What It Is And How To Heal Your Gut

Testing And Diagnosis

To know for sure if you have SIBO, you’ll need to see your healthcare provider for an official diagnosis. SIBO can be diagnosed through a hydrogen breath test, which measures the presence and amount of hydrogen and methane gas produced by the wayward bacteria in the small intestine.

To complete the test, you drink a solution containing sugar, such as lactulose (most commonly used in SIBO tests), glucose, or xylose. If the bacteria is present, it will feed off the sugar and release hydrogen or methane gas, which is how the test works to identify SIBO.

Other tests a doctor may perform include a small intestine aspirate and fluid culture, where the provider will do an endoscopy to retrieve a sample of the contents of your small intestine. This is more invasive, so I typically don’t recommend it because hydrogen breath tests are just as effective.

My Functional Medicine Treatment Plan

Conventional medicine typically treats SIBO with a course of antibiotics like rifaximin or metronidazole. While antibiotics do help kill the bad bacteria, they also end up killing the good bacteria necessary to keep SIBO from returning.

In fact, studies have shown that many patients have to be on antibiotics long-term since they contribute to SIBO recurrence and increased gut symptoms. (11) If you want to avoid the vicious antibiotic cycle, read on to learn how I treat SIBO in functional medicine.

1. Uncover Any Underlying Causes

The first step to sustainable healing for SIBO is to identify the root cause of why it occurred in the first place. Work with a functional medicine practitioner who can run labs and compile a comprehensive health history to uncover the cause of SIBO and devise a plan of action for healing. I discuss the most common underlying causes of SIBO further below.

2. Avoid High-FODMAP And Lactose-Containing Foods

FODMAPs stands for “Fermentable Oligo-, Di-, Monosaccharides, And Polyols,” which are specific carbohydrates that feed gut bacteria and encourage them to proliferate. Some foods that are high in FODMAPS include onions, cabbage, beans, apples, and rye.

Monash University, a leader in research on this topic, has a great app to help you stick to low FODMAPs.

Lactose is also a trigger for SIBO in many patients, so it’s a good idea to cut milk products from your diet, at least until you can identify if this worsens your condition.

3. Take Probiotics

Probiotics containing a combination of Bifidobacteria, Enterococcus, and Lactobacillus have been shown to affect irritable bowel syndrome positively, and may aid in rebalancing your microbiome population. (12)

While they can be great in other situations, avoid probiotics that contain prebiotics, which can feed the bacterial overgrowth present in SIBO. You can also incorporate more probiotic-rich foods into your diet, such as sauerkraut, kimchi, yogurt, and kefir.

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