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What is SIBO?

Published date: September 12, 2023 | Modified date:
by Dr Stephen Wangen

Here’s what we’re going to cover

  1. Should Bacteria Be in the Small Intestine?
  2. The Bacterial Balancing Act
  3. Treating SIBO


SIBO stands for small intestine bacterial overgrowth. It’s all the rage right now in the IBS world, but what exactly is it?

Should Bacteria Be in the Small Intestine?

Your gut is full of bacteria. In fact, there are somewhere in the neighborhood of 100 trillion bacteria down there!  So how can it be a problem?

Well, some people get hung up on the idea that the bacteria are in the small intestine. Actually, everyone has lots of bacteria in both their small and large intestines, so it’s not that you shouldn’t have any bacteria in your small intestine. In fact, bacteria play a huge role in how you digest your food.

The Bacterial Balancing Act

So that isn’t the problem. The problem is that you have some bacteria that have colonized more territory than usual. Another way of saying this is that your bacteria are out of balance.

small intestine bacterial overgrowthI like to call these bacteria “indifferent” bacteria. They aren’t the really bad bacteria that will automatically wreak havoc on your digestion, and they aren’t the really good bacteria that are considered the good guys, or what people often call probiotics. They are somewhere in between.

You normally have lots of different kinds of bacteria in your digestive system. Dozens of different kinds, even, including many of these indifferent bacteria. But they are normally at relatively low levels and in balance with the other bacteria down there.

If they begin to colonize more territory than usual, they can become problematic. Notice that I used the word colonize. That’s because all bacteria are constantly looking for territory to colonize. It’s a competition, and it’s just what they do. But when everything is healthy, they keep each other in check and stay relatively balanced.

But when they get out of balance, this can become a problem. Why?  This is not a problem in the same way that some really bad bacteria are a problem. Those really bad bacteria may produce toxins and completely interfere with your digestion, even at low levels.

But remember how I said that your bacteria help you to digest your food?  These overgrown bacteria can interfere with and change how you are breaking down your foods, which in turn can lead to digestive symptoms.

Treating SIBO

There are many reasons why they can get out of balance, but once it happens, it needs to be treated. This can be a very involved process, because it takes a long time to create bacterial imbalances in your microbiome, and it can take a long time to properly treat a bacterial overgrowth.

This is why treating SIBO is often easier said than done, and many people find short term treatments to be unsatisfactory.

If you need help treating a bacterial overgrowth, please don’t hesitate to reach out to us. We work with patients via telehealth from just about everywhere, so you don’t need to be near us.

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