How to Treat SIBO: A Straightforward Guide

If you’ve been dealing with bloating, gas, or unpredictable stomach pain, chances are you might have small intestinal bacterial overgrowth (SIBO). It’s not a mystery disease – it’s an excess of bacteria in the part of your gut that isn’t supposed to host them. The good news? You can tackle it without endless doctor visits and confusing jargon.

First, confirm the problem. A breath test that measures hydrogen or methane after you sip a sugary solution is the most common way to diagnose SIBO. Your doctor can order it, and the results will tell you which type of gas your bacteria are producing – that helps decide the right treatment plan.

Targeted Antibiotics: The Fast‑Track Fix

The quickest route to relief is a short course of antibiotics that zero in on the overgrown microbes. Rifaximin is the go‑to drug for hydrogen‑producing SIBO, while a combination of rifaximin and metronidazole works better for methane producers. Most patients feel better within a week or two, but it’s crucial to finish the full prescription to avoid relapse.

If you can’t take antibiotics or prefer a natural approach, consider herbal antimicrobials like oregano oil, berberine, or garlic‑derived allicin. Studies show they can reduce bacterial load with fewer side effects, though you might need a longer treatment period.

Diet Tweaks That Keep the Bloat Away

Antibiotics clear the immediate threat, but without dietary changes the overgrowth often returns. The low‑FODMAP diet is the most widely recommended plan – it cuts out fermentable carbs that feed the bad bacteria while still giving you enough calories and fiber to stay healthy.

A simpler alternative is the Specific Carbohydrate Diet (SCD). It eliminates grains, lactose, and most sugars, focusing on meat, fish, eggs, non‑starchy vegetables, and limited fruit. Many people report less gas and more regular bowel movements within a few weeks.

Don’t forget to hydrate. Drinking enough water helps move food through the gut and prevents constipation, which can worsen SIBO symptoms.

Probiotics and Motility Boosters

After you’ve cleared the excess bacteria, repopulating your gut with good microbes is key. A high‑quality probiotic that contains strains like Lactobacillus plantarum or Bifidobacterium infantis can keep the balance in check. Start with a low dose and increase gradually to avoid gas flare‑ups.

Improving intestinal motility prevents future overgrowth. Herbal agents such as ginger, peppermint oil, or Iberogast stimulate peristalsis, helping food move faster through the small intestine. In some cases, doctors prescribe prokinetic drugs like low‑dose erythromycin for short periods.

When to Seek Professional Help

If symptoms persist after a full antibiotic course and diet overhaul, you might have an underlying condition – such as chronic constipation, low stomach acid, or a structural issue in the gut. A gastroenterologist can run additional tests like imaging or motility studies to pinpoint the cause.

Also, keep an eye on nutrient deficiencies. SIBO can impair absorption of vitamin B12, iron, and fat‑soluble vitamins. Simple blood work can catch these early, so you can supplement before they become a problem.

Bottom line: Treating SIBO is a three‑step process – eliminate the excess bacteria with antibiotics or herbs, starve any leftovers with a low‑FODMAP or SCD diet, then rebuild a healthy gut with probiotics and motility aids. Follow these steps, stay consistent, and you’ll likely see your bloating and discomfort fade away.