Irritable Bowel Syndrome (IBS) is nothing short of an epidemic, affecting nearly one in six people in Western Countries.
It’s one of the most common reasons for visits to the doctor, and yet, most doctors have no clue how to treat it and don’t know what’s causing it.
IBS is what’s called a functional disorder.This means that, in theory, before being diagnosed with IBS, other diseases should be excluded. This basically means that the usual lab tests (colonoscopy, gastroscopy and bloods) won’t show any physical problems, which excludes other recognised gut diseases like Crohn’s disease, Ulcerative colitis or Coeliac. Assuming that you meet certain criteria (called the Rome Criteria), you’ll then be told that…
It’s ‘just’ IBS... which is pretty much just another way to say that they don’t really know!
This can be really disheartening! I know from my personal experience (read my story here) that you’re symptoms are very real!
But here’s the kicker:
Studies show that up to 80% of people diagnosed with IBS actually have an underlying condition called SIBO, or Small Intestinal Bacterial Overgrowth.
WHAT IS SIBO?
The majority of our gut bacteria should be in the colon (aka — the large intestine), where they have a very positive effect on our health.
However, various factors (we’ll get to that in a minute) can cause the bacteria to overgrow into the small intestine — where they should normally be present in fairly small amounts — causing IBS-like symptoms such as diarrhea, constipation, gas, reflux, and or course, bloating!
In other words, SIBO is like a chronic infection in your gut. It’s not that the bacteria overgrowing are pathogenic (causing disease like E. coli, Salmonella) but too many bacteria in the wrong location — aka the small intestine — is a problem.
SYMPTOMS OF SIBO
- Bloating — the most common symptom!
- Gas, Excess Burping & Flatulence
- Diarrhoea
- Constipation
- Alternating diarrhoea and constipation
- Abdominal cramping
- Acid reflux
- Food sensitivities
- Joint pain
- Skin rashes
- Iron and B12 deficiency
WHAT CAUSES THESE SYMPTOMS?
The bacteria are not supposed to be present in high number in the small intestine and when they are, they cause a number of problems.
- When you eat certain foods, especially foods high in FODMAPs and fibre, they’re fermented by your gut bacteria. If this happens in your large intestine, it’s a good thing! However, if it happens in your small intestine, the excess gas can cause abdominal bloating and pain, constipation (associated with methane gas), diarrhea or both (the symptoms of IBS). Excess gas in the small intestine can also cause acid reflux (from the excess pressure in the stomach), belching and flatulence.
- The bacteria also interfere with your normal digestion and absorption of food and are often associated with damage to the lining of the small intestine, leading to leaky gut. Learn more about leaky gut here.
- It can leads to deficiencies in nutrients.
- They can decrease proper fat absorption — by deconjugating bile — leading to deficiencies of fat soluble vitamins such as vitamins A & D, and potentially fatty stools.
- The bacteria produce endotoxins, like LPS, which can burden your liver, affect your immune system and eventually lead to a range of systemic symptoms such as joint pain, chronic fatigue, skin issues and even anxiety.
THINK YOUR MIGHT HAVE SIBO? TAKE THE QUIZ

- Have you been diagnosed with IBS?
- Did your symptoms develop after having gastro-enteritis/food poisoning (often called post-infectious IBS). This is the #1 cause of SIBO.
- Do you suffer from bloating about 30 minutes after eating?
- Do you have any other digestive symptoms?
- Do you feel like you have even more gas and bloating when eating common healthy foods like onions, garlic, apples and cauliflower (also known as high FODMAP foods)?
- Have you ever noticed that fibre worsens your constipation?
- Do you have fatty stools (stools that float in the toilet)?
- Have you ever noticed an improvement in IBS symptoms after a course of antibiotics (but the symptoms return shortly after)?
- Did your symptoms develop or became worse after taking pain medications, like opiates?
- Do you have low stomach acid or take proton pump inhibitors like losec or nexium? (also a very common cause of SIBO.)
- Do you have hypothyroidism (like Hashimoto’s) or another auto-immune condition?
- Have you had any abdominal surgeries, including a C-Section or appendicitis?
- Are you hyper-mobile or have Ehlers-Danlos Syndrome?
Even if you only answer ‘YES’ to just 2 of the questions above, you might have SIBO and I would recommend getting tested for it (see more about getting tested below).
If you have IBS or think you might have SIBO, try our FREE SIBO QuickStart Guide and reduce your symptoms in just 3 days.
DIAGNOSIS… HOW DO YOU KNOW YOU HAVE IT?
