SIBO Is Real
Small intestinal bacterial overgrowth (SIBO) is a real condition. SIBO is diagnosed when there is an excess and imbalance of bacteriain the small intestinal. In other words, when there are more bacteria than normal and the “bad” bacteria outnumber the “good” bacteria.

While the large intestine is home to 10 billion to 10 trillion microbes, the small intestine should only have 1,000 to 100 million.
Symptoms of SIBO
When bacteria overgrow, they produce gas and other byproducts. This can cause a variety of symptoms, including burping, bloating, indigestion, abdominal pain, nausea, gas, diarrhea, and malnutrition. Many of my clients with SIBO report an uncomfortable feeling of fullness after eating.
Common Causes of SIBO
Three of the most common causes of SIBO are low stomach acid, slow motility, and constipation.
Three Ways to Prevent (or Heal from!) SIBO
1. Support Robust Stomach Acid.

An acidic stomach (pH of 1.5) is a healthy stomach. Stomach acid drives digestion of food (which aids absorption) and also kills unwanted bacteria. When stomach acid is low, “bad” bacteria are able to pass through the stomach and get into the small intestine, where they can overgrow and turn into SIBO.
The most common causes of low stomach acid are STRESS and long-term use of acid-blocking medications. Keeping your stress below 7/10 and pitching the Prilosec are two ways to turn up the acid.
Be aware of acid-blocking medications
- Proton pump inhibitors
- Omeprazole (Prilosec)
- Esomeprazole (Nexium)
- Lansoprazole (Prevacid)
- Rabeprazole (AcipHex)
- Pantoprazole (Protonix)
- Antacids
- Calcium carbonate (Alka-Seltzer, Tums)
- Magnesium hydroxide (Milk of Magnesia)
- Maalox, Mylanta, Rolaids
- H2 blockers
- Cimetidine (Tagamet HB)
- Famotidine (Pepcid AC)
- Nizatidine
2. Support the Migrating Motor Complex (MMC)

Peristalsis is the wave-like contraction that pushes food through the digestive tract. It is what allows you to swallow food even while upside down.
The migrating motor complex (MMC) is when a peristalsis-like wave occurs between meals to “sweep” undigested food and bacteria from the stomach to the colon, for elimination. Think of the MMC as the “washing machine of the stomach.”
The MMC occurs every 90 minutes, but is easily interrupted by eating. Grazing all day prevents the MMC from doing its job, contributing to the development of SIBO.
To optimize the MMC, consider fasting 4-5 hours between meals. A gurgling or growling stomach is not always a sign that you’re hungry, but a sign that your MMC is working! Doing a 16-hour intermittent fast 2-3 times per week will also support the MMC.
3. Support Regular Elimination.

Healthy elimination means pooping at least once daily. Constipation is defined as 3 bowel movements or less per week, particularly stools that are hard, dry, or difficult to pass. When waste cannot be eliminated, it backs up, forcing bacteria to overgrow into the small intestine.
Eating plenty of fiber, drinking enough water and avoiding constipating medications are three ways to help you go #2 regularly.
- Fiber. Fiber is what your intestines “push” against to move food down the tube, so eating too little can cause things to back up. In addition to promoting regular bowel movements, fiber also supports a healthy gut by feeding your “good” bacteria. Visit Easy Ways to Boost Fiber in Your Daily Diet to learn more.
- Water. As you increase your fiber intake, it’s important to drink more water. Fiber is like a sponge, pulling water into the gut and softening your stool. Dehydrated stools are harder to pass.
- Medications. All medications have side effects. Visit The Big 8 Constipation-Causing Medications to learn if the medication you’re taking might be backing you up.