Skip to content 
What is SIBO? SIBO is small intestinal bacterial overgrowth. It can cause unwanted bloating, fatigue, constipation, diarrhea, gas, nutritional deficiencies and more. And it’s one of the most common reasons that clients are experiencing their digestive symptoms. The traditional method for treating SIBO is to take antibiotics for 2-4 weeks to “kill” the SIBO and potentially to do an elimination diet. But this standard of care does not work for a couple reasons: 1) It’s not addressing the root cause of the SIBO 2) It is not empowering you as the client to understand how to prevent it from coming back 3) It is only addressing the small intestine
SIBO is a symptom, not a root cause like you may have been told.
In this episode of Love Your Gut podcast, if you feel completely stuck with your SIBO I want to give you some insight as to why your SIBO keeps coming back, what you can do about that, and then some actionable tips at the end of what you can do now while you’re working on actually clearing your SIBO. So if you feel like you’ve tried all the antibiotics, all the herbals all the diets, everything this episode is for you. Tune in to hear more!
In Today’s Episode We Discuss:
- What SIBO is and how to diagnose it.
- How to treat SIBO effectively and why the low FODMAP diet and Zai Faxon’s traditional methods don’t work.
- Why SIBO is a symptom and not a root cause
- Knowing how genetics influence SIBO and how to determine the mechanism behind the SIBO
- Adding in prebiotics and probiotics for SIBO recovery
- Lifestyle changes such as optimizing sleep, stress management, connection and happiness in our SIBO journey.
- Taking care of the gut environment by fixing the food issue
- Some of the root causes for SIBO we see with clients
- Why consistency is crucial for SIBO recovery journey
- A comprehensive approach to SIBO
- Three reasons why your SIBO keeps coming back
- Three actionable tips to beat SIBO faster
Resources Mentioned:
Dr. Pimentel new Research https://youtu.be/7atCK2wjJvQ
Blog: https://www.drheatherfinley.co/blog/
Quiz: https://www.drheatherfinley.co/?s=quiz
Additional Resources:
Follow & Review on Apple Podcasts
Are you following my podcast? If you’re not, I want to encourage you to do that today so you don’t miss any future episodes! I would also appreciate it if you would leave me a review on Apple Podcasts or Spotify! I read each of them, and they help me make sure I am providing the content that you love to hear!
Transcription:
Hey, welcome to the love your gut podcast. I’m your host, Dr. Heather Finley, I know what you’re thinking, how am I supposed to love my gut when all it does is hold me back. I thought the same thing before I found relief from my own gut health issues. I dedicated my life to getting into the bottom of my own gut issues. So I can help women just like you transform theirs. Now, I’m here to guide you through your own gut health journey. We do this through identifying your root causes and making sustainable and transformative changes. As a result, you can unleash your true potential. My goal is to empower you with the information and tools you need to love your gut. So it loves you back right here on this podcast.
