During the past few years, I did a lot of Google searches around, “What is SIBO?”

Off-and-on, I suspected I had it.

My suspicions were correct. I have SIBO.

What is SIBO

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What is SIBO? Symptoms, testing, diet, treatment agutsygirl.com #SIBO #IBS #gut


SIBO stands for small intestinal bacterial overgrowth.

We all have bacteria in our guts; in both the small and large intestines. This should be no surprise to you.

Those with SIBO have an abnormally large amount of bacteria in the small intestine; bacteria where it should not be.

How do I know if I have SIBO?

My most telling symptom was that it felt like something was “feasting” in my upper gut constantly.

When it got really bad, I’d hear rumbling and I’d feel absolutely famished 24/7. No amount of food could satisfy the hunger pangs I’d get.

Once the feasting, rumbling feeling settled, it would drop to my lower stomach and I’d feel bloated (and crabby and more crabby and just blah).

You might not feel that, but other symptoms can include things like:

  • bloating
  • diarrhea
  • constipation
  • pain
  • B12 deficiency
  • rashes
  • fatigue
  • food sensitivities
  • headaches
  • all of the above (ugh, the dickens!)

Want to learn more about this? Check out THESE 8 SIBO Signs and Symptoms.

SIBO Breath Test

Just because you feel the above, does not mean you have SIBO. As a matter of fact, you should never just assume. Assuming means you make a lifestyle change that might not be necessary.

But if the above things are present, ask your doctor of s/he will do the testing. There are 2 main types of tests. The first is invasive via enteroscopy.

I don’t know anyone who has been diagnosed in this way since it requires a lot more out of patient and doctor.

The second, most common, way is via the SIBO breath test. This is how I was diagnosed.

My doctor had me tested through Commonwealth Labs. The testing is not fun, and it requires a 24-hour preparation period before taking the test; the first 12 hours require a specific diet, and the last 12 hours require a complete fasting period. 

Once the tests begin, you simply blow air into testing tubes and then mail those testing tubes in. Click HERE to learn exactly how to do the SIBO breath test.

What is SIBO? How to do the breath test agutsygirl.com #SIBO #IBS #guthealth

The tests themselves are measuring the amount of hydrogen or methane in your breath. The Paleo Mom states (on page 299),

Neither hydrogen nor methane is produced by our cells, but rather only by intestinal bacteria. In healthy people, hydrogen- and methane-producing bacteria live almost exclusively in the large intestine, so 80 percent of the gas that is produced is expelled by flatus. When these bacteria live higher up in the digestive tract, a larger and larger percentage can be measured in the breath as they metabolize sugars.

By the way, you can also get a SIBO test online now. See them all HERE.

You can also test at home to simply understand how your body reacts to different FODMAP foods via the FoodMarble Aire device.

Treatment (minus diet)

Treatment, quite honestly, will depend on your doctor and his/her beliefs.

These are the most common approaches:

  1. antibiotics
  2. herbal antibiotics
  3. elemental diet
  4. combination of any and/or all of the above

It truly just depends on several things.

If you like this information and want my whole e-book on SIBO, grab your copy of Reasonable SIBO.

Herbal Antibiotics

My current treatment is exactly as The Paleo Mom describes in her book via alternative health care practitioners,

a variety of medicinal or botanical antimicrobials, including monolaurin, cat’s claw, wormwood, goldenseal, pau d’arco, olive leaf extract, garlic, barberry, Oregon grape, and oregano oil.

Additionally, SIBO oftentimes causes a huge Vitamin B12 deficiency, which The Paleo Mom mentions as a severe SIBO case. That was me! I had to inject via my belly Vitamin B12 2-3 times per week.

Side note: I went through an entire cycle of IVF doing shots at home. The day I was diagnosed with all of this, my doctor’s phlebotomist gave me a shot. It was excruciating. I never remembered it to hurt that bad. So here I am now, at home, with my needles and B12 juice. And if I’m being honest, I’ll tell you that I have yet to do a shot. This is because I’m scared. But I will resume in January. Scouts honor. I must get better.

Updated in 2021: I did all of this and more on my SIBO journey. I documented the whole process and everything I did via the e-book above, after relapsing a total of 4 times. I have been thriving since July of 2018!


The SIBO “diet” can be many different things, but the one thing that is typically always regarded as mandatory is following the FODMAPS diet.

