3 Mistakes Keeping You Stuck in the Chronic SIBO Cycle
If you've treated SIBO once or twice and it came back, you already know how this goes. You get a few weeks, maybe a few months, of relief, and then the bloating creeps back in, the constipation or loose stools return, your energy crashes, and you're told to do another round.
That puts you in the category of chronic recurring SIBO, and it has to be handled completely differently than a first-time case. Here are the three mistakes we see keeping people stuck in this chronic recurring SIBO cycle.
Mistake 1: Only running a SIBO test
Mistake 1: Only running a SIBO test
A SIBO test tells you that bacteria are overgrowing in your small intestine. That's it. It doesn't tell you why those bacteria is being allowed to be there and what broke down in the self-cleaning mechanisms of the gut to allow it to be there. So treatment gets aimed at killing the bacteria by default, because nothing else was ever looked at.
In our 1:1 practice, a comprehensive stool test is the bare minimum to give greater context to why SIBO is present because it shows us how your gut is actually functioning and where the self-cleaning mechanisms broke down. We can see whether you're producing enough stomach acid, whether your bile is flowing and emulsifying fat, whether your beneficial bacteria are depleted, whether your gut immune system is activated or depleted, which all help to explain why the small intestine lost its ability to self-clean and prevent SIBO. And when there are symptoms that suggest fungal burden, a toxin burden like mold, or congested detox pathways in the picture, we test deeper, because those are the deeper root causes that persistently allow SIBO to occur again even after multiple rounds of killing protocols.
Mistake 2: Just doing a killing protocol
Mistake 2: Just doing a killing protocol
Most SIBO treatment is a killing protocol and nothing else. Rifaximin, or a round of herbal antimicrobials, and you do feel better for a while because the bacterial load is down. Then it comes back. So you do another round. And another.
Killing bacteria over and over without understanding and addressing the greater gut environment is like cutting weeds without pulling up the roots. It keeps coming back. And every round does damage on the way through, depleting the beneficial bacteria your gut lining depends on and leaving you more vulnerable to the next overgrowth than you were before. This is exactly why so many of our clients arrive after 5, 8, even 10 rounds feeling worse than when they started. They didn't fail the protocol. They've just never had a provider uncover and address the deeper root-cause drivers that allow SIBO to occur in the first place.
Mistake 3: Treating SIBO like it's the root cause
Mistake 3: Treating SIBO like it's the root cause
SIBO is not a root cause. There is a reason your gut lost its ability to self-clean, and those reasons are the deeper root cause drivers of SIBO that need to be uncovered and addressed.
Your small intestine has its own self-cleaning mechanisms, and when they're working, bacteria don't overgrow there. These are the most common deeper root cause drivers we see disrupting them in chronic recurring SIBO.
Nervous system disruption, which impacts your GI motility and your vagus nerve, because the self-cleaning mechanisms of your small intestine are run by your nervous system.
Maldigestion, which can stem from that same nervous system disruption or from depletion caused by stress, under-eating, and more, and which shows up as low stomach acid, low digestive secretions, and even bile insufficiency. Your digestive secretions are a fundamental part of your gut's self-cleaning system, so when they're insufficient, SIBO is more likely to occur.
Low thyroid function, which can stem from several root causes of its own. A sluggish thyroid, and especially a low free T3, will slow your gut motility and lower your digestive secretions and liver processing, all of which impact your gut's self-cleaning mechanisms and can lead to SIBO formation.
Environmental exposures such as mold and fungal, which we are always assessing for in our practice. These impact your liver and your bile formation, which again contributes to SIBO formation by reducing your gut's self-cleaning mechanisms.
There are many different deeper root cause drivers of SIBO, which is why SIBO is so common, but each of those root cause drivers has a different treatment. This is why it is so important to actually understand the unique pattern behind your recurring SIBO. It can be one of the above or several of them at once, and what your results show is going to change the way your treatment is done and how successful you are at fully clearing and recovering from chronic SIBO.
Until we know which of those mechanisms stopped working and why, another killing protocol is only going to entrench the problem further and disrupt your system more, while the actual root causes go untouched.
If you want to learn more about the deeper root cause drivers of chronic recurring SIBO and how we support it in practice, read our full article: The Root Causes SIBO Protocols Miss
What This Actually Means
What this actually comes down to
It's not about killing more bacteria. It's about finding what allowed the overgrowth in the first place and restoring a gut that can keep itself clean, so you're not doing this again in three months.
If you're looking to finally get support to break that cycle, book a complimentary 30-minute Strategy Call. We'll talk through your symptoms, your health history, and your goals to make sure we're the right practice to support you, and we'll share what working with us looks like. You'll leave with the information you need to get set up with our team and finally understand your body and heal your gut for good.
Book your complimentary Strategy Call here
If you already have labs but no one has put the full story together for you and shown how your symptoms are connected, we offer Case Review Calls. It's an hour-long call where we review your labs, share our perspective on what we believe is going on, and highlight where we may need more information. If you decide to do the 1:1 work with us, the cost of the call gets applied to your 1:1 program.
In Health,
Abby & the Above Health team