Welcome back to the next episode of the love your gut podcast. This is your host, Dr. Heather Finley, and I am so excited to talk to you today about SIBO small intestinal bacterial overgrowth. It’s so common, it’s one of the top questions that I get over on Instagram, that everyone wants to know about why SIBO keeps coming back. It’s such a hot topic. And it’s something that I’m super passionate about, because I see it all the time in the clients and the gut Together program. So my goal today is to really give you some insight as to why your SIBO keeps coming back, what you can do about that, and then some actionable tips at the end of what you can do now while you’re working on actually clearing your SIBO. So if you feel completely stuck with your SIBO, you feel like you’ve tried all the antibiotics, all the herbals, all the diets, everything you feel like you are on this ferris wheel that you cannot get off of this episode is going to help you so much, and is also going to allow you to feel like you can stop buying tickets to this CBOE fair that you don’t want to be at anymore. So first, I’m going to just start off if you’re listening and you’re like What is SIBO? Do I have SIBO SIBO is small intestinal bacterial overgrowth, it can cause a lot of unwanted bloating, fatigue, constipation, diarrhea, gas, nutritional deficiencies, and so much more. And the only way that you can actually diagnose SIBO is through a breath test. So you may or may not have had this breath test. And to be honest, sometimes it’s not even necessary to have this breath test, the testing is still not crazy accurate, there’s a lot of ways in which the test can actually be messed up. So that’s a different episode for another time. But if you’re curious about SIBO, and you’re curious if you have it, the breath test is the actual only way to know if you have it. But really beyond that, if you have chronic bloating, chronic constipation, chronic symptoms of any kind and SIBO is part of that. What I want you to take away from this episode is that you have to address the root cause or the reason that you have the SIBO in the first place. It is one of the most common reasons that clients continue to experience symptoms is the root cause was not addressed. So the traditional method for treating SIBO is actually to take antibiotics for two to four weeks to quote unquote, kill the SIBO. And potentially do an elimination diet, a lot of clients will go to their GI doctor test positive for SIBO via the breath test and be prescribed Zai Faxon and the low FODMAP diet. And usually clients feel really good. They start taking the antibiotics, they’re doing the low FODMAP diet, they feel amazing. They’re like, Oh my gosh, this is the answer to my problems. They stopped the antibiotics, they continue low FODMAP. And then their symptoms slowly creep back. And the reason for this is if you’re just focused on killing the SIBO, and you also are restricting your diet of so many of the prebiotic fibers that we need. This does not work. So this standard of care doesn’t work for three reasons. One, it is not addressing the root cause of the SIBO. Two, it’s not empowering you as the client to understand actually how to prevent it from coming back. And three, it’s only addressing the small intestine. So I want you to zoom out for a little bit. And if you’ve ever taken anatomy or you’ve ever taken any health class where you’ve learned about the human body, I want you to think about actually how all the organs in your body really are connected, but especially just how complex the digestive process So this is, and this could probably be a series of 14 different podcast episodes on breaking down every piece of digestion. But what I want you to what I want you to think about is this concept of, we’re zooming so far in on the small intestine and the bacteria that is there and killing it, killing it killing it. But we’re not focused on all the other things that set the stage for digestion. So SIBO is a symptom, not a root cause, like you may have been told in the past. So the first thing that I want to talk about is this concept of clearing and killing the bacteria. I hear it all the time, what do I need to take to kill this bacteria or what what herbals or antibiotics do I need so that I can just get rid of it. And the problem with this is, if we’re just focused on killing, we are not focused on balancing and nourishing, and that is a huge piece of the SIBO picture is balancing and nourishing the gut, there is not a one size fits all approach for SIBO, I wish that it was so cut and dry, you know, you have bloating, or you have constipation, or you have SIBO. And you do this protocol, and everyone does the same protocol, and then it gets rid of it. But the problem is that you have different genetics, different needs different root causes, the reason that I could have SIBO is completely different from the reason that you could have SIBO. So we need to actually dig a bit deeper, to see why you have the SIBO. And potentially not just focus on clearing and killing. So determining the mechanism behind the SIBO here is super, super important. Because another piece of this is if you’re clearing, clearing, clearing, killing, killing, killing, and you’re not nourishing your gut bacteria, it further perpetuates the issue. So you need an abundance of healthy good bacteria in your gut to actually help your guts thrive. So if we’re just killing them off, and we aren’t focusing on how we can actually allow the gut to flourish, we run into a problem. It’s like maybe you have a dead spot on your lawn, and you’re just focused on fertilizing that one spot or using whatever it is to kill what’s causing the problem. But you’re not zooming out and seeing the bigger picture of okay, what’s going on under the soil? Why is there a dead spot here? And how can I actually prevent this dead spot in my lawn from coming back? Hey,
I know you’re absolutely loving this episode. But I have to interrupt real quick to ask you a huge favor. My mission is to empower as many women as possible to find relief from their digestive symptoms, and you are a part of that mission. And the best way that you can help me to pursue this mention this by going over to iTunes, and giving us a five star rating in review so that more people can find this podcast. Now back to the episode.
