340-0193 or contact me here.