The SIBO Guide
July 8, 2026
Online Clinic
Digestive & Urinary
When you feel bloated and gassy or experience stomach cramps more often than usual, you might have Small Intestinal Bacterial Overgrowth or SIBO. This is a condition in which an unusually large number of bacteria grow in the small intestine. This disrupts digestion and nutrient absorption, leading to various uncomfortable symptoms.
Signs & Symptoms
- Abdominal bloating and distention are the uncomfortable feelings of fullness and pressure in the abdomen.
- The bacterial fermentation of carbohydrates produces gas. This leads to increased flatulence (passing gas) and burping. While some gas is normal, excessive gas that interferes with daily life is a common SIBO symptom.
- SIBO can disrupt normal bowel function, leading to either diarrhea, constipation, or alternating episodes of both. The fluctuating nature of these symptoms can make diagnosis challenging.
- Some people experience nausea and even vomiting. This may be related to bacterial overgrowth and the inflammation it causes in the gut.
- Damage may occur in the small intestine’s lining, leading to increased intestinal permeability, also known as “leaky gut.” This can allow undigested food particles to enter the bloodstream, triggering immune responses and contributing to food sensitivities and intolerances.
Treatment
- Antibiotics are often the first line of defense, targeting the overgrowth of bacteria.
- Dietary changes using a low-FODMAP diet, which restricts certain fermentable carbohydrates, can help manage symptoms. This often involves avoiding certain breads, cereals, dairy, legumes, and some fruits and vegetables. The goal is to reintroduce as many FODMAP foods as possible after eight weeks, depending on symptoms. Work with a dietitian to ensure you are getting adequate nutrition.
- Supplements like vitamin B12, iron, and vitamin D may be recommended.
- A healthcare professional should oversee treatment. If you suspect you have SIBO, talk to your doctor. They can perform diagnostic tests, including to identify and develop treatment options for the root cause of SIBO.