Small Intestinal Bacterial Overgrowth (SIBO)

What is it?

  • Small Intestinal Bacterial Overgrowth, or SIBO, occurs when the bad or pathogenic bacteria in your small intestine get out of balance and overgrow. When there is an imbalance of your gut bacteria, this is called dysbiosis. Many diseases and symptoms are associated with having dysbiosis. Making sure your gut bacteria is in balance is very important. Gut health is the foundation of your overall health. Your gut bacteria impacts your behavior, mood, pain, hormones, memory, immunity, metabolism, anxiety, and more. Excess bacteria in your gut feed off of undigested, sugary, and processed food in your small intestine. In particular, they love to feed on sugar, simple and complex carbohydrates, starches, and alcohol. Short chain carbohydrates and sugar alcohols that are poorly absorbed by the body and eaten frequently, result in abdominal pain and bloating. These are called FODMAPs which stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols.

  • As the bacteria feeds, it causes the carbohydrates to ferment, which produces hydrogen as a byproduct. Hydrogen can in turn feed single-celled organisms in your small intestine called archaea, which then produce methane as a byproduct. So when you have SIBO you have excess levels or hydrogen, methane, or both in your digestive system. 

  • Depending on which gas is most predominantly produced, you can develop different symptoms and respond better to different treatments. Hydrogen-dominant SIBO typically leads to diarrhea, whereas methane-dominant SIBO is usually associated with constipation. 


  • Functional Gastrointestinal Disorders: Our gut relies on nerves, muscles, enzymes, and neurotransmitters to properly digest food. While enzymes mainly break down our food, the nerves, muscles and neurotransmitters physically move the food through our digestive tract from the stomach to the small intestine and to the colon. This movement is called "gastric motility." When this happens in a healthy gut, bacteria gets passed through the digestive tract along with the food to its final destination in the colon. Problems arise when something interferes with this process. Chronic interference leads to a functional gastrointestinal disorder. This damage to the nerves or muscles in the gut can result in leftover bacteria in the small intestine, increasing your risk for SIBO. 

  • Diet: A low fiber, high simple sugar diet and alcohol triggers three things: 1) functional gastrointestinal disorders (FGID)-related symptoms, 2) dysbiosis aka gut bacteria imbalance, and 3) increasing small intestinal permeability called leaky gut.

  • Chronic Stress: Chronic stress has been proven to produce intestinal motility problems and pain seen in SIBO.

  • Physical obstruction: Scarring from surgeries or Crohn’s disease can also cause an abnormal buildup of bacteria in the small intestine. Diverticuli, which are tiny pouches that can form in the wall of the small intestine, can also collect bacteria instead of passing it on to the colon, where it belongs.

  • Medications: There are also medications that influence or disrupt the amount of good gut bacteria, such as antibiotics, acid-blocking drugs, and steroids. Medications also deplete us of important vitamins and minerals. It is essential we are not deficient in vitamins and minerals necessary to function and feel our best. I recommend nutritional testing to see if you are deficient in any vitamins or minerals.


  • Gas, bloating, and diarrhea

  • Abdominal pain or cramping

  • Constipation

  • Diagnosis of irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD)

  • Food intolerances such as gluten, casein, lactose, fructose, and particularly histamine intolerance

  • Chronic illnesses such as fibromyalgia, chronic fatigue syndrome, diabetes, neuromuscular disorders and autoimmune diseases

  • Vitamin and mineral deficiencies, including vitamins A, B12, D, and E

  • Fat malabsorption (signified by pale, bulky, and malodorous stools)

  • Rosacea, eczema, and other skin rashes

  • Leaky gut which is the separation of your gut cells that cause an increase in inflammation, immune activation, and stress on the body


  • Diagnosis requires 5 of the following for 6 weeks or more: morning stiffness, pain on motion or joint tenderness, joint swelling, positive rheumatoid factor on blood test, xray changes

  • Full bloodwork panel that evaluates infections, organ function, inflammation, and vitamins

  • Nutrient deficiency testing

  • Digestive function testing

  • Food intolerance and allergy testing

  • Hormone testing

Allopathic Treatment Options

  1. Anti-rheumatic drugs

  2. Corticosteroids


  4. Immunosuppressants

  5. Blood pressure medications

  6. Hormones and birth control pills

  7. Low FODMAP diet

Naturopathic Treatment Options

  1. Starve overgrown bacteria

  2. Treat infections

  3. Remove food allergies, intolerances, and environmental toxins.

  4. Encourage whole foods diet to promote good bacteria

  5. Repair and restore gut flora

  6. Repair and restore gut integrity and digestive movement

  7. Address nutrient deficiencies

  8. Support liver health to detox environmental toxins and infections

  9. Address micronutrient deficiencies to build up the physiology/biochemical function of the body

  10. Find out what foods you are intolerant to through food intolerance testing. Dr. Felty's patients experience relief after removing foods that bother them

  11. Reduce stress and anxiety naturally through mind body techniques such as somatic experiencing, meditation, and qigong

  12. Support physical health and reduce pain through  abdominal massage and manual adjustments

  13. Hydrotherapy

  14. Teach lifestyle adjustments unique to your lifestyle and schedule that may include exercise and other lifestyle habits. Dr. Felty looks at more than your symptoms. She provides care for your whole health. Many different factors impact your symptoms. Dr. Felty will take time to educate you and work with you to feel better

  15. Naturopathic Counseling

  16. Homeopathy

  17. Referral to other healers or practitioners relevant to your health and healing.

Everyone is unique and has different reasons why they develop Irritable Bowel Syndrome. Good news is that everyone can improve their condition and activate their natural ability to heal. Dr. Felty can educate you on what your body, mind, or spirit needs to improve and heal from this. Call her office 773-472-0560 or fill out this form here to request an appointment.

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