How to find an online SIBO practitioner that’s right for you

If you’ve heard about SIBO and its most common symptoms, you might be concerned that you are one of the 85% of IBS sufferers who actual have SIBO. Or you might have been tested by your doctor and told you have a positive SIBO result. Either way, you’re probably now wondering where you can find someone to help you navigate this complicated condition. Given the difficulties that many SIBO sufferers have with finding the right support locally, we thought it would be helpful to give you some guidance to finding an online SIBO practitioner.

Here’s what we’re going to cover:

Why you need professional support with SIBO
The benefits of working with an online SIBO practitioner
How consultations, testing and supplements work online
Where to find an online SIBO practitioner
What to look for on a practitioner or clinic website
Questions to ask practitioners before you start working together

Why you need professional support with SIBO

As SIBO sufferers ourselves once, we know the frustrations and wasted time that can come from trying to overcome a tricky GI condition like SIBO using good old fashioned Google and a DIY approach. With most gut-related imbalances, the ever changing nature of the microbiome, particularly in response to healing diets, lifestyle changes and antimicrobials, means ongoing problem solving is required to overcome SIBO.

The right SIBO practitioner will help you avoid all the common mistakes and to problem solve throughout your healing journey. They will also be up with the latest SIBO science and be able to lean on the experience of helping hundreds of SIBO sufferers just like you.

Gut healing can be an expensive process but typically the practitioner will only represent around a third of that cost. This means, regardless of whether you have the right support, you’ll end up spending a similar amount of money on just the testing and supplements (and not always the right ones). In most cases, a good SIBO practitioner will likely end up saving you money by reducing the amount of unnecessary testing and supplements you need to experiment with.

The benefits of working with an online SIBO practitioner

Some clients like to physically walk into a clinic and sit opposite their practitioner. For others, the idea of leaving the house, driving across town and sitting in a waiting room is the last thing they want during a symptom flare. And for others they simply don’t have a choice, as the small number of practitioners specializing in SIBO means finding one locally just isn’t a possibility. For these clients, working with an online SIBO practitioner solves the biggest obstacle to getting their health back on track.

Here are some of the major benefits to working with an online practitioner or clinic:

No need to travel for appointments, saving time and money
Access to SIBO specialists outside your city or state
Testing completed in the comfort of your own home on a convenient day and time
Often have more flexible schedules, including after-hours appointments
Appointments unaffected by your need to travel for work (or leisure) as long as you have an internet or phone connection

How does testing, consultations and supplements work?

With an online clinic, everything can be arranged without needing to leave the house. In short:

> Consultations: all consultations are completed online using video conferencing (e.g. Skype, FaceTime, etc.) or telephone if preferred.

> Testing: SIBO testing is completed at home, with test kits sent and returned via mail. Results are then sent to your practitioner who will provide them and an interpretation during your consultation.

> Supplements: all supplements can be ordered online and delivered to your address.

Where to find an online SIBO practitioner

If you feel that working with an online practitioner is the right option for you, the next question is where to find one that specialises in SIBO. Here are the best ways:

> Google search: if you search for ‘online SIBO practitioner’ you may find a few websites to create a short list. Many of the blog posts and articles written about SIBO testing and treatment options will be written by practitioners who also offer client consultations.

> Social media: there are a number of SIBO support groups on Facebook, some of which keep a list of known SIBO practitioners (including the SIBO Discussion/Support Group). Most will work in a physical practice but some may have online clinics or consultations available.

> Personal referral: if you’re lucky, someone you know may have found a great SIBO practitioner working online that they can recommend.

> SIBO resource websites: some websites run by bloggers and testing companies include a list of SIBO practitioners, some of whom may work online. One such resource is run by SIBOTest.

> Health forums and discussion groups: The internet is full of forums and groups on every topic, including SIBO. We had not heard of Reddit until we heard many of our clients first learnt about us on one of their SIBO forums.

If you’re reading this post, it means you’ve managed to shortcut the process a little. But, if you live outside of the countries we are able to work in, one of these options should help.

What to look for on a practitioner or clinic website

Once you have found a practitioner or clinic that offers online consultations, what should you look for on their website to help decide if they are right for you?

1. Do they highlight SIBO as a particular specialty?

If a practitioner specializes in SIBO, it will be mentioned on the website. For example, when we describe our expertise, we say we specialize in chronic constipation, small intestinal bacterial overgrowth (SIBO), gut infections and other chronic digestive complaints. If it’s not mentioned on the website then it’s unlikely to be something they are an expert in.

