9 SIBO Natural Treatment Options for Gut Support

Small intestinal bacterial overgrowth (SIBO) can cause uncomfortable digestive symptoms as a result of too much bacteria growing in the small intestine.

‍Many people turn to natural treatment options when traditional antibiotic therapy is ineffective, but many of these lack evidence. 

Continue reading to learn more about SIBO and the effectiveness of popular natural treatment options for SIBO. 

Nourish offers insurance-covered nutrition counseling by registered dietitians. With convenient online visits, you’ll learn how to improve your gut health naturally through diet and lifestyle changes. 

What is SIBO? 

Your digestive tract contains billions of bacterial cells that make up your gut microbiome. Some bacteria live in the small intestine, but the majority populate the large intestine. 

Small intestinal bacterial overgrowth (SIBO) is a condition that happens when the small intestine becomes overpopulated with bacteria from the large intestine, causing digestive symptoms, inflammation, and malabsorption. 

There are many different risk factors and underlying causes of SIBO, including:

• Irritable bowel syndrome (IBS).
• Chronic pancreatitis. 
• Narcotic use.
• Diabetes. 
• Intestinal diverticulosis.

SIBO is typically diagnosed with a breath test, which helps identify gasses like hydrogen that are produced by the bacteria in the small intestine. 

Common Symptoms of SIBO

The most common symptoms of small intestinal bacterial overgrowth include:

• Abdominal pain. 
• Bloating. 
• Gas. 
• Diarrhea. 
• Sometimes constipation. 

Because these symptoms can overlap with other digestive conditions, it’s important to talk to your doctor if you suspect you have SIBO.

Take our SIBO quiz to identify if your symptoms and other risk factors indicate you may have SIBO. 

9 Natural Treatment Options for SIBO

The first line of treatment for SIBO is typically antibiotic therapy.

However, not everyone responds to this intervention, making natural SIBO treatments a popular next step. 

However, there is limited research on many of the natural treatment options for SIBO.

Talk to your doctor about the best approach to treat your SIBO.

1. Eating a Low FODMAP Diet 

A low FODMAP diet may be a natural treatment option for SIBO, but more research is needed.

Much of the evidence surrounding the low FODMAP diet is related to treating irritable bowel syndrome (IBS). 

While IBS and SIBO cause similar digestive symptoms and can co-occur, they are different conditions with distinct treatment recommendations. 

“FODMAP” is an acronym standing for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols.

These are sugars that can be fermented by gut bacteria and may worsen digestive symptoms in certain people. 

Examples of high FODMAP foods include:

• Garlic.
• Onions.
• Apples. 
• Cow’s milk.
• Legumes.
• Wheat. 
• Honey. 

The diet involves a short-term elimination of foods high in FODMAPs to “starve” the harmful bacteria in the small intestine, followed by a reintroduction phase. It’s best to do this type of diet under the supervision of a registered dietitian trained in gastrointestinal conditions. 

2. Taking Probiotics and Prebiotics

Probiotics and prebiotics are present naturally in food and are also available in supplement form.

Probiotics are types of bacteria beneficial to gut health, and prebiotics are types of fiber that help good bacteria grow. 

Evidence supporting probiotic use for treating SIBO is limited and conflicting.

‍Some studies have shown that probiotic supplements can reduce SIBO symptoms and increase the effectiveness of antibiotic therapy. 

Other research has found probiotic use increases the risk of developing methane-dominant SIBO (one of the subtypes of SIBO that can cause constipation). 

Many prebiotic-rich foods, like onions, asparagus, and garlic, are high in FODMAPs, which may worsen SIBO symptoms. 

Talk to your doctor or dietitian before starting any probiotic or prebiotic supplements to treat SIBO. 

3. Consuming Digestive Enzymes 

Your body naturally produces digestive enzymes to help break down food into nutrients. 

• Amylase breaks down carbohydrates.
• Lipase breaks down fat. 
• Protease breaks down protein. 

These digestive enzymes are available as supplements, and there are a few situations in which your doctor may recommend them for managing SIBO. 

