I see a lot of information about SIBO on websites and social media, especially in relation to giving advice on how to cope with the symptoms.

Symptoms

Common symptoms of SIBO include:

• bloating
• nausea or vomiting
• diarrhoea
• fatigue
• weight loss
• joint pain
• skin problems
• depression
• malnutrition

Yet many of these symptoms are the same as for other conditions. So it’s not always straightforward to know if you have SIBO or something else, just from symptoms.

This is one reason it is a good idea to get advice from a qualified professional rather than from friends on social media. What helps one person with SIBO is not necessarily going to be the right thing for someone else.

You could perhaps get a test from your doctor or another health professional. If that test is positive, your doctor might consider a course of antibiotics appropriate. Yet, SIBO often returns after a course of antibiotics, so this is not a long term solution for most people.

But, more importantly, we should consider that if the test for SIBO is positive – what is the underlying cause? Because some of the underlying conditions that result in symptoms of SIBO can be serious.

Causes

Here are some of the underlying causes of SIBO:

• Medications such as antacids and proton pump inhibitors
• Low stomach acid
• History of traumatic head injury
• Chronic diabetes or chronic pancreatitis
• Early neurodegenerative disease such as Parkinson’s disease
• Intestinal disease such as coeliac disease
• Other causes of damage or scarring to the intestinal wall, such as radiation therapy or surgery
• Immune system deficiency such as HIV
• Hypothyroidism

The best diet for SIBO

The low FODMAP is often suggested as the best diet for SIBO, and I agree this is a great place to start. The low FODMAP diet can really help to reduce symptoms. On the other hand, in some cases, it could be very important to consider what the underlying cause of those symptoms is. Particularly because the low FODMAP diet is not recommended for most people in the long term.

If you think you have SIBO:

• Consider having testing, either through your doctor or privately
• Consider a trial of the low FODMAP diet to reduce symptoms
• Work with a qualified practitioner such as a qualified medical herbalist to determine what the underlying cause could be