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SIBO
SIBO

9 SIBO Natural Treatment Options for Gut Support

Christa Brown, MS, RDN, LD
Medical Reviewer: 
Christa Brown, MS, RDN, LD
|
Author: 
Jennifer Huddy, MS, RD, LD
Published:
September 12, 2023
5
min read

Table of Contents

What is SIBO? 
Common Symptoms of SIBO
9 Natural Treatment Options for SIBO
Takeaway
Managing Gut Health with an RD 
SIBO

Key Takeaways

  • Small intestinal bacterial overgrowth (SIBO) is a digestive condition that happens when bacteria from the large intestine overpopulate the small intestine, causing symptoms like abdominal pain and diarrhea. 
  • Traditional antibiotic treatment may not work for everyone, making natural treatment options, like herbal supplements and dietary changes, popular. 
  • While preliminary evidence supports the use of many of these natural treatments, it’s important to talk to your doctor to identify the best care plan for you. 

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.

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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. 

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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. 

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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.  

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Frequently Asked Questions

What naturally kills SIBO?

Certain herbal supplements, like berberine, peppermint oil, and oil of oregano, have antimicrobial properties that have been shown to help kill the excess bacteria in the small intestine and improve symptoms of SIBO. 

One study from 2014 found that herbal supplements were as effective as traditional antibiotic therapy for treating SIBO. However, overall evidence on natural SIBO treatments is limited, so talk to your doctor about the best options for you. 

‍

What is the fastest way to cure SIBO?

The most effective way to cure SIBO is to treat the underlying cause, which includes conditions like motility disorders and chronic pancreatitis. In addition, antibiotic therapy is the first-line treatment to eradicate bacteria in the small intestine and improve symptoms. 

However, antibiotic therapy isn’t effective for everyone. Some people benefit from natural treatment options such as herbal antimicrobials and dietary changes to manage SIBO.

What is the best herbal SIBO treatment?

Numerous herbal supplements have antimicrobial properties, which may have a similar effectiveness as antibiotic therapy in treating SIBO. 

Examples include:

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

However, research on these therapies is limited, making it important to discuss any supplement use with your doctor.

References

View all references
  1. Achufusi, T. G. O., Sharma, A., Zamora, E. A., & Manocha, D. (2020). Small Intestinal Bacterial Overgrowth: Comprehensive Review of Diagnosis, Prevention, and Treatment Methods. Cureus, 12(6), e8860.

‍

  1. Sorathia, S. J., Chippa, V., & Rivas, J. M. (2023). Small Intestinal Bacterial Overgrowth. StatPearls Publishing.

‍

  1. 3 Step FODMAP Diet Guide. (2019). Monash University.

‍

  1. Davani-Davari, D., Negahdaripour, M., Karimzadeh, I., Seifan, M., Mohkam, M., Masoumi, S. J., Berenjian, A., & Ghasemi, Y. (2019). Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods, 8(3).

‍

  1. Ianiro, G., Pecere, S., Giorgio, V., Gasbarrini, A., & Cammarota, G. (2016). Digestive Enzyme Supplementation in Gastrointestinal Diseases. Current Drug Metabolism, 17(2), 187-193.

‍

  1. Bures, J., Cyrany, J., Kohoutova, D., Förstl, M., Rejchrt, S., Kvetina, J., Vorisek, V., & Kopacova, M. (2010). Small intestinal bacterial overgrowth syndrome. World Journal of Gastroenterology : WJG, 16(24), 2978-2990.

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  1. Ní Chonchubhair, H. M., Bashir, Y., Dobson, M., Ryan, B. M., Duggan, S. N., & Conlon, K. C. (2018). The prevalence of small intestinal bacterial overgrowth in non-surgical patients with chronic pancreatitis and pancreatic exocrine insufficiency (PEI). Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 18(4), 379–385.

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  1. Chedid, V., Dhalla, S., Clarke, J. O., Roland, B. C., Dunbar, K. B., Koh, J., Justino, E., Tomakin, E., & Mullin, G. E. (2014). Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth. Global Advances in Health and Medicine, 3(3), 16–24.

‍

  1. Clark, A. K., Haas, K. N., & Sivamani, R. K. (2017). Edible Plants and Their Influence on the Gut Microbiome and Acne. International Journal of Molecular Sciences, 18(5).

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  1. Khanna, R., MacDonald, J. K., & Levesque, B. G. (2014). Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Journal of Clinical Gastroenterology, 48(6), 505–512.

‍

  1. Lee, A. A., Baker, J. R., Wamsteker, E. J., Saad, R., & DiMagno, M. J. (2019). Small Intestinal Bacterial Overgrowth Is Common in Chronic Pancreatitis and Associates With Diabetes, Chronic Pancreatitis Severity, Low Zinc Levels, and Opiate Use. The American Journal of Gastroenterology, 114(7), 1163–1171.