Some new research, actually by Dr. Pimentel supports that SIBO. And IBS actually might be the result of small intestinal dysbiosis versus just an over abundance of bacteria. So what this means for you is that it’s not necessarily that SIBO is caused by too much bacteria, it means it’s the composition. So the balance of bacteria is very important. If you have quote unquote, bad bacteria in your small intestine, then what about the good bacteria, we don’t really actually want a ton of bacteria in our small intestine anyways. But if you have only bad bacteria in your gut, and no good, the problem actually might be the lack of good bacteria. So this antibiotic and a low FODMAP approach is only further perpetuating the lack of balance. There’s also some research showing that the diversity of bacteria is lower in clients with SIBO. So what we want to take away from this is we don’t want to continue to lower the diversity in your gut. Because the what we know from the largest studies to date on gut health is the more diversity you have in your gut, the better. So the focus now needs to be on how can we repair and rebuild versus just going back to antimicrobials or antibiotics. I am a fan of adding in prebiotics and probiotics for SIBO recovery when appropriate. And obviously that’s something that you need to talk to your health care provider about. But prebiotics and probiotics are super important because when we’re looking at why the SIBO happened, and if you are someone who has lower amounts of diversity, we want to be able to repopulate. So remember that the prebiotics are the food for the probiotic bacteria. So we need both. And in my opinion, most of the time, we actually need more prebiotics versus probiotics. So number two points that I want you to take away from this is knowing the why helps you to feel empowered to know the how, because without the why we can’t understand how, if we don’t know why you have SIBO in the first place, we can just continue to put you on this ferris wheel of symptoms versus getting you off of the Ferris Wheel. And one of the reasons that I think people get stuck on this path is because they’re just focused on supplements, we cannot focus on supplements alone, we also have to focus on our lifestyle, because the lifestyle factors could actually be the major contributing factor to the symptoms that you’re having. It’s very trendy in the gut health world to think about all the probiotics and prebiotics and motility supplements and all that and for sure they do have their time in place. But if you’re super stressed, and you’re not sleeping, and you have a lifestyle that doesn’t allow your body to actually rest and actually digest, it truly does not matter at the end of the day, what supplements you’re taking. Because not every symptom needs a supplement. Sometimes symptoms need a lifestyle change. So that could be potentially sleeping more, or drinking more water. Or honestly, it could be working on having more happiness and fun in your life. I know for many of our clients, they’re so entrapped in this SIBO recovery bubble, they’re so worried about getting rid of their SIBO that they’ve forgotten to have fun and to laugh and to spend time with their family or friends, and to do things that bring them joy. And I think that joy and having fun. And having happiness in your life is a big factor in healing because you need those endorphins, and you need to not have your world revolve around SIBO I know that it is so uncomfortable. And the symptoms can be it feels so debilitating at times and it can make you not want to do anything. But focusing on getting out and enjoying yourself is definitely a part of the process. So some of the lifestyle changes that we really hone in on it with our clients are optimizing sleep, making sure that someone is getting not only adequate sleep, but also restful sleep, there is a difference between being in bed for eight hours and really, truly sleeping for eight hours. The next one is stress management, really working on getting the body out of a fight or flight state and also retraining the nervous system to manage stress better. If you are the type of person that feels very activated by any stressful situation that comes your way. This is definitely a sign that your nervous system needs some work. And I actually have an episode is episode three, where I talk to Lindsay Mitchell, about the nervous system. So if you want to check that out, you can you definitely can. But a nervous system that is dysregulated can also be a root cause as to why your SIBO keeps coming back. In addition to that movement, I see it on both ends of the spectrum clients that are so uncomfortable that they don’t prioritize movement and by movement, I’m not meaning doing a 60 minute hit class. But just moving, walking, getting outside, moving the body movement does stimulate the gut to move and so there’s a happy there’s almost a Goldilocks mentality, not too much, not too little. On the other end of the spectrum is clients who feel like the only way that they can manage their bloat is through exercising and so their body is so overtrained and under nourish, it doesn’t allow themselves time to actually heal into repair. And then as I mentioned earlier, another piece of this lifestyle component is connection and happiness. We need connection in our lives. We need happiness, and so finding outlets for that is an important piece of the SIBO journey.
