Part 1 Why Treating SIBO Requires More Than Diet
Elimination diets like FODMAPs are a common go-to for managing SIBO, offering temporary relief from symptoms like bloating and discomfort. But is cutting out foods enough to treat SIBO? In this blog, we uncover the root causes of SIBO, the limits of restrictive diets, and why a balanced approach is essential for long-term healing. Discover how stress, motility issues, and the gut-brain connection play a critical role in recovery.
Understanding SIBO and Its Root Causes
If you’ve been managing your SIBO with a restricted diet like low-FODMAP, you’re not alone. Many people turn to elimination diets to find relief from symptoms like bloating, discomfort, and digestive distress. But if your symptoms keep returning—or you’ve found yourself stuck in a cycle of cutting out more and more foods—you might be wondering: Is there more to the solution? The answer is yes.
First, if you haven’t already, consider getting a SIBO breath test and working with a practitioner who can provide targeted treatment. At Steddy Health, we treat SIBO using botanicals and create a customized approach tailored to your SIBO breath test results while addressing the root causes of your SIBO. If you prefer antibiotics, consult your primary care doctor or a gastroenterologist to prescribe the appropriate protocol. Addressing SIBO isn’t just about symptoms; it’s about understanding and managing its underlying causes. And yes, it’s “causes,” plural—not a singular issue.
FODMAPS - fermentable oligosaccharides, disaccharides, monosaccharides and polyols. These are short-chain carbohydrates that can ferment in the small intestine, triggering symptoms in individuals with SIBO. While these foods are highly nutritious, they can be challenging for those with gut imbalances.
The Limits of Diets Like FODMAPs
Many people find temporary relief by cutting out foods like onions, garlic, or wheat. But if you’ve been stuck in an endless cycle of elimination without real progress, it’s worth asking: Is there more to healing SIBO? The answer lies in looking beyond dietary restrictions.
Elimination diets like the low-FODMAP diet are often recommended for SIBO because they reduce fermentable carbohydrates that feed bacterial overgrowth. While this can provide significant symptom relief, they are not designed to treat the underlying issues causing SIBO. Although these foods are commonly associated with triggering symptoms, they are not the root cause of SIBO. Here’s why relying solely on dietary restriction to manage SIBO has its limits:
1. Symptom Management, Not Root Cause
FODMAPs and other restrictive diets help by temporarily starving bacteria in the small intestine, reducing fermentation and gas production. However, eliminating these foods entirely from your diet also deprives the beneficial bacteria in your large intestine of the nutrients they need to thrive. Many FODMAP foods, such as onions, bananas, and asparagus, are rich in prebiotics for the survival of the good bacteria in your large intestine. While FODMAPs can provide symptomatic relief, they do not address the underlying reasons for bacterial overgrowth in the small intestine.
2. The Risk of Food Fear
Elimination diets can unintentionally foster a fear-based relationship with food. When people associate certain foods with symptoms, it often leads to the mistaken belief that these foods are the root cause of the problem. This simplification of association into causation can create stress and anxiety around eating. The resulting hypervigilance during meals—constantly monitoring for bloating or discomfort—ironically disrupts digestion further and negatively impacts gut health.
3. Long-Term Impact on Gut Resilience
For many SIBO patients, the discomfort and bloating that occur after meals can lead to heightened sensitivity around eating. This often results in progressively cutting out more foods that seem to precede symptoms. Social media further fuels this cycle, offering quick fixes and extreme measures like elemental diets, which promise to eliminate bacteria in the small intestine. While these approaches may offer short-term relief, restrictive diets can reduce the diversity of gut bacteria over time. This loss of microbial diversity can exacerbate dysbiosis (imbalances in the gut microbiome), making it even harder for the gut to fully recover and regain resilience.
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What Causes SIBO? Root Causes Beyond Diet
SIBO isn’t just about food—it’s a symptom of deeper issues in the gut. To truly address SIBO, it’s essential to understand the root causes that allow bacterial overgrowth to develop and persist. Here are some key factors:
1. Stress and the Gut-Brain Axis
During periods of stress, the body prioritizes the "fight and flight response," which causes digestion to slow down and blood flow to be diverted away from the gastrointestinal tract. This can disrupt the delicate balance of gut bacteria, contributing to symptoms like IBS. If the stress becomes chronic, this disrupts the gut-brain connection, impairing vagus nerve function and slowing gut motility. Stress also affects stomach acid production, immune function, and the balance of gut bacteria, all of which contribute to SIBO.
2. Motility Issues and the Migrating Motor Complex (MMC)
Motility issues can stem from structural problems such as scarring, growths, or vagus nerve damage caused by infections or trauma. Chronic stress can also lead to vagus nerve dysfunction, further impairing motility. Additionally, functional gastrointestinal conditions like IBS often disrupt normal motility patterns. The MMC (Migrating Motor Complex), which serves as your gut’s natural housekeeper by sweeping bacteria and debris from the small intestine during fasting periods, begins to fail. When the MMC is not functioning properly, bacteria accumulate in the small intestine, creating the conditions for SIBO to develop.