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What Is Causing Your Gas and Bloating?

Do you struggle with gas, bloating, stool changes, abdominal cramping and pain, and reactivity to many foods? Or have you ever been told you have Irritable Bowel Syndrome (IBS) or Leaky Gut Syndrome? If so, you may have Small Intestine Bacterial Overgrowth (SIBO).

What is SIBO?

SIBO occurs when there is abnormal growth of bacteria in the small intestine that do not normally inhabit this region. The bacteria go from the colon up to the small intestine due to abnormal gut function. The peristalsis or regular wave-like contractions do not correctly move bacteria and food downward. In addition to digestive problems, untreated SIBO increases the risk of leaky gut, vitamin deficiencies (A, D, K, E, B12), and issues related to poor calcium absorption, such as osteoporosis and kidney stones.

Causes of SIBO

  • Food poisoning can damage the motor complex involved in peristalsis and impede food movement through the GI tract. Bacteria from the colon then migrate to the small intestine.
  • Low stomach acid allows bacteria to penetrate the digestive tract (stomach acid is a normal barrier to bacteria). The use of proton pump inhibitors (PPIs) is a known cause of SIBO.
  • Low bile flow increases susceptibility to bacteria penetrating the digestive tract.
  • Low pancreatic enzyme output (pancreatic insufficiency) impedes the digestion of food and the breakdown of bacteria in the small intestine. It is known that pancreatic insufficiency is associated with SIBO.
  • Abdominal surgeries such as gastric bypass and others may cause SIBO. In addition, scar tissue and adhesions can impede small intestine activity.
  • Various medical conditions (diabetes, celiac disease, diverticulosis, Crohn’s disease, radiation therapy to the area, and others) can slow the passage of food through the small intestine and cause bacteria buildup.


The proper way to test for SIBO is breath testing. You collect a baseline breath test and then consume a sugar drink to perform this test. Then more breath samples are collected to measure hydrogen, methane, and hydrogen sulfide levels. These gases are formed when there is an overgrowth of bacteria. The gases are absorbed from the gut into the bloodstream, transported to the lungs, and exhaled in the breath.

Elevated hydrogen produced by fermenting bacteria also fuels methane and hydrogen sulfide–producing organisms. Each of these gases correlates with certain digestive conditions:

  • Hydrogen: loose stool or general SIBO symptoms
  • Methane: constipation
  • Hydrogen sulfide: diarrhea


Most patients with SIBO are treated with diet changes, such as the LOW FODMAP Diet, which reduces the type of sugars that quickly ferment and create gases. However, this diet is used short term. To normalize levels of the overgrowth of bacteria in the small intestine, I commonly recommend SIBO-specific probiotics, like our SIBO Wellness, as well as herbal products that lower the bacteria level. Common ingredients include oregano, sage, thyme, berberine, bilberry, allicin, grape seed, and others. In severe cases, I may also recommend short-term antibiotic therapy and natural treatments. It is also imperative to follow natural protocols that help gut motility to prevent relapse with SIBO.

Testing and treatment for SIBO are available at the Stengler Center For Integrative Medicine ( Also, you can pre-order my new book coming out in 2024, The Holistic Guide To Gut Health, which goes into detail how to naturally treat common digestive ailments,aps,153&sr=8-6

Dr. Mark Stengler NMD, MS, is a bestselling author in private practice in Encinitas, California, at the Stengler Center for Integrative Medicine. His newsletter, Dr. Stengler’s Health Breakthroughs, is available at and his product line at