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  1. Konturek, P. C., Brzozowski, T., & Konturek, S. J. (2011). Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. Journal of physiology and pharmacology : an official journal of the Polish Physiological Society, 62(6), 591–599.

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  1. Liu, J., Lv, C., Wang, W., Huang, Y., Wang, B., Tian, J., Sun, C., & Yu, Y. (2022). Slow, deep breathing intervention improved symptoms and altered rectal sensitivity in patients with constipation-predominant irritable bowel syndrome. Frontiers in neuroscience, 16, 1034547.

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  1. Deloose, E., Janssen, P., Depoortere, I., & Tack, J. (2012). The migrating motor complex: control mechanisms and its role in health and disease. Nature reviews. Gastroenterology & hepatology, 9(5), 271–285.

‍

  1. O'Dwyer D. (2021). Homemade Elemental Diet to Treat Intestinal Methanogen Overgrowth: A Case Report. Integrative medicine (Encinitas, Calif.), 20(2), 32–41.

‍

  1. Lu, M., Dai, T., Murray, C. K., & Wu, M. X. (2018). Bactericidal Property of Oregano Oil Against Multidrug-Resistant Clinical Isolates. Frontiers in microbiology, 9, 2329.

‍

‍

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Charlotte
, 
NC
North Carolina
35.2272086, -80.8430827
Sacramento
, 
CA
California
38.590576, -121.489906
Richmond
, 
VA
Virginia
37.540726, -77.436050
Surprise
, 
AZ
Arizona
33.629002, -112.330170
Mesa
, 
AZ
Arizona
33.415184, -111.831474
Louisville
, 
KY
Kentucky
38.252666, -85.758453
Des Moines
, 
IA
Iowa
41.586834, -93.624962
Lakewood
, 
CO
Colorado
39.704708, -105.081375
Kansas City
, 
KS
Kansas
39.112701, -94.626801
Reno
, 
NV
Nevada
39.529633, -119.813805
Tacoma
, 
WA
Washington
47.258728, -122.465973
Aurora
, 
CO
Colorado
39.7405111, -104.830994
Oxnard
, 
CA
California
34.197659, -119.175949
Amarillo
, 
TX
Texas
35.221996, -101.831299
Henderson
, 
NV
Nevada
36.039524, -114.981720
Vancouver
, 
WA
Washington
45.633331, -122.599998
Gilbert
, 
AZ
Arizona
33.352825, -111.789024
San Bernardino
, 
CA
California
34.115784, -117.302399
Columbus
, 
GA
Georgia
27.800583, -97.396378
Hayward
, 
CA
California
37.668819, -122.080795
Milwaukee
, 
WI
Wisconsin
43.038902, -87.906471
Lubbock
, 
TX
Texas
33.576698, -101.855072
Norfolk
, 
VA
Virginia
36.850769, -76.285873
Tulsa
, 
OK
Oklahoma
36.153980, -95.992775
Garland
, 
TX
Texas
32.914341, -96.636559
Fort Lauderdale
, 
FL
Florida
26.124161, -80.143593
Tucson
, 
AZ
Arizona
32.248814, -110.987419
Salt Lake City
, 
UT
Utah
40.760780, -111.891045
Corona
, 
CA
California
33.875670, -117.568840
Madison
, 
WI
Wisconsin
43.073051, -89.401230
Huntsville
, 
AL
Alabama
34.7014286, -86.6597495
Kansas City
, 
MO
Missouri
39.099728, -94.578568
Irvine
, 
CA
California
33.684566, -117.826508
Chula Vista
, 
CA
California
32.640072, -117.084038
Denton
, 
TX
Texas
33.215530, -97.132446
Aurora
, 
IL
Illinois
41.7571701, -88.3147539
Baton Rouge
, 
LA
Louisiana
30.4494155, -91.1869659
Columbus
, 
OH
Ohio
39.961178, -82.998795
Baltimore
, 
MD
Maryland
39.2908816, -76.610759
Detroit
, 
MI
Michigan
42.331429, -83.045753
Chesapeake
, 
VA
Virginia
36.7183708, -76.2466798
Birmingham
, 
AL
Alabama
33.5206824, -86.8024326
Scottsdale
, 
AZ
Arizona
33.501324, -111.925278
Cincinnati
, 
OH
Ohio
39.103700, -84.513610
North Las Vegas
, 
NV
Nevada
36.201946, -115.120216
Riverside
, 
CA
California