2. Do they provide an outline of their approach to testing, treatment approaches and other content that demonstrates their expertise?

The more information about SIBO outlined on a website, the more confidence you can have in their approach and expertise. We like to write blogs and articles on different SIBO topics - you can find a list of our SIBO articles HERE.

3. Are they also experts in general digestive health and other GI imbalances?

SIBO rarely exists alone and commonly comes with other gut infections like parasites and pathogenic bacteria. This is particularly true of relapsing cases of SIBO. For this reason, choosing a practitioner or clinic with expertise in other GI conditions will prevent the need for multiple practitioners down the line.

4. Do they work with a team of other SIBO and digestive experts?

Working with an online clinic that has a team of practitioners has a number of benefits;
a) a broader base of expertise in different GI conditions if you don’t just have SIBO.
b) improved problem solving for difficult or resistant SIBO cases via case conference meetings.
c) continuity of care within the same practice should anything happen to your practitioner.

5. Do they offer a complimentary pre-consultation call?

As many of our clients have never worked with an online practitioner before, we like to offer a free 15 minute pre-consultation call where our practitioners can understand a little bit more about your story and our potential clients can understand more about how our process works. This is pretty common with online practitioners and helps potential clients feel comfortable with their practitioner before booking a call.

6. Do they have availability and convenient appointment times for you?

Depending on where a practitioner is based, they may or may not have appointments available at convenient times. If they have an online appointment booking calendar, you should be able to see their availability and whether the offer options like after hours or weekend consultations.

Questions to ask practitioners before you start working together

Hopefully a lot of the big questions about SIBO have been answered on their website, but a pre-consultation call can be a great option to ask any additional questions you might have. These are only going to be process related, as you won’t be able to ask for health advice on these calls.

What is your experience with SIBO?

This is important because many generalist practitioners have limited experience with SIBO and complex cases. For us, experience is made up of three categories:

1. Advanced study on SIBO - functional nutrition training, advanced SIBO training or SIBO conferences, learning the latest science and clinical approaches for SIBO and constantly staying up to date is important in this constantly evolving field.

2. Experience with SIBO clients - nothing beats the first hand experience of working with SIBO clients of all types and complications. Having helped hundreds of SIBO clients in the last two years alone, we’ve seen every kind of SIBO and treatment approach. This means we know how to personalize a protocol and problem solve throughout, based on our previous experience of similar cases. Asking about success rates for SIBO is not quite the right question because most of our SIBO clients don’t just have SIBO contributing to their symptoms. So yes, we can get rid of SIBO numbers easily, but the most important outcome is long term symptom reduction and helping our clients take back control of their gut - we don’t stop until this has been achieved.

3. Personal SIBO journey - while not essential, practitioners who have been through a SIBO journey themselves can add extra tips and tricks they learned through the process, empathise with the daily struggles and give you the confidence that you’re on the right path.

What are the different treatment approaches that might be recommended or considered?

Some practitioners rely on a one-size-fits-all protocol for different SIBO cases. Over the years, we have found that personalizing each and every protocol and amending it throughout the process in response to progress and symptoms has delivered the best results. We also recommend working with a practitioner who is open to various natural antimicrobials as well as alternative approaches such as the elemental diet and even working alongside your medical doctor’s use of antibiotics for resistant cases. You also want to find a practitioner who can refer onto other modalities for addressing SIBO root causes like adhesions, malfunctioning ileocecal valve, stress, etc. Working as a multidisciplinary team is often needed to address contributing factors to your SIBO.

Next steps

If you are based in the USA, Canada, UK, Australia or New Zealand then we’d love to be able to work with you to overcome SIBO and any additional GI root causes you may have that are contributing to your symptoms. It is something that all of our practitioners specialise in doing every day. Once we know exactly what’s going on, we can come up with a plan for getting your health back on track. If you’d like support, please head to the ‘Work With Us’ page of the website to learn more.

If you are from any other countries around the world, we really hope this blog post helps you with finding the best SIBO practitioner and the one that is right for you.

SIBO FAQs

Q - How long does it take to treat SIBO?

A - A round of antimicrobials is normally 4-6 weeks. Typically methane gas will reduce by

20-30ppm with each 4-6 week protocol. Some clients require more than one round, depending on the levels and type (hydrogen and/or methane) identified on testing. Allowing 2-4 months to address SIBO is a good starting point. If other imbalances, infections or overgrowths are identified, these will be addressed separately either before or after SIBO.

