Today I want to share with you 28 things to do during a SIBO flare up because these things work. At least they have for me.
In 2015, I wrote a blog post called 21 Things to Do During a Colitis Flare Up. It’s been pinned over 7,000 times, and I still refer people to it frequently.
You might be reading this thinking, “Well if you already wrote one for Colitis, then why are you writing another one for SIBO?”
Because Colitis and SIBO are not the same; there are differences. Are there some parallels? Of course. The basics don’t change with gut healing, and I’ll keep them on this list, making note of the ones that I feel are the same no matter what type of gut flare you’re having.
28 Things to Do During a SIBO Flare Up
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** = something I’d recommend for any type of gut flare up
1. Atrantil
I have mentioned Atrantil a few times over the past year, and while this might not be for everyone, it’s definitely been wonderful for me.
Atrantil targets the small bowel to provide relief where it is needed. Where digestive issues begin.
My doctor recommended I try in 2017, and it worked then so I wanted to use it again now.
If you click HERE, you can see more about it + how I take it. I started the first month of it on Saturday; 2 pills, 3 x’s per day with meals.
2. **Makeup
Lots of makeup; no shame.
I told you yesterday about very visible acne when I’m in a SIBO flare up, so to combat feeling awful in that department, too, I wear lots of makeup – actually, just some and only when I have in-person work meetings or other events as such.
That said, y’all know I’m a Beautycounter girl.
Most especially, during a flare, the goal is to ensure we’re reducing the toxic load all around.
Choose that skincare and makeup wisely.
3. **Drink bone broth, and drink a lot of it
Broth, broth, broth. I’m an old hippie when it comes to the magic of broth.
I’ve been on the train since long before it was “cool.”
I make my own 99.9% of the time. When I can’t, I’ll buy. And the best packaged bone broth is THIS.
4. NO FODMAPS (unless I’m on antibiotics)
No FODMAPS. I cut them. Plain and simple.
When and if I start the antibiotics again, though, I’ll add them back in.
5. No Kombucha
Killin’ me y’all. Seriously.
I was used to drinking a bottle of booch a day, but definitely not right now. Kombucha is a fermented tea.
I don’t need any help with any extra fermentation going on.
I’ve experimented with keeping kombucha in during a flare and it was miserable.
6. No Probiotics
Everyone has an opinion about this one, so I’ll share mine with you.
What is the goal of a probiotic? To supply healthy, gut-friendly bacteria to populate the intestinal wall.
But what happens when you’re trying to reduce the amount of bacteria that’s sitting in the small intestine?
Debatable, but every single time I’ve taken probiotics during a SIBO flare, I’ve felt worse.
My theory is that (both probiotics and prebiotics) are only feeding and help build more of that bad bacteria, making us miserable.
That said, the second I feel like it’s eradicated or near-eradicated, I begin the probiotic (THIS is the one I take) again to help build (actual) good bacteria up again.
7. **Just Breathe
We learned a few breathing techniques while at Nutrition School, but try breathing in for a few counts, hold for a few and then release for a few. Repeat several times.
I do this, but I also just stop to focus on breathing.
Getting myself into a SIBO flare up was triggered by stress, but adding more stress by not breathing certainly isn’t going to help.
There is so much power in a deep breath.

8. ** Cry
You read that correctly. Just cry.
I did on Saturday, and it felt good. I think of how often my children cry, but how their crying one minute might lead to total happiness the next.
Honestly, I’ve needed to cry a lot these past few months, and I have done very little of it.
It’s okay to cry over SIBO. Or anything else for that matter.
9. HCL
Low stomach acid is one of the reasons I relapse, but I no longer believe it’s the only reason.
I had gotten down to just 1-2 HCL pills with protein-rich meals and so I got lazy and stopped taking them.
But I immediately went back up to 4, and continued doing 4 for (about) three meals a day.

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10. ** Vitamin C
My friend Jen got me hooked on the power of vitamin C for the whole family, namely the children.
I chose Doctor’s Best because it,
contains Q**- C, which is manufactured in Scotland and prized for its quality and reliability. Vitamin C is indispensable to the body for its role in the synthesis of collagen, carnitine, and certain brain chemical transmitters. Abundant clinical research confirms Vitamin C’s fundamental support for the immune system, brain, eyes, heart and circulation, and all organ systems.*
During a flare, you know all the immune support you can find. (Do make note, though, that if you have diarrhea you must take very small doses.)
