So You Have Small Intestine Bacterial Overgrowth...

Welcome to The Healthy Gut. I'm Rebecca Coomes and I'm here to help you live well with SIBO, break free from your painful and embarrassing symptoms and start living the life you know you deserve to live. Do you imagine a life without SIBO, where you're free to eat out, go on vacations and feel healthy? I'm here to help show you how you can achieve that and so much more.

Since 2015, I have helped thousands of SIBO patients from around the world stop feeling trapped by their SIBO. No matter whether they've just been diagnosed or have been dealing with SIBO for a while, everyone can benefit from some support. So let's start: what is SIBO, what does it really do to us and can we ever live a life free from our symptoms?


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What exactly is Small Intestine Bacterial Overgrowth?

Put simply, Small Intestine Bacterial Overgrowth (SIBO) is an overgrowth of normal bacteria in the small intestine. It is not pathogenic bacteria, but regular bacteria that has either entered via the top of the digestive system (mouth and nose for example), or has migrated up from the bottom of the digestive system; the large intestine.

SIBO is a common condition, affecting millions of people around the world, but is still a relatively unknown condition and often goes undiagnosed for years, if not decades.

Studies have shown it is the most common cause of Irritable Bowel Syndrome (IBS). A study published in the American Journal of Gastroenterology in 2003 showed that 84% of IBS patients had SIBO. Leading SIBO researcher and gastroenterologist, Dr Mark Pimentel from Cedars Sinai in Los Angeles says ‘most of IBS is actually SIBO’.

Up to 20% of Americans and 1 in 5 Australians have Irritable Bowel Syndrome. IBS is the most common digestive complaint in the world. Many of them will have it because of SIBO.

I know what it's like to live with SIBO and painful gut issues

I have struggled with gut issues most of my life and suspect I had SIBO from early childhood. I know how isolating it can be to live with these painful and invisible issues. I know how frustrating it can be when it feels no one understands what you're going through. And I know how hard it can be to get the right kind of medical help. That's why I developed The Healthy Gut, so I could help people just like you. I don't want you to suffer a moment longer. The Healthy Gut has the tools and support you need to live well with SIBO and beyond.

Rebecca Coomes, SIBO patient, Founder of The Healthy Gut, host of The Healthy Gut Podcast and author of the SIBO Cookbooks

What Are The Typical SIBO Symptoms?

The one thing that is consistent with SIBO is that no two people are the same when it comes to their symptoms. Some people barely feel a thing while others are bedridden and unable to work. However, there are a handful of symptoms that may be experienced if you have SIBO. You can have one, some or all of the symptoms below.

Symptoms also change over time, so it is important to remember that just because you feel awful today, doesn't mean you will feel awful for the rest of eternity.  Hooray for that!

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    Abdominal pain and/or cramping

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    Alternating constipation and diarrhoea

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    Food intolerances and sensitivities

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    Belching and/or flatulence

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    Heartburn / acid reflux

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    Brain fog

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    Memory loss

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    Chronic digestive complaints

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    Joint pain

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    Depression and/or anxiety

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    Respiratory symptoms, such as asthma

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    Skin issues such as itchy skin, hives, rashes, eczema, psoriasis, acne 

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    Vitamin and mineral deficiencies, especially Vitamin B12 and iron

Here are three of my most popular episodes on The Healthy Gut Podcast where I interview leading SIBO doctors about what SIBO actually is. My fans regularly tell me how much my podcasts have taught them about SIBO and gut health. I guarantee they'll help you too.

If you love these episodes, make sure you subscribe on Apple Podcasts so you get new episodes a soon as they come out.

What causes SIBO?

SIBO is caused by three things: a structural issue with your small intestine, a motility issue with your small intestine, or an immune issue with your small intestine.

There are many things that can lead to these three things, and you may find you have several factors contributing to your small intestine not working properly.

Understanding why your gut is not working effectively is one of the most important factors in successfully treating SIBO and preventing a relapse. Check out the following popular articles on SIBO to help you understand this condition more fully.

Top 3 Causes Of Sibo Blog

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What's The Best Way To Treat SIBO?

