--- title: "SIBO" entity: "page" canonical_url: "https://www.healthflow.ca/sibo" markdown_url: "https://www.healthflow.ca/llms/page/sibo" lastmod: "2026-09-17T20:54:23.099Z" --- # SIBO (Small Intestinal Bacterial Overgrowth) Get tested for SIBO and clear stubborn bloating, gas, and gut pain for good. SIBO is when bacteria overgrowth happens in the small intestine. It throws off digestion and mimics IBS. That's why cutting "trigger" foods alone rarely works. [Healthflow Naturopathic](/naturopathic-medicine) tests for SIBO, treats the root cause, and helps you stay symptom-free. Book Online ## Quick Facts What it is: An abnormal increase in bacteria, or bacteria that doesn't belong in the small intestine. Common signs: Bloating, excess gas, abdominal pain, diarrhea and/or constipation, uncomfortable fullness after eating. How it's diagnosed: A hydrogen/methane breath test, sometimes paired with stool testing or bloodwork. Our approach: A three-phase root-cause protocol: test, treat, and restore, built around your specific results. ## What is SIBO? Small intestinal bacterial overgrowth [(SIBO)](/learning-center/small-intestine-bacterial-overgrowth-natural-treatment-with-timeline) happens when bacteria from the large intestine migrate into the small intestine. It also happens when bacteria already there multiplies past healthy levels. Your small intestine is where most nutrient absorption takes place. When excess bacteria sets up shop there, they ferment food (especially carbohydrates) before your body can absorb it. That fermentation produces hydrogen and methane gas, which drives most classic SIBO symptoms. SIBO is often the mechanism behind digestive symptoms that get labelled as irritable bowel syndrome [(IBS)](/learning-center/ibs-vs-sibo-symptoms-differences-treatment-options). The two overlap closely enough that they're frequently confused, though they're diagnosed and treated differently. ## Symptoms of SIBO Symptoms vary from person to person and can range from mild to significantly disruptive. The most common include: - Bloating and visible abdominal distension, often worsening through the day - Excess gas and belching - Abdominal pain or cramping - Diarrhea, constipation, or a pattern that alternates between the two - Uncomfortable fullness after eating small amounts - Nausea - Fatigue and brain fog from nutrient malabsorption - Unintentional weight loss in more advanced or longstanding cases As a general pattern, SIBO tends to be more bloating-predominant, while IBS symptoms tend to be more pain-predominant — though there's meaningful overlap, testing is the only reliable way to tell them apart. ## What Causes SIBO? SIBO is usually a downstream effect of something else that's allowing bacteria to accumulate or migrate into the small intestine. Common contributing factors include: - Impaired gut motility — a sluggish migrating motor complex (the “housekeeping wave” that sweeps bacteria through the digestive tract between meals) lets bacteria build up. Often linked to prior food poisoning, diabetes, or hypothyroidism. - Low stomach acid , whether from long-term use of acid-suppressing medications, H. pylori infection, or age-related decline — stomach acid is one of the body's main defenses against bacterial overgrowth. - Structural issues in the digestive tract, such as surgical adhesions, diverticula, strictures, or a history of gastric bypass surgery. - Underlying conditions including Crohn's disease, celiac disease, scleroderma, and pancreatitis. - Certain medications , including opioids and some other drugs that slow digestive transit. Identifying which of these factors apply to you matters because it shapes both the treatment plan and the prevention strategy afterward — clearing the bacterial overgrowth without addressing the underlying cause is a common reason SIBO returns. ## Possible Complications of Untreated SIBO Because SIBO interferes with normal nutrient absorption, ongoing, unaddressed overgrowth can lead to: - Deficiencies in vitamin B12 and fat-soluble vitamins (A, D, E, K) - Iron deficiency - Unintentional weight loss and, in more severe cases, malnutrition - Reduced bone density over time, related to calcium and vitamin D malabsorption Most people don't reach this level of severity, but it's a good reason not to let persistent digestive symptoms go uninvestigated. ## How SIBO Is Diagnosed SIBO is confirmed with a [hydrogen/methane breath test](/learning-center/how-to-read-sibo-test-results-and-next-steps). After drinking a lactulose or glucose solution, you breathe into a collection device at set intervals over two to three hours. Hydrogen and methane levels are