A low FODMAP diet has saved me, but the key is in some very specific, deep-down digging I had to do.

For example, most bloggers and most lists will tell you that blueberries are FODMAP approved. This is only kind of true. If you eat 20 blueberries and you have SIBO, you should be okay. But, if you have 40+ blueberries, you will likely not be okay. And let’s all be honest, 40 blueberries is nothing. I used to eat that almost nightly, and then wonder why I felt so horrible.

[p.s. The e-book contains 300+ graphics dedicated to these portion sizes for various foods. Grab your own copy of REASONABLE SIBO HERE.]

I wore my “hot pants” (I love referring to them as this!) last week, and most days of the week these days because I finally feel comfortable in them. My stomach never bloats. I feel at peace.

Bloat be gone. Healing from SIBO. sarahkayhoffman.com

Little-by-little, day-by-day, I am tackling SIBO.

I am also tackling severe adrenal fatigue and a low thyroid….but all of that for another day.

If you liked this post, you might also enjoy:

  1. DIY Elemental Diet
  2. Food Marble Breath Test {podcast episode with Aonghus Shortt}
  3. 90-Day Gut Healing Journal


What is SIBO? Symptoms, testing, diet, treatment agutsygirl.com #SIBO #IBS #guthealth
What is SIBO? Testing, treatment, diet. sarahkayhoffman.com

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  1. Hi Sarah! I hope you are doing well. It’s good to hear you are finding your way to healing. This is a very informative piece, and I hope it helps some people who are also suffering. Those tests do not sound like fun. You look great in that workout shot, though!

  2. I have been diagnosis with Candida Overgrowth, is SIBO the same thing. Prior to the diagnosis for 25 years I was diagnosis with IBS, until my new doctor took a food allergy test. Which showed Candida Overgrowth along with food allergies to wheat, dairy, eggs and yeast. There are more food allergies, but those were very easy for me to give up. It has been a long road to recovery, I still get digestive upsets that create a incontinence in the form of diarrhea. I have eliminated wheat, dairy, eggs, etc, and have lost 30 pounds. Actually I am now too skinny and am looking for foods to eat to help me gain a little. I went from nearly 170 pounds to 125 in eleven months. The good thing is that most days for me are good, only once in awhile I still get uncontrollable diarrhea. I am always looking and researching this, in which I now know is hidden in our foods in our American diet. Any help would be mostly appreciated.

    1. HI Sandy! There are so many things that could be going on. I don’t know for sure, and I am not a doctor. I’d recommend you get a comprehensive testing portfolio done. If it’s diet and lifestyle you’d like to explore more, please do join our 28-day group: http://bit.ly/skhjanp

  3. Oh I desperately want to be bloat-free! Just diagnosed with IBS. You’re going to be my inspiration… Someday I won’t bloat!

  4. From what I’ve read, garlic is a fodmap. So how does it help SIBO if you’re avoiding fodmaps? Thanks!

    1. Garlic is super high FODMAP. However, in this way it’s used as an antimicrobial. I’d imagine that it’s combined with many other things for a very specific reason. That said, when I took a similar supplement to try to eradicate my SIBO (instead of the antibiotic), it did *not* work for me. Everyone is different, though. Hope that helps!

    2. Also, to be clear, this post was written at a time when that protocol WAS working for me, but mine was to severe and ended up needing the antibiotic, which you can read about by searching “Rifaximin” on my blog.

  5. Thanks so much for posting this! I was diagnosed with SIBO symptoms for three years now and have had the same awful, extreme hunger feeling in my upper gut. This post gives me hope I’m on the right track to heal my sibo, and that it’s possible 🙂 Thanks for the inspiration <3

  6. I also have that permanent starving hungry feeling. It just started one day and never left. You don’t read about it much with SIBO so it’s a relief to see I’m not crazy and the only one experiencing it!

      1. I hope you don’t mind me asking, but did yours shift after you took rifaximin (I know you said it took a 3 week course to start seeing positive effects) or before that? I’m going down the herbal route right now but I do have rifaximin stockpiled just in case!

  7. So happy to have found this article. I feel extreme hunger 24/7 and it is quite literally driving me insane. I am super bloated all of the time, and have so many food restrictions. It is really hard to feel starving all of the time yet also not have an appetite. I am doing the herbal protocol right now but am afraid it’s not working, do I have to find a doctor or gastro to prescribe me rifaximin?

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