There are 3 current treatment options for SIBO: antibiotics, herbal antimicrobials and the Elemental Diet. I got into detail about each one in my article about SIBO treatment options.

If you would like to learn the current best-practice approach to treating SIBO from a leading SIBO doctor, I recommend undertaking Dr Allison Siebecker's SIBO Recovery Roadmap™ Home Study Course. It is based on the system that Dr. Siebecker and her colleagues have used to treat SIBO for years, and shares the exact solutions Dr. Siebecker uses to train other physicians at a post-graduate level. Sign up for the course here.

Should You Test and Re-Test For SIBO?

SIBO testing can be helpful to determine whether you indeed have SIBO, but more importantly, to understand what type of SIBO you have.  Currently, SIBO tests can diagnose hydrogen and methane SIBO.

Why is this important? If you have hydrogen SIBO, you will require a certain type of treatment that differs from the treatment for methane SIBO.  Simply going off symptoms does not give you enough information on what type of SIBO you have, and can result in substandard treatment and outcomes.

Check out my full article on how to test for SIBO where I review the different types of tests, the pros and cons for each test, and why you would consider re-testing after a round of treatment.

Should You Follow A SIBO Diet?

A SIBO diet is used to help calm down symptoms, but it does not treat SIBO. Let me repeat that, a SIBO diet does not treat SIBO.

It can be very helpful in calming down your SIBO symptoms, as it reduces the amount of fermentable carbohydrates and fibres from your diet. It is a short term solution and should not be followed for more than 6 months.

There are several diets that are used by SIBO patients, including the SIBO Specific Food Guide, SIBO Bi Phasic Diet, Low FODMAP Diet, Fast Tract Diet, Low Fermentable Diet, SCD and GAPS.  You can read more about the various SIBO diets in my article on everything you need to know about SIBO.

I regularly see people who have become very fearful of food, staying on a highly restricted diet for years and struggling to expand to new foods without severe reactions. Joining my free Facebook SIBO Recipes Group is a great way to learn new recipes, ask food questions and get tips and tricks from other SIBOers.

If you have ever experienced disordered eating or an eating disorder, following a SIBO diet may not be suitable for you, as it can be triggering.

When I work with my SIBO coaching clients, we identify how well they are tolerating a wide range of foods.  If they can tolerate something, there is no reason for them to eliminate it from their diet, regardless of whether it is considered 'safe' on a SIBO diet.

I followed the SIBO Bi Phasic Diet by Dr Nirala Jacobi and found it very beneficial in reducing my symptoms - the first time in years.  For this reason, I have written a range of SIBO Cookbooks and SIBO Meal Plans, providing you with a range of delicious recipes that you can enjoy while going through your treatment. I also have hundreds of freely available SIBO recipes available for you to enjoy.

If you're not confident in the kitchen, why not watch one of my SIBO Cooking Shows on YouTube? I show you exactly how to make some of my delicious recipes.  If you like more interaction with your cooking, you can also join me for a live SIBO Cooking Class where I cook a range of SIBO recipes for you. Held online, you can tune in from the comfort of your own home and ask me questions as I cook for you. These classes are a lot of fun and you get access to the exclusive recipes that are not found anywhere else. Plus, you get a recording of the class so you can watch it again and again.

If you're based in Melbourne, Australia, you can join me on a private SIBO shopping tour at the Prahran Market. We shop for your unique requirements and I share my hints and tips of shopping and cooking for SIBO.

What's The Best Way To Prevent Your SIBO Relapsing?

Without doubt, the best way to prevent your SIBO relapsing is to address the underlying cause of your SIBO.

SIBO Myths

1. SIBO Isn't A Real Condition

This statement is proclaimed all too often by ill-informed medical professionals who have not kept up to date with the latest research. SIBO has been studied at length and is a real thing. If your doctor doesn't believe in it, ask them to look at the work of Dr Mark Pimentel or Dr Allison Siebecker.

2. SIBO will be gone after 1 round of antibiotics

Sadly for the majority of people, SIBO is a complex condition and requires multiple rounds of treatment. There are some very fortunate people who feel vastly improved after a short round, but the majority of people need to spend some time healing their gut.

