9 SIBO Healing Mistakes Everyone Makes

Eradicating SIBO and healing your damaged gut is a journey full of trial and error, and lots of hard, HARD work. With our scientific and clinical understanding of the condition continuing to grow, protocols and recommendations are constantly evolving and as with any gut condition, what works for one person doesn’t necessarily work for the next. This means a lot of SIBO sufferers are struggling to keep up with the most up-to-date and effective treatment approaches.

I’ve been there. Having experienced my own SIBO nightmare and now healing SIBO for my clients on a daily basis, I’ve made and seen almost every mistake under the sun. We’re all human, after all. But, if you are new to this journey, I want to help you learn from the experiences of those who’ve come before you and avoid some of the many pitfalls on the road ahead. So let’s get into it. Here are the most common SIBO healing mistakes I’ve encountered that I want to help you avoid while trying to eradicate SIBO and heal your gut.

1. Not knowing which type of SIBO you have.

Not all SIBO is created equal. And what we call ‘SIBO’ will likely be classified as many distinct conditions in the not too distant future. We are already seeing this with the major differences identified between hydrogen and methane dominant SIBO. But, there’s also; where in the small intestine, what type of bacteria or archaea are overgrown, whether there is autoimmune or structural elements to consider, as well as many other factors.

This is why testing is critical and why interpretation of test results, as well as a detailed health history by a skilled practitioner, is critical to developing an effective treatment protocol. Using a one-size-fits-all protocol that you found online is very likely not going to work when it comes to this complex condition.

2. Other gut infections are also present.

SIBO is often not alone. Many of my clients’ test results also reveal the existence of serious gut infections. These can include parasites like Blastocystis hominis and Dientamoeba fragilis or bacterial infections like H. pylori or Citrobacter. And SIBO treatment is generally much less effective while these other gut infections are present . For this reason, I like to address gut infections before addressing overgrowths.

If you’ve only tested for SIBO and your treatment is no longer improving symptoms (and/or SIBO levels), it could be time to test for what else might be hiding in your GI tract.

3. Not following a tailored diet approach.

There is no one best diet approach to SIBO. Each client needs a diet that is tailored to their test results, previous diet history, current lifestyle and antimicrobial treatment protocol. Whether you subscribe to the ‘starve them’ or ‘feed them’ philosophy, both approaches require tailored planning before, during and after the antimicrobial phase of treatment.

The two main dietary mistakes that I see really often are:
1. They’ve read the research on feeding bacteria to improve antimicrobial effectiveness and interpret this to mean they should continue eating high FODMAP and/or SCD illegal foods both during and after taking antimicrobials or antibiotics.
2. Adhering to strict SCD + Low FODMAP for too long after antimicrobial treatment before retesting. If you can’t start to introduce small amounts of fermentable carbohydrates within two to three weeks of finishing antimicrobials, you treatment hasn’t been successful. You need to retest, and develop a new protocol.

4. Expecting one round of antibiotics or antimicrobials to be all you need.

SIBO is hard to eradicate. Relapse rates for both antimicrobials and antibiotics are as high as 50% in published studies. Expecting a single round to be all you need will likely set you up for disappointment, depending on the severity of your condition.

SIBO is not an all or nothing condition. It is about getting the levels of bacterial down to a point where they are no longer an ‘overgrowth’. So while you may still have SIBO after one round, your symptoms should be significantly improved after an effectively designed protocol. But, unless you retest, you may find your symptoms progressively build back up to their previous levels over the following months. This is because you stopped treatment too soon.

5. Only using a single antimicrobial at a time and repeating treatment with the same product.

This is most common among clients trying to treat themselves without the help of a skilled SIBO practitioner. Specific antimicrobials and specific combinations are effective for certain types of overgrowths. I always use at least two different antimicrobials at a time and never repeat treatment with the same products if subsequent rounds are required.

SIBO is very adapable and will quickly develop resistance to repeated use of a single product. Even practitioners using antibiotics have worked this out, with current best practice approaches incorporating a double antibiotic therapy.

Just remember these two simple principles: ‘combine to kill’ and ‘rotate to avoid resistance’.

6. Not using probiotics effectively.

Probiotics can be an important part of a SIBO treatment protocol, but only if used correctly. Here’s a few points to keep in mind:
> Probiotics do not add to an overgrowth or make SIBO worse. Contrary to popular belief, probiotics are transient and will not colonise your small intestine.
> That isn’t to say that specific strains don’t have beneficial effects on the way through. Some probiotic strains can stimulate the Migrating Motor Complex (MMC), decrease inflammation, heal leaky gut and have antibacterial effects.
> It’s best to start probiotics when you start antimicrobial treatment but only use helpful strains. This is also an individual thing as different strains can cause symptom flare ups for some people and ineffective brands are mostly a waste of your time and money.

7. Not disrupting biofilms.

As many as 75% of bacterial, archaeal and fungal infections involve biofilms. Biofilms are the extracellular matrix that acts as a protective home for the infection to live in. This protective home makes the infection up to 1,000 times more resistant to antibiotic therapies and therefore, more difficult to kill. This is why a SIBO treatment protocol that does not include a biofilm disrupting agent is more likely to fail.

8. Failing to address any underlying root causes for relapse.

SIBO is a much more complex condition than simply too much bacteria in a specific part of your intestine. By treating SIBO like other infections, many practitioners fail to address the underlying root causes and structural changes required to avoid repeated relapses.

The two most common mistakes are:
> Not stimulating the migrating motor complex using a prokinetic for those with post-infectious SIBO.
> Not addressing adhesions for those with post-surgical SIBO.

9. Trying to treat SIBO using only information from blogs and support groups.

Treating SIBO effectively is actually a more complex process than most clients initially realise. Depending on the type, severity and cause of your SIBO, there can be functional, structural and autoimmune elements to consider. And with scientific and clinical understanding of the condition continuing to grow, best practice protocols and recommendations are constantly evolving.

If you chose a practitioner who specialises in SIBO treatment, not only will you be using the latest and most well researched approaches, you’ll also be by-passing a lot of the mistakes clients typically make when trying to treat themselves. Regularly refining your treatment protocol depending on your reactions and results is another complex problem solving activity that a SIBO specialist will be able to work through with you.

Next steps.

If you’re looking to work with a practitioner who specialises in SIBO, our team is currently accepting new clients - you can book an appointment using our online booking system. Healing SIBO is a journey. If you are ready to begin yours, please head to the Work With Us page to learn more about how we work online with clients in many countries to test for and treat the many root causes of SIBO, IBS symptoms and other GI conditions.

You can read our approach to SIBO treatment HERE and more FAQs about how we work HERE.