Diagnosed with SIBO? Five Steps to Symptom Relief By Lauren Minchen MPH, RDN, CDN

Have you been diagnosed with SIBO? Treatment with appropriate medical and diet interventions can be effective for relieving SIBO symptoms and helping reset bacterial balance in your digestive tract.

SIBO (Small Intestine Bacterial Overgrowth), simply put, is an overabundance of bacteria in your intestines. An array of good bacteria (probiotics) is a healthy thing, but SIBO develops when bacteria becomes overgrown. This overgrowth is typically the result of low stomach acid, insufficient bile and enzymes, or a deficiency of immunoglobulins in the small intestine that manage bacterial balance. 

Bacterial imbalance that characterizes SIBO manifests in symptoms similar to IBS, including bloating, constipation, diarrhea, nausea, indigestion, unintentional weight loss, and fatigue. The overlap of IBS and SIBO symptoms can lead to confusion and disillusionment when these symptoms don’t respond to IBS treatment, but it’s important to know that you can take clear and intentional steps toward a restored, healthy digestive tract. With commitment, determination, and the right support, symptom relief and a calm gut can be in your future.

So, what changes can you make to relieve painful symptoms and restore a balanced digestive tract? At diagnosis, your doctor will likely prescribe 10-14 days of antibiotics, sometimes in conjunction with prokinetic agents, which boost gut motility. As you begin your antibiotic round, it’s recommended that you also begin making targeted diet and lifestyle changes. 

Below are five powerful steps you can take to restore healthy bacterial balance and gut function:

  • Commit to making recommended diet changes. The low FODMAP diet and the Specific Carbohydrate Diet (SCD) are two diets that are recommended for managing SIBO and restoring healthy bacterial balance. The low FODMAP diet is an elimination diet (meant to be followed for 4-6 weeks) that cuts out certain carbohydrates and sugars that can irritate the digestive tract. The SCD is a grain-free, low sugar, and lactose-free diet that has been shown to reduce IBS, IBD, and SIBO symptoms. See a dietitian for guidance on beginning one of these diets.

  • Eat smaller, more frequent meals. With SIBO, you will likely be experiencing gas and bloating as a result of suboptimal motility. Consider shrinking your meal size to reduce the load on your digestive tract. Five to six small meals per day is the recommended frequency to support adequate nutrient intake.

  • Consider a food sensitivity test to uncover potential symptom triggers. Eliminating problematic foods can be effective in relieving SIBO symptoms and reducing the risk of recurrence. Speak with a dietitian or other healthcare provider about pursuing food sensitivity testing and implementing your results.

  • Avoid probiotics—at first. Given SIBO is, by nature, an overabundance of bacteria, taking a probiotic can make symptoms worse. Wait until the last few days of your antibiotic round before beginning a targeted probiotic supplement. Talk with a dietitian about the right one for you, and know that you may need to wait longer than 10-12 days into treatment before beginning to take one, depending on how quickly your body responds to antibiotic treatment.

  • Take digestive enzymes with meals. The overabundance of bacteria in SIBO can eat up B12 and bile salts that help us absorb fats, potentially leading to nutrient deficiencies over time. Supplementing with a comprehensive digestive enzyme supplement may help boost absorption of essential nutrients, while reducing gas and bloating from any fermenting food that is slow to move through your digestive tract.

While living with SIBO may be disruptive and painful, with the right guidance, you can take clear and intentional steps to restore healthy bacterial balance and a calm digestive tract.

Lauren Minchen is a Registered Dietitian Nutritionist based in NYC and the author of Bariatric Slow Cooker Cookbook. With over a decade of experience in private practice, she prioritizes her clients’ individual needs to help them achieve their own invincible lifestyle. Her specialties include digestive health, autoimmune conditions, and PCOS. To work with Lauren, visit https://www.laurenminchen.com/.