Whether you’re struggling with bloating, gas, abdominal discomfort, diarrhea, constipation, or food reactions, SIBO may be one possible contributor to your digestive symptoms. With over 20 years of clinical experience, Dr. Matt Gowan, ND helps patients investigate potential causes of persistent digestive symptoms and develop personalized treatment plans, including SIBO testing when appropriate.

Why Patients Choose Us for SIBO Care

• 20+ years digestive-focused clinical experience
• 4.9-star rating with 200+ reviews
• Experience assessing and treating SIBO and IBS
• Published research in digestive health
• Evidence-informed, root-cause approach
• Collaborative clinic with 3 naturopathic doctors

Could Your Digestive Symptoms Be Related to SIBO?

SIBO can cause a variety of digestive symptoms, and symptoms can differ from person to person. Common symptoms associated with SIBO may include:

• Bloating, particularly after eating
• Excessive gas or belching
• Abdominal discomfort or cramping
• Diarrhea or loose stools
• Constipation or difficult bowel movements
• Feeling uncomfortably full after meals
• Digestive symptoms triggered by certain foods

These symptoms can also occur with IBS and many other digestive conditions, which is why identifying possible contributing factors is important before deciding on treatment.

What Is SIBO?

Small intestinal bacterial overgrowth (SIBO) occurs when excessive numbers of bacteria are present in the small intestine. These bacteria can ferment carbohydrates from food, producing gases that may contribute to bloating, abdominal discomfort and changes in bowel habits.

Different patterns of intestinal gas production may also be associated with different symptoms. Hydrogen is more commonly associated with diarrhea, while methane is often associated with constipation.

Because SIBO symptoms overlap considerably with IBS and other digestive disorders, symptoms alone cannot determine whether SIBO is present.

How Is SIBO Tested?

SIBO is commonly evaluated using a breath test that measures hydrogen and methane gases produced after drinking a test solution. The results can help identify patterns of intestinal gas production that may be associated with different digestive symptoms.

SIBO breath test kits can be ordered through our clinic and completed at home. We can help determine whether testing is appropriate and review the results in the context of your symptoms and medical history.

Breath testing can provide useful information, but results should not be considered in isolation. Symptoms of SIBO can overlap with IBS and other digestive conditions.

What Causes SIBO?

SIBO can develop when the normal mechanisms that keep bacteria from accumulating in the small intestine are disrupted. Rather than having a single cause, SIBO is often associated with factors that affect intestinal movement, digestion, or the structure of the digestive tract.

Factors that may contribute to SIBO include:

• Reduced intestinal motility, which can allow bacteria to remain in the small intestine longer than normal
• Previous gastrointestinal infections, including food poisoning
• IBS and other chronic digestive disorders
• Chronic constipation or slow intestinal transit
• Structural changes in the digestive tract, including those related to previous abdominal surgery
• Certain medications or medical conditions that can affect digestion or intestinal motility

For some people, treating the bacterial overgrowth alone may not be enough. Identifying and addressing factors that may have contributed to SIBO can be important, particularly when symptoms repeatedly return after treatment.

Our Approach to SIBO Treatment

SIBO treatment should be individualized based on your symptoms, health history, bowel patterns, and test results when available. Our approach focuses on reducing symptoms, addressing bacterial overgrowth when appropriate, and identifying factors that may contribute to recurrence.

Depending on your individual needs, treatment may include:

• Identifying and addressing problematic foods or food sensitivities that may contribute to digestive symptoms and changes in bowel function or intestinal transit
• Dietary strategies to help reduce bloating, gas, and other digestive symptoms
• Herbal antimicrobial therapy when appropriate
• Support for intestinal motility, particularly when constipation or slow transit is present
• Nutritional support to address potential deficiencies
• Addressing underlying factors that may contribute to SIBO
• Strategies to reduce recurrence after successful treatment
• Probiotics and digestive support† when appropriate

† Probiotics should be used thoughtfully in SIBO. Different probiotic strains can have different effects, and some people with SIBO may experience increased bloating, gas, or other digestive symptoms with certain products. Probiotic recommendations should therefore be individualized rather than assuming that every probiotic is appropriate for every person with SIBO.

Because SIBO can have different underlying causes and symptom patterns, there is no single treatment plan that is appropriate for everyone. Our goal is to develop an individualized approach that addresses both your current digestive symptoms and factors that may be contributing to them.

Frequently Asked Questions About SIBO

1. What does SIBO feel like?

SIBO can cause a variety of digestive symptoms. Common complaints include bloating, excessive gas, abdominal discomfort or cramping, diarrhea, constipation, and feeling unusually full after meals. Symptoms often worsen after eating and may vary depending on the types of gases being produced in the intestine.

Because these symptoms can also occur with IBS and other digestive conditions, symptoms alone cannot determine whether someone has SIBO.

2. How do you test for SIBO?

SIBO is commonly evaluated using a breath test. After drinking a test solution, breath samples are collected over several hours and analyzed for gases such as hydrogen and methane produced by intestinal microorganisms.

The results should be interpreted together with your symptoms and medical history, as breath testing has limitations and a positive result should not be considered in isolation.

3. Can SIBO cause constipation?

Yes. Methane production is particularly associated with constipation and slower intestinal transit. This is more accurately called intestinal methanogen overgrowth (IMO) because methane is produced by microorganisms called methanogens rather than bacteria.

People with methane overgrowth may experience constipation along with bloating, gas, abdominal discomfort, and a feeling of incomplete bowel movements.

4. Can SIBO come back after treatment?

Yes. SIBO can recur after successful treatment, particularly when factors that contributed to the overgrowth are still present. Problems with intestinal motility, chronic constipation, certain medical conditions, structural changes in the digestive tract, and other factors may increase the likelihood of recurrence.

For this reason, our approach considers both the overgrowth itself and factors that may be contributing to its development or recurrence.

5. What is the difference between SIBO and IBS?

IBS (irritable bowel syndrome) is a disorder characterized by symptoms such as abdominal pain, bloating, constipation, and/or diarrhea. SIBO (small intestinal bacterial overgrowth) refers to an abnormal increase or alteration of microorganisms in the small intestine.

The symptoms can overlap considerably, and some people with IBS may also have SIBO. However, IBS and SIBO are not the same condition, and having IBS does not necessarily mean that SIBO is present.

6. What is the difference between SIBO and SIFO?

SIBO refers to an overgrowth of bacteria in the small intestine, while SIFO (small intestinal fungal overgrowth) refers to excessive fungal organisms, such as yeast, in the small intestine.

The two conditions can produce similar symptoms, including bloating, gas, abdominal discomfort, and changes in digestion. However, they involve different microorganisms and therefore may require different approaches to assessment and treatment.

7. Can I order a SIBO breath test through your clinic?

Yes. SIBO breath test kits can be ordered through our clinic and completed at home. The test typically measures hydrogen and methane produced following a test solution.

We can help determine whether SIBO testing is appropriate for your symptoms and review your results in the context of your digestive history. Book an appointment with one of our naturopathic doctors to discuss SIBO testing and treatment options.