Disclaimer:
This content is for educational purposes only and reflects my personal experience. It is not medical advice and is not a substitute for professional medical care. Always consult with a qualified healthcare provider before making changes to your treatment or health plan.
Let’s talk about something deeply unsexy but genuinely life-altering: SIBO.
If you’re getting ready for the day, scrolling on the sofa, or lying in bed wondering why your body feels like it’s constantly working against you, this is for you. Because six years ago, I had never heard of SIBO either. And yet it has been one of the biggest drivers behind my worsening health.
Not loudly. Not dramatically.
Quietly. Persistently. And very convincingly disguised as “just IBS.”
What Is SIBO?
SIBO stands for Small Intestinal Bacterial Overgrowth.
Under normal circumstances, the small intestine contains relatively low levels of bacteria compared to the colon. Its role is to digest food, absorb nutrients, and move waste downward through the digestive tract using coordinated muscular contractions (gut motility), stomach acid, bile, and digestive enzymes.
With SIBO, this system breaks down.
Bacteria that should stay in the colon migrate upward into the small intestine, where they begin fermenting food too early. This fermentation produces gases and inflammatory by-products that interfere with digestion, nutrient absorption, gut motility, and gut–brain signalling.
This is why SIBO is not “just a gut issue.” It is a whole-body condition that can affect energy, cognition, hormones, and overall health.
IBS But Not IBS?
For years, I was effectively treated as if I had IBS even though nothing that normally helps IBS helped me.
IBS is a diagnosis of exclusion. It describes a collection of symptoms, not an underlying cause. That means many people diagnosed with IBS are actually living with an undiagnosed condition that hasn’t been properly investigated.
If you’ve been told you have IBS but:
- dietary changes don’t help
- probiotics make symptoms worse
- bloating is constant rather than food-specific
- symptoms fluctuate wildly or keep escalating
…there may be something else driving your symptoms.
One of the most common explanations for “IBS but not IBS” is SIBO.
Unlike IBS, SIBO has a clear physiological mechanism: bacteria fermenting food in the wrong part of the gut. This helps explain why symptoms often persist despite standard IBS treatments and why many people later develop nutrient deficiencies, anaemia, chronic fatigue, or brain fog.
When symptoms don’t respond to IBS treatment, that isn’t a personal failure, it’s often a sign the diagnosis never fully fit.
Types of SIBO and Why Symptoms Differ
SIBO is not one single condition. There are multiple gas patterns, and each affects the gut differently:
- Hydrogen-dominant SIBO Often associated with diarrhoea, urgency, and loose stools.
- Methane-dominant overgrowth (IMO) Linked to constipation, bloating, and slowed gut motility.
- Combined hydrogen and methane SIBO Alternating constipation and diarrhoea.
- Hydrogen sulfide SIBO A newer subtype associated with sulfur-producing bacteria and reactions to sulfur-rich foods such as eggs.
Different gases affect gut motility in different ways. Methane, for example, has been shown to slow intestinal transit, which explains why constipation-dominant SIBO behaves very differently from hydrogen-dominant forms.
Common SIBO Symptoms (Beyond Digestion)
Because most nutrient absorption happens in the small intestine, SIBO can lead to systemic symptoms, including:
- Constant or severe bloating (often 24/7)
- Vitamin and mineral deficiencies despite supplementation
- Iron deficiency and anaemia
- Fatigue and post-exertional crashes
- Brain fog and cognitive slowing
- Unexplained weight loss or weight gain
In my case, I gained 15kg (around 30lb) in two years without changing my diet. My microbiome and metabolism had shifted completely. This wasn’t about willpower, it was physiology.
Why Nothing Seems to Help
One of the most frustrating aspects of SIBO is that many standard “gut health” interventions make symptoms worse.
Probiotics, for example, can increase bacterial load in an already overcrowded small intestine. High-fibre or fermented foods may worsen bloating and pain. Even doing everything “right” can feel like it backfires.
Persistent bloating happens because bacterial fermentation produces gas faster than the gut can move it along, especially when gut motility is impaired.
How SIBO Is Tested
The most common diagnostic tool for SIBO is a breath test, which measures hydrogen and methane gases after consuming a sugar solution.
The test requires dietary preparation, fasting, and multiple breath samples over several hours. It is uncomfortable and imperfect – false positives and negatives can occur.
This is why symptoms and lived experience should always be considered alongside test results, not dismissed because of them.
SIBO Treatment Options
There are several approaches to treating SIBO:
- Antibiotics, most commonly rifaximin, which acts locally in the gut
- Additional antibiotics for methane-dominant overgrowth
- Herbal antimicrobials
- Combination protocols
I have tried multiple approaches over the years – traditional and holistic. Some helped temporarily. Some worsened my symptoms.
What ultimately mattered most was not what I took, but whether the treatment matched my body’s capacity.
The Missing Piece: Root Causes
SIBO does not happen in isolation.
It is commonly associated with:
- Impaired gut motility
- Immune system dysfunction
- Chronic illness such as ME/CFS
- Nervous system dysregulation
- Reduced bile or enzyme production
- Physical inactivity due to disability
In my case, chronic illness, reduced movement, and immune dysfunction created the perfect conditions for recurrence. Treating SIBO without addressing these factors is why so many people experience relapse.
Learning to Work With My Body
After years of failed treatments, I was forced to change approach.
Instead of fighting symptoms, I learned to listen to them. To notice patterns. To understand capacity. To work with my body instead of against it.
That shift, more than any supplement or antibiotic, changed the trajectory of my health.
The Bigger Picture: A Body-Led Framework
I’m currently creating a body-led framework for navigating chronic illness.
Not another rigid protocol.
Not another “do this for 30 days” plan.
A framework that teaches you:
- How to interpret your body’s signals
- How to make sense of conflicting advice
- How to advocate for the care you actually need
- How to choose interventions that match your physiology, capacity, and context
The SIBO ebook will be one part of this series — a condition-specific guide showing you how to apply the framework to SIBO:
✔️ The science and mechanisms
✔️ The treatment landscape
✔️ The missing “why” behind recurrence
✔️ And most importantly: how to work with your body instead of fighting it
Think of it as a guide in a world of options – not telling you what to do, but teaching you how to decide.
Early Access + Free Bonus Content (£21 Value)
If you sign up for early access, you’ll receive exclusive bonus content for free, normally worth £21.
This bonus is designed to help you start developing body-led awareness while reading the ebooks.
👉 Join the email list here to get early access, first notification when the SIBO ebook is released, and the free £21 bonus.
If this resonated, even uncomfortably, trust that.
Your body is already speaking. I’m just here to help you learn the language. 💛
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