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Last Updated on October 7, 2025 by Nikki Hawkes

SIBO: it’s important to find the possible causes

by | Nov 12, 2023 | Gut Health and Digestion

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 or 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

You might like to read my post: Uncovering Foods that Mimic Gluten in Coeliac Disease

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 through a medical herbalist
  • Consider a trial of the low FODMAP diet to reduce symptoms
  • Work with a qualified medical herbalist to determine what the underlying cause could be

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Nikki Hawkes Medical Herbalist and Functional Medicine Practitioner

Nikki Hawkes

BSc.Hons, PG.Dip

MNIMH, MCPP

Nikki Hawkes holds a BSc (Hons) in Phytotherapy and a Postgraduate Diploma in Nutritional Medicine. She is a registered member of the National Institute of Medical Herbalists (MNIMH) and the College of Practitioners of Phytotherapy (MCPP). Both require degree-level entry. With over 20 years of clinical experience, she also holds certification as a Functional Medicine Health Consultant. Her practice combines traditional herbal medicine with current research in nutrition and functional medicine.