measured throughout. A significant rise in either gas within that window signals bacterial fermentation happening earlier in the digestive tract than it should. Breath testing has limits. False negatives happen in a meaningful share of cases, often due to hydrogen-sulfide-producing bacteria that standard tests don't capture, or improper test preparation. That's why we sometimes pair breath testing with stool analysis or targeted bloodwork to get a fuller picture. If you've already been tested, a [Naturopathic Doctor](/about) will walk through what the numbers and patterns actually mean. Healthflow practitioners can order SIBO lactulose breath testing directly, without a physician referral, through our [functional testing](/functional-testing) services. ## The Healthflow Approach to SIBO We test before we treat, and we don't stop at symptom relief. Our approach runs in three phases: - Test. We confirm SIBO with breath testing (and additional testing where useful) and rule out overlapping conditions like IBS. Your protocol is built on data, not guesswork. - Treat. Based on your results, history, and preferences, we build a custom antimicrobial phase using herbal antimicrobials, pharmaceutical options in coordination with your prescriber, or both. This is paired with a time-limited dietary strategy to reduce your symptom burden while treatment works. - Restore. Once the overgrowth is addressed, we focus on the factor that allowed SIBO to develop in the first place, often motility support, plus a structured food reintroduction plan. This phase is what actually determines whether SIBO stays away. Care is available in-person at our Calgary clinic or virtually across Alberta. Direct billing is available for many extended health plans. ### What to Expect Walk out of your first visit with a real plan - not a "wait and see." Your 50-minute session with your ND covers: - Full symptom history - Prior testing review - Diet and lifestyle factors - Breath testing recommendation (if you haven't had one) You'll start with something useful that same day. Results come back within two weeks. From there, we build your three-phase plan together. Short 10 to 25-minute follow-ups keep things on track through the treat and restore phases - so we adjust based on what's actually working for you. ## When to Seek Immediate Medical Care [Naturopathic care](/naturopathic-medicine) addresses and treats SIBO. However, see a physician promptly or seek emergency care if you experience rectal bleeding, severe or unrelenting abdominal pain, persistent vomiting, significant unintentional weight loss, or signs of dehydration. ## Get Clear Answers on Your SIBO Symptoms We'll review your symptoms and history, recommend the right testing, and build a treatment plan around your results - not a generic protocol. [Book Your Consultation →](/contact) ## Frequently Asked Questions Is SIBO the same thing as IBS? No. IBS is a functional diagnosis based on symptom patterns. SIBO is a measurable overgrowth of bacteria in the small intestine, confirmed with breath testing. The two share symptoms like bloating and altered bowel habits, and SIBO is thought to underlie a meaningful subset of IBS cases. But they're diagnosed and treated differently. How long does SIBO treatment take? Most protocols run several weeks to a few months. The timeline depends on how long SIBO has been present, which gases are elevated, and whether an underlying cause like low motility needs to be addressed alongside the overgrowth. Your practitioner will give you a custom timeline after reviewing your results. Can SIBO come back after treatment? Yes. Recurrence is common if the underlying cause goes unaddressed. That's why our protocol includes a motility and prevention phase after initial treatment, rather than stopping once symptoms improve. Do I need a doctor's referral for SIBO testing at Healthflow? No referral is required. As licensed naturopathic doctors, our practitioners can order functional testing, including SIBO lactulose breath testing, directly. Can SIBO be treated with diet alone? Diet can help manage symptoms, but it generally doesn't clear an existing bacterial overgrowth on its own. Most effective protocols pair a time-limited dietary strategy with antimicrobial treatment and motility support afterward to reduce the risk of relapse. Is SIBO breath testing covered by insurance? Healthflow direct bills for Naturopathic Doctor appointments only. Coverage depends on your specific extended health plan. Most tests are covered through Health Spending Accounts. ## Related Reading Explore our learning centre to read more about SIBO and other digestive concerns.