11. ** No constricting pants
I first wrote about this idea via Unbutton Those Pants in 2012.
I stated, “By lunch, the demons began pushing against my lower belly, making even subtle movements difficult.”
The statement was referring to a time period in 2005. Both in 2005 and 2012 I had no idea that SIBO was the problem.
Tight constriction around the waist will have you feeling even worse.
Get the loose, baggy pants out because you’ll feel so much better. (I discuss this concept in detail in an interview HERE.)
12. Chia seeds
I can’t say this one works for everyone or for all types of flare ups, but during a SIBO flare up, I eat chia seeds.
The reason is that they are low-FODMAP and I’m not eating a ton of fiber elsewhere.
I keep it basic with a version of my gut healing chia pudding.
13. **Gelatin and collagen
I don’t care when or where or how, but I do my best to add gelatin and/or collagen (<- click that link for my Guide to Collagen vs. Gelatin) in every single day.
14. **Meal spacing and/or long nightly fasting
When you’re in a SIBO flare, you must learn to give the digestive system a break.
SIBO means an overgrowth in the small intestine, and that food sits there with slower transit time to move out.
If you’re constantly eating, the food doesn’t have time to make its way out before more food gets piled on.
That’s definitely not what you want.
I have talked about meal spacing for SIBO before HERE.
What I have been doing this time is a longer nightly fasting (and thus I’m also skipping early am workouts most days).
Yesterday I did a 13-hour fast (read: Intermittent Fasting for SIBO), and I’m hoping to do the same today. I stop eating at 6:30 pm and don’t eat again the next day until 7-9 am.
15. **Drink water, and drink a lot of it
Keep everything moving through the system.
I try to reduce the amount of water I drink with meals, and instead drink it around meals.
16. **Reduce or eliminate amount of skins you consume (via fruit, vegetables, etc.)
I made zucchini and green beans doused in Nutiva Organic Liquid Coconut Oil with Garlic the other night, but before sautéing the zucchini, I took all the skin off.
Yes, normally you should try to eat the skins – that’s where the fiber lies, but during a SIBO flare up, you’re not trying add any extra fibers to feed bacteria.
17. Watch the fiber consumption
And to that end, just watch fiber in general. I haven’t had an abundance of fiber this week, at least not in the ways I usually do.
18. **Eat nothing that contains artificial flavorings, chemicals, etc.
If the body can’t recognize something, it’s stressed.
Artificial flavorings and chemicals would fall there.
19. **Reduce or eliminate sugar
Sugar feeds all the wrong things.
My sugar consumption has been drastically reduced since Saturday.
You can debate sugar all you want – that it does or doesn’t matter, but if you’re going through a SIBO flare up, just try to reduce or eliminate it because I promise it will only help you heal faster.
20. **Skip the (intense) workout
In the early days of my healing, it didn’t matter if I was flaring and I had an 8-mile run on my workout calendar. I ran anyways.
Horrible, terrible, no good, very bad idea.
I’ve tamed my workouts since Saturday, but I haven’t cut them altogether.
p.s. Also worth reading: What I Really Think About Workouts and Gut Healing.
21. **Be careful with carbs, but also know that you do not need to completely get rid of them
I’m currently grappling and experimenting with this one.
Mostly, and namely, with rice. Rice is low-FODMAP and in some circles it’s now even considered Paleo, and yet it would never be GAPS or SCD, which is what many follow who have SIBO.
Root veggies are also a great source of carbs (sweet potatoes, turnips, parsnips, rutabaga).
Ironically, without failure, the root veggies almost always make me miserable and the rice is absolutely fine.
I’m experimenting with thoughts and ideas and research around rice and the gut, but at the end of the day, you just need to understand which ones work for your body and which ones do not.
Wondering HOW you can still eat carbs and FODMAPs? Reasonable SIBO was made for you!
22. Don’t be afraid of fat
In fact, if you have IBD-C, up the fat intake (unless you do not have your gallbladder, then that’s a whole other issue).
I started incorporating a variety of oils into my diet, and when I did that, stopped using coconut oil 24/7.
Coconut oil is constantly coming under scrutiny, but guess what? I absolutely thrive with it, so I started upping the amount of coconut oil I consume per day.
23. **No alcohol
I rarely drink, and so when I do, even 2 vodka waters is good for me.
However, on St. Patrick’s Day I had a ton, which I know aided in triggering the mayhem. If you are going through a SIBO, or any, flare, you must nix the alcohol.