Q - What is our experience and success rate with SIBO?

A - For clients that stick with the process and have good compliance, the short answer is “almost 100%”. The long answer is a little more complicated. This is because our focus isn’t just on SIBO numbers. We can reduce SIBO numbers and some clients take longer than others. With severe and stubborn overgrowths of mixed SIBO types, as many as a few rounds trying various eradication options are required. Any longer than this and we commonly uncover an additional infection (e.g. parasite) that didn’t show up on testing and has been impacting treatment. Our main focus is on symptom reduction, relapse prevention and helping our clients take back control of their gut for the long term. Because most SIBO clients also have a range of other imbalances, gut infections and GI damage, proper healing can take a little longer.

Q - What is the estimated cost of a natural SIBO protocol, including testing?

A - We typically recommend budgeting around $200-$250 per month for supplements, including antimicrobials, biofilm disruptors, digestive and detox support products. A lactulose breath test is between $200-250 depending on the lab. For those on a protocol, consultation packages start from $149 per month (depending on the practitioner you choose) and include email support between calls. On the whole, from Initial Consultation and testing through to supplements and monthly support, we recommend budgeting around $2,000 over a six month period, depending on what is identified on testing and how you respond to products.

Q - Can we use existing SIBO test results

A - Yes, we can interpret breath test results from reputable labs. Ideally these will be a 2.5-3 hour test and have 15-20 minute intervals between breath samples so we can interpret the transition between small and large intestine. If they are more than 6 months old or treatment has been undertaken since testing, we will normally recommend restesting to get a clear understanding of the current SIBO levels and type.

Q - Can we interpret other lab testing?

A - Yes. For the purposes of our review of your health history and creation of your protocol, we can incorporate previous functional gut health testing completed within the last 12 months. The most common tests we interpret include stool testing (E.g. DSL GI Map, Genova GI Effects, etc.), breath testing, organic acids testing, food sensitivity testing and hormone testing (E.g. DUTCH test).

Q - How is our SIBO approach different and why is it likely to work when other treatments have failed?

A - This really depends on what you have already tried. We have an article on The Most Common SIBO Mistakes, but here are the three most common reasons for unsuccessful SIBO protocols are:

1. Parasites or pathogenic bacteria not identified via SIBO testing also being present. Common on initial stool testing because of biofilm. After a round of herbal SIBO treatment using a biofilm disrupting agent, often additional root cause infections can be identified on advanced stool testing.

2. Not realising that 20-30ppm per 4-6 weeks is the expected reduction and therefore assuming progress is failure.

3. Not being able to problem solve your response to treatment. This is common in one-size-fits-all protocols because every single case of SIBO is different. This is the benefit of having worked with hundreds of SIBO clients in our clinic of all shapes and sizes. We’ve seen what works and what doesn’t and have learned how to adapt and adjust protocols as clients progress through their protocol.

Q - Do we work on diet as well as supplements?

A - Yes, diet is an important part of eradicating SIBO. We include dietary inclusions and exclusions in each protocol as well as provide helpful resources for recipes. We can also provide further support with diet recommendations and implementation during sessions if needed.

Q - Why do we recommend herbal antimicrobials rather than antibiotics?

A - While our short-term focus is on eradicating SIBO and other pathogens, the long term goal is reduced symptoms and a healthy gut. Some antibiotics are effective at the first part (eradicating) for some conditions, but typically cause long-term damage to our microbiome and intestinal membranes. Unfortunately, recent studies have shown that many beneficial strains never recover post antibiotics. In our experience, a damaged microbiome and GI tract is the basis for many long term chronic and autoimmune conditions and is not a risk we recommend our clients take. Natural antimicrobials tend to take longer but without the long term damage which is what you have to weigh up. If a natural approach doesn’t resonate with you then it just means we’re likely not the right fit for you.

Q - Do we also address other issues like hormonal imbalances, thyroid conditions etc.

A - Our focus is on restoring balance to the gut on the basis that many conditions are secondary to gut dysfunction. “All disease begins in the gut”, after all. In our experience, secondary conditions, including hormone imbalances can be corrected through healing the gut and with a few additional supports where required. If you require specialist support for a separate condition, we will do our best to refer you to a practitioner with the necessary training and experience.

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SIBO, Digestive Health, IBSBella LindemannNovember 18, 2019SIBOComment