If you’ve been dealing with bloating, gas, or unpredictable digestion, there’s a good chance you’ve heard of SIBO—or you’ve been told everything is “normal” when it doesn’t feel that way.
Let’s walk through it simply.
What is SIBO?
SIBO (Small Intestinal Bacterial Overgrowth) happens when bacteria that belong in the large intestine start overgrowing in the small intestine.
Common symptoms:
- Bloating (often worse as the day goes on)
- Gas or distention
- Diarrhea, constipation, or both
- Food sensitivities
- Brain fog or fatigue
Why SIBO is often missed
In conventional care, SIBO is frequently under-tested or overlooked.
Why?
- Symptoms overlap with diagnoses like IBS
- Breath testing isn’t always offered
- Patients are often treated symptomatically (acid blockers, fiber, etc.) without asking why the symptoms are happening
Many people are told: “Your labs are normal”—while still feeling uncomfortable daily.
How we diagnose SIBO
SIBO is typically assessed with a breath test that measures hydrogen and methane gases after a sugar solution.
It’s not a perfect test—but when paired with your symptoms and history, it can be very helpful in guiding treatment.
Treatment: it’s not one-size-fits-all
Yes—SIBO can be treated. But this is where nuance matters.
Treatment options may include:
- Targeted antimicrobials (herbal or prescription)
- Dietary support (short-term, not forever restriction)
- Motility support (helping the gut move properly)
- Gut lining support and digestion support
But here’s the key:
Clearing the bacteria is only part of the work.
Why relapse is so common
SIBO has a high relapse rate—often because the root cause isn’t addressed.
Common underlying drivers:
- Sluggish gut motility
- Chronic stress
- Hormonal shifts (including perimenopause/menopause)
- Prior infections or food poisoning
- Structural or anatomical factors
- Long-term use of acid-suppressing medications
If we don’t address why the overgrowth happened, it often comes back.
A more complete approach
At Tendwell, we think about SIBO in layers:
- Confirm the pattern (testing + symptoms)
- Treat the overgrowth
- Support the terrain (motility, digestion, nervous system)
- Address root causes to prevent relapse
The goal isn’t just short-term relief—it’s longer-term stability.
The Bottom Line
SIBO is common—and commonly missed.
If you’ve been told everything looks “fine” but your gut says otherwise, it may be worth a deeper look.
With the right approach, it’s not just about treating symptoms—it’s about understanding why they’re happening and helping your system reset.
If this sounds familiar, you don’t have to figure it out alone.
We can take a thoughtful, step-by-step approach to get your digestion (and energy) back on track.