24. **No dairy
As I’ve thrived this past year, I have had dairy here and there, and enjoyed it.
But I’ve learned over the years that dairy is the last thing my body needs during a flare up.
Dairy exacerbates all acne, too.
25. **Sleep
Sleep. Sleep. And then sleep some more.
Now is not the time to do 2,417 things in a day.
Your body needs rest, and it needs to find its deepest form of zero stress while simultaneously repairing.
Whatever you have to do, make sleep happen. I’m trying to sleep 8-10 hours per night.
Sleep is ESSENTIAL for healing! Track your sleep in ‘Healing Blooms from Within,’ A Gutsy Girl’s 90-day gut healing journey journal.
Use code ALL10 at checkout to save 10% off your copy of the journal; either the physical version or the instant PDF download.

26. **Find your zen
For me, this means silence, and with my new office studio, I am getting plenty of it.
I find space to breathe, turn off everything and just sit.
You must find your calm place while flaring.
27. **Pray
I make no justifications that praying and my faith are and have been a huge part of my healing journey.
Jesus Christ is my true healer, but no matter what you believe, I believe you must dig deep to connect with your spiritual side during this time.
28. **Find answers, not drugs
I take LDN (Low Dose Naltrexone), and I do not hide that fact, but I’m not about to be on any and every drug just because a flare up occurs.
If every single thing on this list didn’t work and you truly worked hard at them all, then you might need more help.
What I’ve found over the years, though, is that people think they are “living healthy,” and so far from it.
And there you have it….28 things to do during a SIBO flare up.

These always make me stronger and (in the long run) grateful for health.
p.s. If you found this list valuable, click HERE to share on Facebook with friends and family who might benefit from it as well.
If you liked this post, you might also enjoy:
- Printable SIBO Diet (Reasonable SIBO, Heal Your SIBO)
- Best Supplements for SIBO {based off experience + research}
- FoodMarble AIRE Review
Xox,
SKH
You will heal. I will help.
Sarah, great info, thanks! Maybe you know the answer to this Mystery. I was diagnosed w/ SIBO 4 mos. ago (Self diag. 5 yrs. ago, dealing w/ this 17 years). Xifaxan & herbals limited help, so I have been in Ketosis for ~ 6 weeks. Keto has eliminated food triggers, so stress & anxiety triggers remain. Here’s what’s weird: The Tiniest emotional trigger produces immediate gut pain, & within 15 minutes my belly goes from ~ flat to looking 6 mo. pregnant bloat. This lasts the rest of the day & sometimes the next day. This instant emotional brain to gut response started ~ 10 mos. ago, & my G.I. doc. had read about this response but couldn’t find the info on it. He said it is unusual & thinks it is probably due to a vagas nerve problem. 4 other people in a SIBO FB group I’m in said they have the same problem & are as stumped as I am. I can’t find info on this anywhere. Any thoughts on where I can learn more & find solutions? (Medical journals…). If you can help solve this, You get full credit in the different SIBO… groups I’m in! Sarah, Thank you So much! – Allison (aapayte@aol.com) <3!
I have this issue too. As soon as I have a gut pain my anxiety and panic attacks go full throttle. I develope nausea, dry heaves, body shakes, sweating, dry mouth, diarrhea. You name it. I will sit in that panic attack for hours trying to get a grip on it till the food is digested. For me I know I have a cortisol issue as we have more receptors in our gut. They are going to recheck my thyroid and other hormone glands.
What is the probiotic you take? The link would not come up to show this. Thanks.
Hi Debbie! Here you go –> http://agutsygirl.com/resources/recommended-supplements/ Xox
Hi! Thank you so much for this!! How long are your flare ups or what is average?
Hi,
can i also drink the bonebroth with hisatimintolerance?
Did i understood right, with these thing you lost all the symptoms in three days?
Some can tolerate bone broth with a histamine intolerance; others cannot. You’ll need to see if it works for you or not.
Hey, great post. Funny because I always go straight to bone broth and chia pudding during a flare up and it helps me within days. Its magical!!
So good, right?! Thanks for stopping by.
Hi and thanks for posting this! I do have a question now about the bone broth. I’ve heard and read quite a bit this year about something released specifically from the bones that is irritating for SIBO ( I forgot exactly what) and to stay away from bone broth (regular chicken broth ok, just no bones). Have you heard this or have any updated info? Thanks!
Hi Christine – typically people are referring to histamines. However, are you intolerant to histamines? If not, you should be fine.