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What is SIBO?

Dr. med. Philipp Becker CO

Dec 1, 2023

And how can I treat it?

After reading Dr. Davis's book "Super Gut" which I was recommended by a friend of mine a lot of pennies dropped for me. We have literally a garden inside ourselves. In our gut. And probably in other organs and on our skin, too. But for now, let's stay with the gut.

I have been working with permaculture and its principles in my house and garden for years. So I finally understood that these principles apply to our inner garden as well as to the garden in my backyard. The soil needs to have the right microbes to work harmoniously and yield produce. That includes bacteria, fungi, soil minerals, roots, nematodes like worms, and bigger animals like mauls, birds, etc., and many more! If you are interested in soil microbiology I can recommend the work of Dr. Elaine Ingham on the soil food web.

Our gut has different zones like my garden (starting in our mouth, esophagus, gaster, duodenum, small intestines, and large intestine with our anus see picture below) and they all have different tasks and different microbes to help with these tasks.

However over the past five decades, our exposure to various factors has significantly altered the composition of microorganisms in our gastrointestinal (GI) tracts. These include prescription antibiotics, herbicides, pesticides in food, air, and water, and the pervasive herbicide glyphosate, which also acts as a potent antibiotic.

Additionally, common food additives and drugs, such as polysorbate 80 in ice cream, aspartame in diet sodas, anti-inflammatory medications, stomach acid blockers, and even antidepressants, have contributed to the disruption of our microbiomes. Virtually everyone has been impacted by these microbiome-altering elements.


So what is SIBO, now?

As a consequence, individuals who have sought medical attention for upper respiratory or urinary issues, receiving antibiotic prescriptions, or those who consume modern industrialized foods, have experienced changes in their intestinal microbiomes. However, for a substantial number, approximately one in three individuals or an estimated 100 million Americans, unhealthy microbial species have also migrated beyond the colon, ascending into the 7 meters (24 feet) of the small bowel, resulting in a condition known as small intestinal bacterial overgrowth (SIBO).

This equates trillions of unhealthy microbes that rapidly live and die, producing a cascade of breakdown products. Some of these byproducts enter the bloodstream through a process termed "endotoxemia". The term endotoxin came from the 19th century discovery that portions of various Gram-negative bacteria could cause toxicity. Over the next 50 years, studies revealed that the effects of endotoxin were due to lipopolysaccharide found in the bacteria's outer membrane that migrate through the intestinal wall into the bloodstream.

This can explain how disrupted GI microbes' products manifest as skin conditions like rosacea or psoriasis, cognitive decline, depression, joint swelling, and pain associated with fibromyalgia and rheumatoid arthritis, among other health conditions.


To determine if you might be suffering from this prevalent and health-impairing condition, consider the following questionnaire and mark each situation that applies to you:

  • Do you experience food intolerances, such as legumes, nightshades, FODMAPs, histamine-containing foods, fruit, fructose, etc.?

  • Do you observe fat droplets in the toilet after a bowel movement, or do most of your stools float?

  • Do you struggle with frequent loose stools, bloating, and abdominal discomfort?

  • Have you found relief from gastrointestinal symptoms by supplementing with pancreatic enzymes or bile acid supplements?

  • Do you have persistent or recurrent skin rashes despite treatments like steroid creams?

  • Have you used stomach acid blockers, statin cholesterol drugs, non-steroidal anti-inflammatory drugs, antidepressants, or opiates for more than a few weeks?

  • Have you been diagnosed with H. pylori?

  • Do you suffer from health conditions such as fibromyalgia, irritable bowel syndrome, restless leg syndrome, ulcerative colitis, Crohn’s disease, or celiac disease?

  • Have you been diagnosed with hypothyroidism?

  • Have you undergone abdominal surgery, such as gallstone removal, gastric bypass, or partial colectomy?


Typically, health questionnaires suggest that checking off 3, 4, or 5 items indicates a potential condition. However, in the case of SIBO, even one affirmative response raises suspicions to nearly 100% certainty that this process is affecting your health negatively.


This list only scratches the surface of illnesses influenced by the GI microbiome. When we consider disruptions in other body areas, like the sinuses, mouth, throat, airway, uterus, vagina, prostate gland, skin, and more, we gain a deeper understanding of the significant impact body microbes have on human health. For instance, an imbalance in the vaginal microbiome can lead to recurrent vaginal candidiasis, miscarriages, and premature labor.


What can I do to heal SIBO?

Restoring a healthier GI microbiome begins by eliminating disruptive factors. This includes reducing exposure to antibiotics, eliminating sources of herbicides and pesticides, minimizing contact with heavy metals like mercury and cadmium, opting for filtered drinking water to remove chlorine and fluoride (you can find the filtersystem I use at home here), and avoiding food additives such as preservatives, emulsifiers, and artificial sweeteners.


Following this, we focus on replenishing essential microbial species that have been lost in modern populations. These include bacteria like Lactobacillus reuteri and Lactobacillus gasseri, which not only colonize the small intestine but also produce bacteriocins—natural antibiotics that combat harmful fecal microbes.

I started to produce a probiotic "yogurt" according to Dr. Davis's ideas with 4 specific strains (2 strains of L. reuteri, one strain of L. gasseri and a strain of Bacillus coagulans). You can find it in the store.

Additionally, incorporating fermented foods into our daily diet introduces beneficial microbial species like Leuconostoc mesenteroides and Pediococcus pentosaceus. These transient inhabitants of the GI tract help nurture the growth of beneficial resident species such as Faecalibacterium prausnitzii and Akkermansia muciniphila.


In my opinion, antibiotics are seldom necessary in this context. By adopting these strategies, we can significantly improve various aspects of health and reduce the risk of developing the aforementioned health conditions.

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