What is the difference between SIBO vs IBS?

I brought the perfect person on to the A Gutsy Girl podcast show to break them down, namely SIBO.

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The prevalence of SIBO is increasing, and Dr. Jacobi believes it is due in large part to the fact that our gut dysfunction is increasing and practitioners are becoming more privy to SIBO and what it means.

SIBO vs IBS {and a SIBO Q&A with Dr. Nirala Jacobi}

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SIBO vs IBS {and a SIBO Q&A with Dr. Nirala Jacobi} agutsygirl.com #SIBO

Resources Mentioned

  1. YouTube SIBO series (see below for a list of all videos currently available in the series)
  2. What Caused My SIBO?
  3. Common symptoms of SIBO
  4. All About Probiotic Strains and Species
  5. IBS diagnostic criteria
  6. Reasonable SIBO
  7. TheSIBODoctor.com (her website)
  8. The SIBO Success Plan (her course, includes Bi-Phasic Diet Plan)
  9. clinic, The Biome Clinic
  10. Dr. Jacobi on Instagram HERE
  11. SIBO Diet Recipes – A Gutsy Girl Way

Don’t Miss These Thoughts

  1. Who is Dr. Nirala Jacobi?
  2. What is the difference between SIBO (small intestinal bacterial overgrowth) vs IBS (irritable bowel syndrome)?
  3. What is the lactulose breath test?
  4. “Some people think that SIBO is the biggest cause of IBS, but not everyone who has IBS has SIBO.” – Dr. Jacobi
  5. “Gut symptoms are on the rise, and SIBO diagnosis are getting better.” – Dr. Jacobi
  6. How can I figure out my underlying cause? What is the best way to diagnose?
  7. Does Dr. Jacobi think dietary changes are necessary? And for how long?
  8. What do you think about the Elemental Diet? How about the low FODMAP diet? Other diets for SIBO?
  9. Dr. Nirala’s thoughts on things like: hydrolyzed guar gum, sprouted gluten free oats
  10. “Methane gases are very curious.” – Dr. Jacobi
  11. What is the bi-phasic diet? And how long is the protocol?
  12. “You’ve painted yourself into a corner only eating 10 foods.” – Dr. Jacobi
  13. What are treatment options for addressing stubborn SIBO?
  14. Antibiotic alternatives?
  15. Can you have SIBO and not know it? i.e. no SIBO symptoms
  16. “SIBO actually causes leaky gut. You can’t get rid of leaky gut unless you get rid of SIBO.” – Dr. Jacobi
  17. Is it possible to improve leaky gut (intestinal permeability) while having SIBO? Or should SIBO be treated first?
  18. What do you believe is the gold standard when it comes to a probiotic supplement and SIBO?
  19. The type of bacteria matters when it comes to the probiotic you need.
  20. “It’s an art to produce a good, lasting probiotic that is the strain you need.” – Dr. Jacobi
  21. Why don’t regular doctors think SIBO is real?
  22. What is one thing Dr. Nirala Jacobi thinks people get wrong when it comes to SIBO?
  23. “It should not be this difficult to treat bacteria.” – Dr. Jacobi
  24. Dr. Jacobi’s 3 convictions around gut health and gut healing.
SIBO vs IBS {and a SIBO Q&A with Dr. Nirala Jacobi} agutsygirl.com #sibo #ibs


The main difference between IBS and SIBO is that IBS is a category of functional gut disorders. It’s an umbrella of sorts; SIBO is a cause of IBS.

IBS patients typically get thrown into a bucket of “who the heck knows what’s wrong.” A diagnosis of IBS is then slapped on.

This is the real and raw truth, and after talking at length with Dr. Jacobi it’s clear that part of the reason is because if healthcare providers are not well versed on IBS vs SIBO (or the conditions in general), then we do not heal.

And by the way, remember that it’s not their fault. It is up to us, as patients, to seek the right help. Any old practitioner just will not do; different specialists and practitioners for different conditions.

I have an IBS symptoms list that you can find HERE. {In that post, you’ll also learn more about the differences between IBS and IBD – inflammatory bowel disease.}


SIBO is an overgrowth of bacterial in the small vs. large intestine. This distinction between small and large is actually important because while we do not want an overgrowth of gut bacteria in the small intestine, we do, in fact, welcome too much bacteria in the large intestine.