3. Cheating On Your Diet Will Cause A Relapse

If you recall above, I said that diet doesn't treat SIBO.  So unless you have gone and binged on McDonalds for every meal, of every day, for months on end, eating some carbs or dairy or sugar (of whatever the 'offending' food is) won't be the reason your SIBO has returned.  Instead, it will because the underlying cause wasn't addressed and is still allowing the bacteria to form in excessive numbers in the small intestine.  Until you fix the core root of why your small intestine isn't working properly, you will most likely continue to relapse.

4. SIBO Will Never Be Cleared

SIBO can be treated successfully and people can live wonderful lives without the burden of gut problems. However, someone who has had a compromised digestive system may need to be more careful than the average person to prevent bouts of food poisoning or infection, as they may be more prone to contracting these illnesses. Some people may never achieve 100% resolution of their symptoms, but may get to 80%-90% improvement, which for many, is a wonderful place to be. Most of my clients come to accept their new normal is a bit different from their old normal, but now they are armed with the knowledge of what SIBO is and can listen to their body's signals, they are able to take action much quicker and prevent a full blown relapse.  Even if they do relapse, they know what to do.


Get My Free and Exclusive SIBO Resources


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Thank You For Being Here

As a fellow SIBO patient and founder of The Healthy Gut, I am here for you.

I want to hear your story. I want to know how I can serve you better and make your journey with SIBO less stressful and painful.

I do my best to respond to every email I receive. And yes, they do come straight to my inbox. So drop me a line and introduce yourself to me. I would love to get to know you.

It's great to have you here.  Welcome to  The Healthy Gut.

Follow me on instagram for a daily dose of inspiration

10 thoughts on “Start Here: Small Intestine Bacterial Overgrowth”

  1. Hi Rebecca,
    I have been diagnosed with leaky gut and SIBO.
    I have been prescribed antimicrobials for 60 days by my functional medicine practitioner.
    Do you think the antimicrobials alone will be sufficient, or will I need to undertake a round of the SIBO Bi-Phasic diet too? I already know what my food sensitivities are.

    1. Hi Romina
      If you would like some personalised support, I would be happy to guide you through a 1:1 SIBO Coaching Session. It’s difficult to give tailored advice without knowing anyone’s history so it is difficult to say whether the antimicrobial treatment alone will be sufficient.
      Kind regards

  2. Hello, I now have SIBO 5 years after the removal of my transverse and ascending colon. I was born with it twisted, redundant and eventually it became purple and black before it was removed at age 58. Two years ago my red blood count and hematocrit were elevated and a Cologuard test revealed a fast growing pre-cancerous polyp which was removed during the colonoscopy. The GI doctor told me he went into my small intestine and all looked good. But 5 years ago my surgeon said a GI physician should never go into my small intestine because of bacterial contamination. So, here I am. My small intestine has been much larger than my large intestine as seen on the frequent X-rays and CT scan. My physician said SIBO is a permanent condition for me now.

    Now I’m trying to adjust and would definitely love some recipes for making yogurt, ice cream, pancakes, etc. Any suggestions are greatly appreciated.

  3. I been diagnosed with SIbo and candida from one week ago. I got SIbo after 2 rounds antibiótics . My Gastroenterologist prescribed me xifaxan but I don’t want to take more antibiótics. I am being very sick the last 3 years one another thing. I am taking natural antibiótics or a antimicrobial supplements. Do you know if SIBO can be cured or treated without taking antibiotics? Just taking herbal antibiótics?

    Doris Hernández
    [email protected]

  4. Hi,

    My friend told me about about this healthy gut diet. Can you please confirm this is the right place. She said you follow a meal plan and have to buy some supplements?

    1. Rebecca Coomes

      Hi Samantha
      I have created meal plans for people following a SIBO diet. You can see them here.
      If you have SIBO, it’s common that you’ll need to use some antibiotics or herbal antibiotics to treat it. Have you been diagnosed with SIBO? Or perhaps you might have been told you have IBS?

  5. Hi I have recently been diagnosed with Sibo in UK. I am struggling to find information and a good cookbook. Do you know where I can buy your books in uk. I am following the biphasic protocol which your book is based on. Can you post me one, I prefer an actual cookbook to online. I look forward to hearing from you.

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