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SIBO: what it is and how naturopathy can help
SIBO (small intestinal bacterial overgrowth) is when too many bacteria and other microbes grow in your small intestine, a part of the gut that normally holds relatively few. These microbes ferment your food too early, causing bloating, pain, wind, and diarrhoea or constipation.
A naturopath can help by organising breath testing, working out what allowed the overgrowth to develop, and building a staged plan of diet changes, herbal medicine and gut motility support. We work alongside your GP and specialists.
Book a free gut health assessment to find out how we can help.
What is SIBO?
Most of your gut bacteria live in your large intestine, where they belong. Your small intestine is where you digest and absorb most of your food, and it normally has far fewer bacteria.
In SIBO, bacteria build up in the small intestine. They ferment carbohydrates before your body has absorbed them, producing gas. That gas is what stretches the gut and drives many of the symptoms.
Some people have an overgrowth of methane-producing microbes instead of, or as well as, bacteria. These microbes are archaea rather than bacteria, so current medical guidelines call this intestinal methanogen overgrowth (IMO). Methane is linked with slower transit, so IMO tends to show up as constipation.
Common symptoms of SIBO
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Bloating and a distended belly, often building through the day or after meals
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Abdominal pain or cramping
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Excess wind
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Diarrhoea, constipation, or swinging between the two
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Nausea
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Fatigue and poor concentration
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Low iron, and sometimes low (or even high!) B12
Bloating is the most common symptom, but no single symptom is specific to SIBO. The symptoms overlap with IBS, food intolerances and other gut conditions, which is why a thorough assessment matters.
What causes SIBO?
Your body has several built-in defences that keep bacteria out of the small intestine: stomach acid, digestive enzymes and bile, a valve between the small and large intestine, and regular waves of muscle activity that sweep the gut clean between meals. SIBO develops when one or more of these is weakened.
Common contributors include:
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Slow gut movement (motility). This can follow a bout of gastro or food poisoning, or come with an underactive thyroid or diabetes.
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Medications, including opioid pain relievers and, in some people, long-term acid-reducing medication.
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Abdominal surgery or adhesions (internal scar tissue), including adhesions from endometriosis.
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Other gut conditions, such as coeliac disease and Crohn's disease.
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IBS. SIBO is more common in people with IBS.
Finding your driver is the key to lasting results. If the underlying cause isn't addressed, SIBO commonly comes back after treatment.
How is SIBO tested?
SIBO is usually tested with a breath test you do at home:
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You follow a short preparation diet and fast beforehand. We'll walk you through this, including any medications or supplements to pause.
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You drink a sugar solution, either lactulose or glucose.
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You collect breath samples at set times over two to three hours.
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The lab measures hydrogen and methane in each sample.
Breath tests are useful but not perfect, so we always read your results alongside your symptoms and history. Not everyone needs a test, and we'll tell you whether one is worthwhile for you.
Can naturopathy help with SIBO?
Our approach works in stages, so we're not just clearing bacteria and hoping for the best.
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Assess. We take a full case history, review any tests you've already had, identify the likely drivers, and decide together whether testing is needed.
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Reduce the overgrowth. We use selective herbal antimicrobials chosen for your gas type and your case, alongside short-term diet changes that reduce symptoms.
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Restore function. We support gut motility and digestion, and address the driver we've identified, so the overgrowth is less likely to return.
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Rebuild. We reintroduce foods to broaden your diet again, correct nutrient deficiencies, and set you up for the long term.
We often work alongside GPs and gastroenterologists. Some people are best served by antibiotics or further medical investigation, and we'll tell you if that's you. See your GP first if you have unexplained weight loss, blood in your stool, persistent vomiting, a family history of bowel cancer, or new bowel symptoms after age 50.
Why work with The Biome Collective for SIBO
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Gut health is our focus. Our team are degree-qualified naturopaths and nutritionists (BHSc) who work with IBS and SIBO every day.
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We find the cause. We look for what's driving your overgrowth, including links with hormones, endometriosis and thyroid health.
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Testing is part of the plan. We can refer you for SIBO breath testing, microbiome stool testing and blood tests where they're useful.
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Online, Australia-wide. All consultations are by telehealth.
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Care that fits your case. Choose 1:1 consultations or The Biome Pathway, our structured 9 or 12 month program.
SIBO FAQs
Is SIBO the same as IBS?
No. SIBO is one possible cause of IBS-type symptoms, and it's more common in people with IBS. Others include bile acid diarrhoea, food intolerances and changes in the microbiome. Testing helps tell them apart. If you've been told "it's just IBS", our free IBS checklist covers five conditions worth ruling out.
Do I need a breath test?
Not always. Testing helps confirm SIBO and shows which gases are involved, which guides the treatment we choose. If your history strongly suggests another cause, or you've tested recently, we may not need to test again.
How long does SIBO treatment take?
It varies. A treatment round often takes four to eight weeks, followed by a rebuilding phase. Some people need more than one round. Complex or recurring cases usually do best with longer-term support, which is what The Biome Pathway is designed for.
Will I have to follow a strict diet forever?
No. We may reduce fermentable foods for a short time to ease symptoms, then reintroduce as many foods as possible. A varied diet matters for long-term gut health.
Can SIBO come back?
Yes, especially if the underlying cause isn't addressed. That's why we focus on motility, digestion and your individual drivers, not just clearing bacteria.
Can I see you if I'm already working with a GP or gastroenterologist?
Yes. We work collaboratively and many of our clients are referred by their GP.
Do you offer SIBO consultations online?
Yes, all our consultations are online, and we see clients from all over Australia.
Not sure if it's SIBO?
Book a free gut health assessment. We'll talk through your symptoms, match you with the right practitioner and explain which care option suits you best.
This page contains general information and isn't a substitute for individual medical advice.