Protease has antibacterial properties, and in conditions like exocrine pancreatic insufficiency (EPI), where the pancreas does not make enough digestive enzymes, SIBO can occur. 

Approximately 15% of people with EPI and 30-40% of people with chronic pancreatitis also have SIBO. 

If your body is not producing enough digestive enzymes, you’ll need to take supplements with every meal to help the digestive process work properly.

4. Using Herbal Antimicrobials 

Certain herbal supplements have antimicrobial properties, which may help treat SIBO naturally by killing harmful bacteria in the small intestine, reducing inflammation, and improving digestive symptoms. 

One study found that a blend of different herbal compounds was just as effective at treating SIBO as antibiotic therapy (the standard treatment for the condition).

Though the initial research is promising, more evidence is needed to recommend these supplements for routine SIBO treatment.

Herbal antimicrobial supplements that may be recommended to manage SIBO include: 

• Berberine.
• Neem oil.
• Peppermint oil.
• Oil of oregano. 

Talk to your doctor about whether herbal supplements should be a part of your treatment plan for SIBO. 

5. Reducing Stress Levels 

Research shows that high levels of psychological stress can impact your gut health, from slowing the rate of digestion to causing gut bacteria imbalances.

As a result of these changes, chronic stress may contribute to the development of various digestive conditions, including SIBO. 

Consider stress management techniques such as deep breathing or cognitive behavioral therapy as part of your natural treatment plan for SIBO.  

6. Implementing Intermittent Fasting

While intermittent fasting typically involves an extended overnight fast or alternate fasting days, fasting for short periods during the day may help treat SIBO naturally. 

The migrating motor complex (MMC) is a digestive function that happens every 90-120 minutes while fasting.

Also known as “cleansing waves,” the MMC helps move food through the digestive tract. 

Research shows that limiting snacks and grazing behaviors between meals may help stimulate the MMC, which can help with gut motility (a function that’s impaired in SIBO). 

7. Supplementing with Oil of Oregano

Oil of oregano is an herbal supplement well-documented for its antibacterial properties, including its use as an alternative to antibiotics for drug-resistant microbes. It has been shown to stop the growth of bacteria in the digestive tract. 

Oil of oregano is a potential natural treatment option for SIBO, but more research is needed.

‍One study from 2014 found that oil of oregano as one of the ingredients in an herbal preparation was just as effective as antibiotic therapy for treating SIBO. 

8. Seeking Professional Help for Your SIBO Symptoms

Because treating the underlying cause of your SIBO is the most effective way to prevent it from coming back, it’s essential to work with a gastroenterologist to target your treatment appropriately. 

A dietitian specializing in digestive health is another valuable healthcare professional who can offer guidance on your diet and lifestyle choices for the best results.

You may also consider a therapist if you feel chronic stress or anxiety is impacting your digestive symptoms. 

9. Taking Vitamin D and Zinc Supplements

SIBO is known to increase inflammation in the digestive tract, which can negatively impact nutrient absorption.

In some cases, SIBO can lead to low levels of specific vitamins and minerals, including zinc and vitamin D. 

Other nutrients, including vitamins B12, K, and A, can also be impacted. 

Ask your doctor about testing for nutrient deficiencies before starting any supplements.

While correcting these deficiencies won’t necessarily treat SIBO, it’s important for your overall health.

Takeaway

Natural treatment options for SIBO are popular and commonly recommended online as an alternative to antibiotic therapy.

The evidence supporting these interventions is preliminary (though promising). 

Always talk to your doctor or dietitian before trying any home remedies for SIBO, including supplements and dietary changes. 

Managing Gut Health with an RD 

You can find relief from your digestive symptoms by working with a registered dietitian.

You’ll receive guidance on food choices, supplements, and lifestyle strategies to manage SIBO naturally. Your dietitian will coordinate with your gastroenterologist to identify the best care plan for you. 

Consider booking an online consultation with a Nourish dietitian to get started on the path to improving your gut health.