33.980602, -117.375496
Plano
, 
TX
Texas
33.019844, -96.698883
Minneapolis
, 
MN
Minnesota
44.977753, -93.265015
Salinas
, 
CA
California
,
Anaheim
, 
CA
California
33.836594, -117.914299
Springfield
, 
MO
Missouri
37.208958, -93.292297
Fort Wayne
, 
IN
Indiana
41.077469, -85.137489
Phoenix
, 
AZ
Arizona
33.448376, -112.074036
Bakersfield
, 
CA
California
35.3738712, -119.0194639
Garden Grove
, 
CA
California
33.774269, -117.937996
Anchorage
, 
AK
Alaska
61.2163129, -149.894852
Indianapolis
, 
IN
Indiana
39.768402, -86.158066
Nashville
, 
TN
Tennessee
36.162663, -86.781601
Tempe
, 
AZ
Arizona
33.425522, -111.941254
Mobile
, 
AL
Alabama
30.695366, -88.039894
New Orleans
, 
LA
Louisiana
29.951065, -90.071533
Knoxville
, 
TN
Tennessee
35.960636, -83.920738
Grand Rapids
, 
MI
Michigan
42.963360, -85.668083
Fontana
, 
CA
California
34.102890, -117.435760
Elk Grove
, 
CA
California
38.418129, -121.393257
Miami
, 
FL
Florida
25.7825389, -80.3118603
Grand Prairie
, 
TX
Texas
32.745499, -97.003532
Fort Collins
, 
CO
Colorado
40.588970, -105.082458
Killeen
, 
TX
Texas
31.117119, -97.727798
Modesto
, 
CA
California
37.639095, -120.996880
Oklahoma City
, 
OK
Oklahoma
35.468491, -97.521263
Santa Ana
, 
CA
California
33.745571, -117.867836
Ontario
, 
CA
California
34.063343, -117.650887
Brownsville
, 
TX
Texas
25.9015688, -97.4984005
Montgomery
, 
AL
Alabama
32.379223, -86.307739
Hialeah
, 
FL
Florida
25.857595, -80.278107
Springfield
, 
MA
Massachusetts
42.102051, -72.585762
Toledo
, 
OH
Ohio
41.652805, -83.537865
Pembroke Pines
, 
FL
Florida
26.007765, -80.296257
Overland Park
, 
KS
Kansas
38.974819, -94.683601
Little Rock
, 
AR
Arkansas
34.746483, -92.289597
Glendale
, 
CA
California
34.142509, -118.255074
Roseville
, 
CA
California
38.752125, -121.288010
Rancho Cucamonga
, 
CA
California
,
Wichita
, 
KS
Kansas
37.687176, -97.330055
Huntington Beach
, 
CA
California
33.659485, -117.998802
Augusta
, 
GA
Georgia
33.4709714, -81.9748429
Worcester
, 
MA
Massachusetts
42.271389, -71.798889
Virginia Beach
, 
VA
Virginia
36.852924, -75.977982
Oceanside
, 
CA
California
33.1958696, -117.3794834
Santa Clarita
, 
CA
California
34.456043, -118.571335
Philadelphia
, 
PA
Pennsylvania
39.952583, -75.165222
Corpus Christi
, 
TX
Texas
27.800583, -97.396378
Portland
, 
OR
Oregon
45.512230, -122.658722
Denver
, 
CO
Colorado
39.739235, -104.990250
Boston
, 
MA
Massachusetts
42.3554334, -71.060511
Atlanta
, 
GA
Georgia
33.7489924, -84.3902644
Chicago
, 
IL
Illinois
41.8755616, -87.6244212
Orlando
, 
FL
Florida
28.538336, -81.379234
Jacksonville
, 
FL
Florida
30.332184, -81.655647
Tampa
, 
FL
Florida
27.950575, -82.457176
Long Island
, 
NY
New York
40.757801, -73.940033
Queens
, 
NY
New York
40.728226, -73.794853
Bronx
, 
NY
New York
40.8466508, -73.8785937
Staten Island
, 
NY
New York
40.643501, -74.076202
Brooklyn
, 
NY
New York
40.6526006, -73.9497211
New York
, 
NY
New York
40.712776, -74.005974
San Jose
, 
CA
California
37.342205, -121.851990
San Francisco
, 
CA
California
37.774929, -122.419418
San Diego
, 
CA
California
32.834686, -117.130775
Los Angeles
, 
CA
California
34.052235, -118.243683
El Paso
, 
TX
Texas
31.761877, -106.485023
San Antonio
, 
TX
Texas
29.387428, -98.496574
Dallas
, 
TX
Texas
32.776665, -96.796989
Fort Worth
, 
TX
Texas
32.755489, -97.330765
Houston
, 
TX
Texas
29.760427, -95.369804
Austin
, 
TX
Texas
30.2711286, -97.7436995
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