SIBO is diagnosed with a 3-hour breath test, which you can do from the comfort of your home. Please note that SIBO can’t be diagnosed with a stool test or an OAT test. Although these could potentially indicate a bacterial imbalance, you need to confirm if it is SIBO with a breath test.
The breath test is done using a sugar solution of either lactulose (not to be confused with the lactose breath test, which is commonly ordered by GPs to rule out dairy intolerance) or glucose.
Recommended labs offering direct patient order:
TREATMENT
If, like me, you’ve suffered from horrible bloating and pain for many years, investing some time and effort in healing SIBO/IBS is well worth the effort and could significantly change your life.
Please note that it’s okay to do the gentle (yet effective) treatments recommended below even without a confirmed SIBO diagnosis.
We’ve put together two kits to get you started:
SIBO KIT: designed for people with SIBO-hydrogen, it includes Neem Plus, Biotoxin Binder and Fodmate.
SIBO METHANE KIT: designed for people with SIBO-Methane, aka Intestinal Methane Overgrowth, which usually causes constipation. It includes Neem Plus, Biogaia Protectis, Atrantil and Fodmate.
WHAT ABOUT DIET?
Yes, diet is super important, and can make you feel better faster than any other treatments/supplements.
Changing diet can be a bit tricky at first, which is why we’ve put together the 4-Week SIBO Challenge, a 4 week Meal Plan specifically designed for people with SIBO. It’s a fantastic way to discover how to eat to feel your best when you have SIBO… and don’t worry, you won’t feel deprived!



Hello,
Had food poisoning at Easter. [organic dried mangos] Got over that.
Then about 3-4-5 weeks later again–or so I thought. Pollo Loco salad—and after eating a lot of it I noticed the salsa was bad. Pretty much singled out these 2 items as different from regular eating. This time could not eat for about 4-5 days. Some diarrhea but not horrible.
Yet it was much worse , I thought perhaps more severe because still weak. The cramping was so severe I actually went to the doctor. He recommended peppermint oil in gelatin. [seemed strange, all that sugar and artificial ingredients–but could not find an Oriental store for agar–just too sick to drive around] This relieved some of the immediate severe pain, but cured nothing. Asked for a stool test. When I got to the lab about 9 days later—first time had poop to collect since not eating. Learned he ordered 2 tests….I forget names, but was angry when I saw the little he ordered., incomplete IMO. Hardly worth the effort and it was a huge effort to get the samples.Also did not do any parasite test. [I was angry, but now reading your blog it might not have been the Stool PCR–so might have been useless?]
Pain was so severe on left side, across transverse colon and even my back in area of kidneys. Tried what I knew or could find. Have been off sugar, carbs [or extremely low] for months. Taking my probiotic, spore restore, magnesium citrate, vit C–others. Relapse again , this time pain on right side, colon, kidney area again. I am not well. Cloves, cayenne, turmeric in my bullet proof coffee every morning. Kimchi, plain yogurt [not sugar and seldom] Took approx. 750 Mag without effect, went to about 12oo–finally. and now if I take 325–explosion. Nothing is normal or regular. Have not had a decent normal poop in months.
Before this had nice soft snakey BM–as Dr. Wahl suggests is good. Perhaps not every morning, but most. NOw is different everyday. Painful. Feels like a rock coming out, yet when check it is mushy. And some days –NONE.
Took low dose Mag Citrate–325 or less the other morning –just hoping for some regularity–and it was explosion, could hardly make it to the bathroom.
Thought gastroenteritis when I read, now wondering if SIBO. Parasites? Both?
Bloating. Pain. Problem BMs.
Craving for carbs. Ate 2 white rolls. Then really Fell off and actually ate a number of Hershey bars. Number to be secret. Horrible. The bread was not satisfying, but the chocolate [with lots of sugar] actually made me feel better? For a short time anyway.
Messed up my work on cycling KETO.
This is a lot, I am concerned that it might be printed here.
I would like to ask you: First your opinion of possibilities.
Second what tests I should request of my doctor. Should he be clueless.
I am very grateful for any suggestions you are able to offer–it has been months now and I just need to get this fixed.
Thank you for taking the time to reply.
Best of everything to you!
Hi, I’m sorry to hear how bad you have been feeling. I would definitely recommend you do the SIBO test. I’m not sure where you are based, but in many countries, you don’t need a doctor to order the SIBO test, you can order yourself. However, I do recommend you work with a practitioner to interpret the test. It is also possible that you have parasites and you could do a PCR stool test for this at your GPs. However, if the test is negative, it doesn’t rule out parasites. Another really useful test, although more expensive, is the GI MAP, which you can also order yourself directly. I hope that helps!