Next up is is knowing that food is not the problem. Food is a piece of the puzzle. But really and truly your environment is the problem. And what I mean by your environment is not only your lifestyle, but also the gut environment. So once you actually fix the processing issue, you can fix the food issue. If you are bloating, regardless of what you eat, or you are bloating, every single day, no matter what you do, this is not a food problem. Because it’s a consistent thing. We need to fix the way in which your body is processing the food. So although doing a low FODMAP diet really short term will help with relief, it’s not addressing the root cause of the symptom. So if you’re doing low FODMAP, which sidenote is only supposed to be about a four to six week elimination, you do need to work with someone to help you reintroduce foods because FODMAPs contain prebiotic fiber, which is the fuel source for your good gut bacteria. And long term, low FODMAP diets, lower the Bifido bacteria in your gut, which are key species that actually help your gut to thrive and flourish. And on that same note, I think there’s a lot of discussion in the gut health world about starving the bacteria. So I don’t want to eat fiber, or I don’t want to eat anything that feeds the bacteria because I want it to starve. But there’s really no research to support starving bacteria. And going back to point number one, remember that it’s about balance. It’s about balancing your gut microbiome and not necessarily just killing everything. So on this piece where food isn’t the problem, the environment is I want to introduce you to some of the root causes that we see with our clients. This is not a comprehensive list, but it’s some of the very, very important ones. And if you want more information on these root causes, I do have a series on my blog, Dr. Heather finley.co backslash blog, I’ll also link it in the show notes, where you can actually read more in depth about these root causes. But the first one that we see often is low stomach acid. When you think about the digestive tract, it actually is an open system. So from your mouth to your anus. Your digestive tract is an open system, you eat food you to it in your mouth, and it goes through your entire digestive tract, it’s open to the outside environment. Anything that enters your mouth enters your stomach, which needs to be broken down via stomach acid. And if food cannot be broken down through stomach acid, it then is more easily fermented once it enters the small and large intestine, which can be a root cause of SIBO. It can also affect your gut motility. If you have low stomach acid, it will slow your gut motility. Because your stomach needs to fill with acid to completely empty. So if we think about this head to toe process of the digestive tract, stomach acid being one of the first things that could go wrong in the process really does affect the overall picture of your digestion. The next one is slow gut motility. So when you think of just the movement of your intestines, if you’re not having a bowel movement, at least once a day, if things cannot move, it affects the makeup of your gut microbiota. So it affects how the bacterial balance in your gut is. And if things are sitting there and fermenting and causing gas like methane or hydrogen gas, that can lead to SIBO. And we need the gut to move things through an efficient pace so that things aren’t sitting there fermenting and causing all sorts of issues. So slow gut motility is one of the other number one things that we see as a root cause for SIBO. And a lot of times SIBO is actually classified as a motility issue. So no matter what you’re doing antibiotic wise or herbal wise, if you are not moving your bowels and there’s no way out, then this root cause of slow motility has to be addressed. The next one and probably the biggest one is stress. So no pill, no supplement, no antibiotic, herbal etcetera will work if you’re locked in fight or flight. It just won’t because your body will not prioritize clearing In SIBO, or healing, if it’s worried about being chased by a bear, and stress is stress to the body. So regardless of what the stressor is, whether you are in a stressful relationship, or your body is stressed, because you’re under eating, or stress, because you’re not sleeping enough, there is no pill, that is going to work, because you have to address your lifestyle. So point number two, you can rewind and listen to that piece. But you have to make the lifestyle changes. And that is why a lot of these programs, mine included, are six months or longer, because it takes time to implement these lifestyle changes. And really, consistency is the number one predictor of success, because you can’t just sleep eight hours or do a stress management routine one time and expect your SIBO. To clear, it’s a daily consistent actions that actually allow your body to to clear the SIBO. And also to remain in a state in which it can be in balance. The next root cause that we often see with our clients is actually to do with the large intestine. So we have trillions of bacteria in our large intestine. And this is