SIBO (Small Intestinal Bacterial Overgrowth) is a complex condition that often causes confusion, especially with all the conflicting information out there. Some people think it’s just another gut infection, while others believe they can simply fix it through diet alone. So, what’s really going on? Let’s explore the top 10 myths about SIBO and separate fact from fiction!

Myth #1: SIBO Is Just Another Form of IBS

It’s easy to see why people mix up SIBO and IBS (Irritable Bowel Syndrome), given they share symptoms like bloating, diarrhea, and constipation. However, these two conditions are not the same. Research suggests that up to 80% of IBS cases may actually stem from SIBO (1), which involves an overgrowth of bacteria in the small intestine. IBS, on the other hand, is considered a functional disorder with a variety of possible triggers. Recognizing this distinction helps ensure you pursue the right testing and treatments for relief.

For twelve years, doctors told me the same thing: ‘You’re too stressed. It’s just IBS. Eat low-FODMAP.’ But none of that was true. It was SIBO all along! This is one of the main reasons for me to start this blog, since I want to help people find SIBO and its solutions.

Myth #2: You Can Diagnose SIBO Based on Symptoms Alone

SIBO symptoms can mimic those of many other digestive issues, so you can’t rely on bloating or irregular bowel movements alone to confirm it. The best way to test for SIBO is a breath test, which measures gas levels to determine if you have it and what type. Without proper testing, you could end up with a misdiagnosis and ineffective treatments that prolong your discomfort. If you think SIBO might be behind your digestive troubles, talk to a doctor about getting a breath test so you can target the problem accurately.

It might not be too easy to get your doctor to sign off on a breath test. Some doctors think the breath tests aren’t reliable enough. When this happens, it might be best to try and find another doctor who is more willing to find actual causes of your symptoms.

Myth #3: SIBO Is Caused by Eating Too Many Carbs

Carbs often get a bad rap for “feeding” bacteria, and while that can contribute to symptoms, the root cause of SIBO is usually tied to problems with gut motility—basically, how well your small intestine moves food along. Low stomach acid, chronic stress, and anatomical issues can also set the stage for bacterial overgrowth. Reducing carbs might lessen some bloating, but it won’t address the core issues that allow SIBO to develop in the first place.

Myth #4: A Low-FODMAP Diet Cures SIBO

The low-FODMAP diet can help manage symptoms by reducing fermentable carbohydrates, but it doesn’t actually eliminate the overgrowth of bacteria in your small intestine. To effectively tackle SIBO, you’ll likely need a multi-pronged plan that could involve antibiotics (like Rifaximin) or herbal antimicrobials, along with prokinetics to keep your digestion moving smoothly.

Remember that following a low-FODMAP diet long-term might hurt your gut microbiome diversity and you might miss out on certain vitamins and minerals, so it’s best to use it in moderation and under professional guidance. It doesn’t cure SIBO either, but it can help manage symptoms. 

Myth #5: Antibiotics Are the Only Treatment for SIBO

While Rifaximin and similar antibiotics are commonly prescribed for SIBO, they aren’t your only option. Herbal antimicrobials can also be effective, and lifestyle changes play a big role in preventing SIBO from coming back. These include: stress management, dietary adjustments, and the use of prokinetics. A well-rounded approach that addresses both the bacterial overgrowth and the factors leading to it is key for long-term success.

I didn’t use any antibiotics at all, since both me and my doctor were afraid it’d do more bad than good, considering I had been suffering from SIBO for twelve years. Instead, we used a mix of other strategies to get my digestion to start moving. 

Myth #6: SIBO Always Causes Weight Loss

Although some people with SIBO do experience weight loss due to nutrient malabsorption, others may actually gain weight. Inflammation and imbalances in gut bacteria can affect how you absorb and store calories. This could lead to weight changes in either direction. Because each person’s body responds differently, it’s important to consider weight fluctuations, nutrient deficiencies, and other individual factors when planning a treatment strategy.

Myth #7: Probiotics Make SIBO Worse

Probiotics get a lot of buzz, and for good reason: they can support a healthier balance of gut flora. But picking the wrong strains may intensify certain symptoms. Some people with SIBO do better with soil-based and spore-forming probiotics, which tend to be well-tolerated. It’s crucial to work with a knowledgeable practitioner who can guide you toward the probiotics that best fit your unique digestive landscape.

Also make sure you don’t use probiotics just before your breath test, it might influence the results.

Myth #8: SIBO Only Affects Digestive Health

SIBO can certainly cause bloating, gas, diarrhea, and constipation, but it can also impact the rest of your body. Fatigue, brain fog, skin problems, and anxiety are sometimes linked to this condition, often due to the way bacterial overgrowth affects nutrient absorption and inflammation levels. If you’re dealing with persistent issues that extend beyond your stomach, treating SIBO could make a noticeable difference in your overall well-being.

Myth #9: Once Treated, SIBO Never Comes Back

Unfortunately, SIBO has a reputation for coming back, especially if the underlying triggers aren’t addressed. These include: poor gut motility, high stress levels, or certain dietary habits. Adopting long-term strategies is crucial. Prokinetics can help keep your digestion running smoothly, while stress management and balanced eating habits also play vital roles. Staying vigilant after you’ve cleared the initial overgrowth gives you the best shot at avoiding future flare-ups.

Myth #10: SIBO Is Just a Fad Diagnosis

Some folks still assume SIBO is trendy or blown out of proportion, but that couldn’t be further from the truth. It’s a medically recognized condition backed by scientific research. The challenge is that many healthcare providers are only beginning to learn about the best methods for testing and treating SIBO. As awareness grows and education improves, more people are receiving accurate diagnoses and better outcomes.

Conclusion

SIBO is a genuine and often complex condition that benefits from a nuanced, long-term approach. By busting these common SIBO myths, you’re now better equipped to make informed choices about testing, treatment, and ongoing management. If you suspect SIBO might be causing your pain & discomfort, consult a knowledgeable healthcare professional about breath testing, antibiotics or herbal alternatives, and prokinetics. With the right plan and a clear understanding of how SIBO works, you can finally move toward a healthier, happier gut!