A healthy gut consists of a strong gut microbiome which is created through having an abundance of good bacteria in the large intestine.

In addition to everything else I’ve written about SIBO on this website, here are more things Dr. Jacobi mentions on the show:

  • Rifaximin is a great antibiotic therapy for SIBO because it stays in the small intestine.
  • Hydrogen-dominant SIBO = Berberine, Neem, oregano
  • Methane-dominant SIBO = garlic extract or oregano oil
  • SIBO treatment in the order Dr. Jacobi typically follows: herbs, antibiotic treatment, Elemental diet (for more severe cases)
  • Bio-film buster (for multiple antibiotic courses); PHGG (partially hydrolyzed guar gum), Ox Bile
  • Classic SIBO symptom = bloating immediately after eating; not classic (but still can indicate SIBO); histamine intolerance, food sensitivities, end-of-day bloat
  • Conditions that can commonly co-exist with SIBO: Restless Leg Syndrome, Acne Rosacea, and Interstitial cystitis
  • PHGG: great for high methane levels
  • Motility disorders are a root cause for SIBO
  • Gut motility can be affected by things like mold and hypothyroidism
  • Adhesions/obstructions can also increase your risk of SIBO

Unlike the IBS diagnosis, a diagnosis of SIBO is more test-based.

Breath testing is the most common way for an accurate diagnosis.

Dr. Jacobi mentions her own breath test she gives, and I have discussed these breath tests at length over the years both on this website and via the YouTube channel.

Small Intestine Bacterial Overgrowth YouTube Videos

Good news! Here is a list of all the videos I’ve tackled thus far around SIBO on the A Gutsy Girl YouTube channel:

  1. SIBO Series Small Intestinal Bacterial Overgrowth
  2. Part 1 Diet
  3. SIBO Part 2 Root Cause Analysis
  4. Part 3 Hydrogen Dominant
  5. FoodMarble AIRE Review 2 Device
  6. SIBO Part 4 Methane Dominant SIBO
  7. Part 5 Hydrogen Sulfide SIBO
  8. SIBO Part 6 The Diagnosis
  9. Part 7 Questions to Ask Your Doctor {After Getting Diagnosed}
  10. SIBO Part 8 How to Do the Breath Test
  11. Part 9 How to Heal SIBO Long Term
  12. SIBO Part 10 Fiber + SIBO

More from A Gutsy Girl

Want to learn even more about the gut and ways to heal it? Learn all the secrets via my signature book, A Gutsy Girl’s Bible: a 21-day approach to healing the gut. Grab your copy on Amazon HERE.

Or, have this book at your fingertips instantly by downloading the PDF now.

  1. Welcome to A Gutsy Girl Podcast
  2. Hang out on Instagram
  3. BFF’s on YouTube
  4. Free resource: The Master Gutsy Spreadsheet
  5. Rated-G Email Club

Wrap Up

Time to wrap this up. As always, a huge goal for this show is to connect with even more people. Feel free to send an email to our team at podcast@agutsygirl.com. We want to hear questions, comments, show ideas, etc.

Did you enjoy this episode? Please drop a comment below or leave a review on Apple Podcasts.

If you’re looking to finally get started on your gut healing journey, Gut Healing for Beginners is now open!

Dr. Nirala Jacobi Bio

Dr. Nirala Jacobi is a naturopathic doctor (ND) and internationally recognized expert on small intestinal bacterial overgrowth (SIBO). She is the creator of the SIBO Biphasic Diet, a resource that has helped tens of thousands of SIBO sufferers around the world.

Dr. Jacobi is the host of The SIBO Doctor Podcast and the founder of The SIBO Doctor, an online educational platform that includes a practitioner certification program. She is also the medical director of SIBOtest, providing innovative testing options for SIBO and IBS.

Dr. Jacobi is known for her systematic and effective approach to diagnosing and treating SIBO and other functional digestive disorders. Having received her naturopathic doctorate in 1998 from the esteemed Bastyr University in Seattle, Washington, she brings more than two decades of clinical experience and expertise to the Biome Clinic.

If you liked this episode, you might also enjoy:

  1. Your Digestive System
  2. Low-FODMAP Diet
  3. Vitamin B12 and SIBO


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