where we want that balance. The primary residence for your gut bacteria is your large intestine, the small intestine where food is actually digested does have some microbes. But primarily those microbes are housed in your large intestines. Same thing with your stomach, it houses very few microbes. And we want the majority of those microbes to actually be in your large intestine, which is why large intestinal dysbiosis is a big factor when it comes to SIBO. But when the large intestine is despite otic or imbalanced, it can promote dysbiosis in the small intestine. And so we want to protect in fuel the large intestinal balance so that it doesn’t affect the small intestine. And this is part of where the inclusion of prebiotic fiber and adequate carbohydrates and adequate fuel for your gut bacteria comes in. And then the last one that I want to mention is hypothyroidism. We see this all the time with our clients. And actually, in fact, this was a part of my story. And one of the reasons were, one of the reasons why I think that I struggled for so long is I was doing all the quote unquote, right things, but I couldn’t get my gut to move. And it’s because my thyroid was super sluggish. So as low thyroid will actually result in a slow gut or slow gut motility. So we want to make sure that the thyroid is functioning optimally and moving, so that you can have the adequate gut motility that you need to be able to have daily, or even multiple times a day bowel movements. So a comprehensive approach to SIBO should include not only lifestyle modifications, also nutrition interventions, actually focused on adding and nourishing the gut versus restricting and starving, targeting the root causes, and then also the use of targeted supplements. So you don’t want to be afraid to experiment with your body and find out what works for you. Sometimes less is more and killing isn’t always the strategy to review, why your SIBO keeps coming back could be from these three reasons. Number one is you are focused on clearing and killing and not balancing and nourishing. Number two is you don’t know the why. So therefore you don’t know the how. And then number three is the food is not the problem. And you need to fix your environment. Because once you fix the processing issue, you can fix the food issue. So I would encourage you to really think about this. And one question that you can reflect on and ask yourself is, do I actually feel better? When I’m starving my gut bacteria when I’m restricting all these foods, and I’m still having the SIBO recurrence and I’m so miserable and so bloated, do you actually feel better? And oftentimes, when I ask our clients that question, they have this lightbulb moment of actually I don’t I feel just as bloated now eating five foods as I did when I was eating a variety of foods. And although you might not feel necessarily better right off the bat actually adding foods in going off of point number three Once you fix the environment once you fix the processing issue, and then you address your lifestyle, and know how to support your gut and focus on bringing balance back, you can slowly start to find the relief that you are looking for. So I want to leave you with just three things that you can do today to help you as you’re on the SIBO journey. Number one is really work on adding in prebiotic fiber to fuel your gut bacteria. There are tons of foods that have prebiotics, just to name a few and some of my favorites, artichokes, asparagus, bananas, oats. All these foods have prebiotics. They are amazing for your gut bacteria, and great to include each day to support that. Number two is working on and incorporating stress management into your daily routine. As I mentioned, you have to get your body out of a fight or flight state in order to be able to beat your SIBO. And then number three, is work on getting seven to eight hours of sleep every night to support your digestion and your motility. These three things that you can do regardless of what your root causes are, which I hope that you start to explore will only help you to be able to beat the SIBO faster, and to also be able to find a bit of relief sooner. So I hope that this episode was helpful. If you had any lightbulb moments or nuggets, feel free to reach out to me via Instagram, and tell me what you learned and tell me what you are going to implement.
Until next time.
Please note that this episode is not a substitute for medical advice and you should always consult your healthcare provider prior to making any changes.
I’m giving your gut a thumbs up because you’re just finished another episode of the love your gut podcast. You know that in order to live a life free from uncomfortable bloating, you need to figure out why you’re actually bloated, right? Well, the best way to do that is by taking my free quiz. Take the next steps towards determining your root causes by visiting Dr. Heather finley.co backslash quiz and learn what it is that’s causing your bloating. Soon enough, you’ll be transforming your gut issues and I can’t wait to help you. Be sure to tune in next week for the next episode of the love your podcast.
