SIBO - Otherwise Known As “Why Does My Tummy Hate Me?”

Hi, everyone! I hope you are enjoying this glorious spring we’ve been having so far. I know I am! I’ve been out planting and hiking and biking, and our community recently opened its pool, so I have even been down there with the kiddo a couple of times.

Today I want to chat a little bit about a topic that isn’t directly Lyme related, though it seems to be very common among Lyme patients, especially those who have treated with a number of antibiotics: SIBO (Small Intestinal Bacterial Overgrowth).

SIBO, like its name states, is basically an overgrowth of bacteria in the small intestine, which, unlike the large intestine, is usually quite free from bacteria. When any number of possible factors cause bacteria to populate there, a number of unpleasant symptoms can occur.

The symptoms of SIBO can be very similar to those of something like Irritable Bowel Syndrome (IBS), and, in fact, it’s common for IBS patients to test positive for SIBO. Typically with SIBO patients may experience abdominal bloating, gas, pain, distention, along with diarrhea and/or constipation.

Testing for SIBO can be a bit tricky, but it is typically confirmed with a breath test. The test involves the patient drinking a solution of some sort of sugar (typically glucose or lactulose) and then blowing into a tube that measures the levels of hydrogen, methane, and other gasses produced as a result of the ingestion of this substance. If a person has SIBO, typically their levels will rise dramatically.

A GI physician may also be able to diagnose this condition if it is found during an upper endoscopy procedure. (My understanding is that not all GI doctors look for it, so it may be something you would want to discuss if you are going to be having that procedure anyway.)


There are a number of predisposing factors that can contribute to or make you more susceptible to SIBO. They include:

  1. Antibiotic use, especially long-term antibiotic use that is frequent with Lyme patients.

  2. Hypochlorhydria (primary or secondary to use of acid blocking medications)

  3. Food not digesting properly (due to a lack of digestive enzymes, bile, etc.)

  4. Malabsorption disorders

  5. Autoimmune disease

  6. Hepatic disease and/or heavy alcohol use

  7. High carbohydrate, high sugar diet

  8. Ileocecal valve dysfunction


Unfortunately, the recurrence rate with SIBO can be quite high, although there are several things that can be done to help lessen the chances of this happening.

  1. Dietary changes - it’s important to look for things in the diet that can be contributing to the problem, specifically certain carbohydrates, starches, and sugars, as those things tend to feed the bad bacteria.

    1. A limited carbohydrate diet like paleo, SCD, GAPS, or Whole30 can often times be helpful.

    2. A low FODMAP diet may also be helpful, either on its own, or in combination with one of the above diets, as FODMAPs are foods that some people have difficulty digesting, and these foods then stay in the GI tract longer and can cause fermentation.

    3. It’s also important to eliminate, or at least limit alcohol, as this can definitely contribute to the problem.

Natural Considerations

Dealing with SIBO can be tricky, as it seems to be a very individualized thing. Typically, a GI doctor will prescribe antibiotics, which may alleviate symptoms. The trick would then be to help your body replenish the good bacteria afterward.

Some people opt for trying any number of botanical protocols, many of which have been shown to be as effective, if not more, than antibiotics. Some of these options might include:

  1. Biocidin

  2. GI Microbix

  3. FC Cidal + Dysbiocide

  4. Tanalbit (plant tannins)

  5. Berberine

  6. Oregano

  7. Lauricidin (monolaurin)

  8. Olive leaf

  9. Garlic

  10. Neem

With any of these things, you will be altering gut flora, so a good probiotic supplement can be helpful. Personally, I have found a good across the board probiotic, along with an S Boulardii (beneficial yeast) to be the most helpful.

Along with all of this, it’s also important to address GI tract motility, if this is an issue for you. There are some products on the market, like Iberogast, that are intended for this purpose. Other options would include ginger, or a prescription compounded Low Dose Naltrexone. Also, making sure any underlying disease process like thyroid, diabetes, or other autoimmune disease, is being treated optimally.

We have a naturopathic doctor (ND) here at Tailor Made, Dr. Paul Ratte, who is able to assist you with both testing and treatment of SIBO, if suspect you might be dealing with this condition.

I have had SIBO a few times myself, but with the things I’ve outlined above, I now manage to keep it in check most of the time, and I’m no longer asking why my tummy hates me!

Until next time, be well.

About the Author

Krista Ostrom

Krista Ostrom is a Lyme Disease patient who has extensive knowledge about Lyme, its many co-infections and co-conditions, nutrition and supplements, food intolerances and allergies, and specialty diets. When she’s not working at Tailor Made Nutrition, you can usually find her hiking with her family, practicing yoga, traveling, cooking her favorite meals, and “geeking out” about integrative health topics.