When digestive symptoms keep cycling back
SIBO treatment for small intestinal bacterial overgrowth.
Bacteria overgrowing in the small intestine can drive bloating, gas, and IBS-like symptoms that keep returning. We treat SIBO in phases: calming inflammation, clearing overgrowth, restoring motility, and rebuilding your gut terrain.
SIBO
Does something about your digestion feel off?
Many people notice that meals trigger discomfort, energy dips after eating, or foods that once felt fine now cause reactions. These symptoms are not random. When viewed together, they often point to an imbalance in the small intestine that deserves closer attention.
The small intestine
Understanding SIBO.
Small intestinal bacterial overgrowth occurs when bacteria that normally reside in the large intestine begin to overgrow in the small intestine. This area is designed for nutrient absorption and typically contains far fewer microbes.
When bacteria are present in excess, fermentation happens too early in digestion. This can lead to gas and bloating, inflammation, nutrient deficiencies, and symptoms that affect the entire body, not just the gut. SIBO is frequently mistaken for IBS. Research suggests that a significant percentage of people diagnosed with IBS may actually be dealing with bacterial overgrowth.
Symptoms
Common symptoms of SIBO.
SIBO symptoms often overlap with other gut conditions, which is why it is commonly missed. Common signs include:
In your digestion
- Persistent bloating, especially after meals
- Excess gas, belching, or abdominal distention
- Abdominal pain or cramping
- Alternating constipation and diarrhea
- Loose stools shortly after eating
Beyond the gut
- Fatigue or sluggishness after meals
- Brain fog or difficulty concentrating
- Skin concerns including acne, rosacea, or rashes
In your nutrition
- Deficiencies in fat-soluble vitamins and other vitamins
- Increased food sensitivity, especially to carbohydrates
Root causes
What causes SIBO?
SIBO typically develops when the systems that protect the small intestine begin to slow or weaken. Contributing factors may include:
Impaired gut motility or a disrupted migrating motor complex
Low stomach acid, digestive enzyme insufficiency, or bile flow issues
Scar tissue, adhesions, or prior abdominal surgery
Post-infectious IBS or food poisoning
Autoimmune or inflammatory gastrointestinal conditions
Long-term use of acid suppressants or repeated antibiotics
Chronic stress affecting the gut-brain connection
When these systems fall out of rhythm, bacterial overgrowth becomes more likely.
Patterns
Types of SIBO.
Not all SIBO presents the same way. Identifying the dominant pattern helps guide care more precisely, and helps avoid approaches that may worsen symptoms.
Hydrogen-dominant SIBO
Often associated with diarrhea, bloating, and urgency.
Methane-dominant SIBO
Commonly linked to constipation, slow motility, and gas.
Hydrogen sulfide SIBO
Less common, and sometimes associated with sulfur-smelling gas, abdominal pain, and fatigue.
Recurrence
Why SIBO often comes back.
SIBO is known for its high recurrence rate. This does not mean it cannot be addressed. It means lasting improvement requires more than reducing bacterial overgrowth.
When motility, digestion, nutrient status, and nervous system regulation are not addressed, symptoms often return. Long-term care focuses on restoring the underlying terrain that allowed SIBO to develop — including related patterns like leaky gut when they are part of your picture.
Flora Labs
Labs for clear answers.
If symptoms are active and you are looking for clarity, lab testing can help identify what may be driving how you feel. This option is often chosen when you want insight sooner, with results reviewed in context so next steps feel grounded and clear.
- 01
Breath test at home
SIBO breath testing to identify hydrogen and methane patterns
- 02
Doctor review
Comprehensive stool analysis for microbial balance and digestion
- 03
Phased plan
Nutrient status testing when deficiencies may be contributing
Our approach
How we address small intestinal bacterial overgrowth.
Treating SIBO requires more than simply reducing bacterial overgrowth. Our approach focuses on restoring digestive rhythm and resilience so your body can digest, absorb, and clear more effectively. Care is personalized, paced to your needs, and often unfolds in phases.
Phase 01
Reduce inflammation
Foundational support to calm irritation, strengthen digestive function, and prepare the gut environment for healing.
Phase 02
Herbal antimicrobials
When indicated, precisely selected botanical agents address bacterial patterns without unnecessary harshness.
Phase 03
Repair motility
Restoring the migrating motor complex — the coordinated movement of the small intestine — to reduce stagnation and promote healthy flow.
Phase 04
Rebuild gut terrain
Reestablishing a balanced ecosystem with whole-food nutrition, probiotics, and long-term strategies that support resilience.
Memberships
Memberships for ongoing support.
If you are looking for continued guidance as your health improves, memberships offer care that evolves over time, with regular check-ins, adjustments, and long-term healing across systems, not just symptom management.
Explore membershipsPatient feedback
Hundreds of patients, in their own words.
4.9/5
from 213 Google reviews
Your symptoms are signals
Let's turn them into a plan.
Book your first telehealth visit and start uncovering the root causes behind how you feel, with a plan built around your history, labs, and goals.
Free e-books
Doctor-written guides you can start reading today.
Download free e-books from Flora's doctors and take the first steps toward better health at home.
Cleaning Up Your Environment & Optimizing Your Fertility
by Dr. Shannon Iselin
A practical guide to reducing everyday environmental toxins while preparing your body for a healthy pregnancy.
Get the free e-book
The Troubled Tummy
by Dr. Maura Henninger
Five keys to reversing pain, embarrassment, and discomfort so you can enjoy happy, healthy digestion.
Get the free e-book