Natural Treatment for SIBO

Many people with SIBO prefer natural treatments over medicines. Others don’t respond to medical drugs and wonder if they can make their SIBO go away naturally. So in this article, we’ll discuss some natural treatment options for SIBO, whether they work, and how you can incorporate them into your SIBO treatment. Let’s begin!

What are the natural treatment options for SIBO?

According to the 2017 Integrative SIBO Conference by Natural Medicine Journal, the main natural treatment options for SIBO include dietary modification and herbal antimicrobials.

Many people also support the use of probiotic supplements for treating the condition (and we have some scientific literature looking at their effectiveness).

Do natural treatments for SIBO work?

There are mixed studies about whether natural treatments can cure SIBO. But since we do have evidence supporting their effectiveness, there’s no harm in trying them out (because they’re relatively free of side effects).

For example, this study divided 165 SIBO patients into two groups — one group received rifaximin (the first-line medical drug for SIBO) and the other received herbal therapy.

The results showed that 46% of the patients who received herbal therapy had a negative breath test (meaning their bacterial overgrowth was gone) compared to only 34% of the patients who received rifaximin.

The study also reported many side effects in patients who took rifaximin. These included:

  • 1 case of severe allergic reaction
  • 2 cases of mild allergic reaction
  • 2 cases of diarrhea
  • 1 case of a C.difficile infection, which occurs when good bacteria in the gut are killed by drugs (leading to an imbalance of the gut microbiota)

This was in contrast to only one case of diarrhea that was reported in the herbal therapy group.

All of this means herbal therapy might be better than medical therapy for treating SIBO (both in terms of effectiveness and side effects).

Another review evaluating 18 studies on probiotic treatment for SIBO found similar results. Probiotics were found to be effective at eradicating excess bacteria, treating abdominal pain, and getting rid of excessive gas production that’s seen in SIBO.

Finally, this study looked at the role of an elemental diet in treating SIBO. In this study, researchers treated 124 patients with methane- or hydrogen-predominant SIBO with an elemental diet for 2 weeks. By day 15, 80% of the patients had normalized their breath test results, which meant that the excessive bacteria in their small intestine were gone.

In fact, some researchers believe that an elemental diet is as effective as rifaximin for eradicating the bacterial overgrowth seen in SIBO. This is extremely useful for patients who can’t tolerate the drug or don’t respond to it.

There is also some evidence for the usefulness of a low-FODMAP diet in treating SIBO. For example, in this case-study, researchers successfully treated a woman with mild SIBO using a low-FODMAP diet, homeopathic medicine, and antimicrobial botanical therapy.

Plus, we have clear evidence that suggests a low-FODMAP diet can have significant effects on the gut microbiota.

So while more studies are needed to study the effect of a low-FODMAP diet for SIBO, we do know that it plays some role in making patients feel better.

Should you use natural treatments for SIBO?

As mentioned earlier, there is mixed evidence regarding the effectiveness of natural treatments for SIBO.

For example, researchers in this study acknowledge the role of alternative treatment approaches to SIBO but they follow it up with something interesting:

“...However, robust clinical trials are generally lacking. Existing studies tend to be small and lack standardized formulations of treatment. …”

This means we need larger and more well-designed experiments to really determine whether natural treatments can work for SIBO.

Another group of people argue that if SIBO is a condition characterized by excessive bacterial growth, anything that supports this growth (like probiotics) can’t treat it. Again, since we do have some evidence for the effectiveness of probiotics, it might be a good idea to try out alternative therapy, especially after you’ve undergone medical therapy and failed to improve.

 Just make sure to talk to your healthcare provider before consuming anything new (because sometimes, herbal treatments and supplements can interact with any existing medications you take, making them either ineffective or amplifying their side effects).

How to treat SIBO naturally?

Before we describe how you can treat SIBO naturally, you should keep in mind that this is just a basic description for educational purposes. Real life treatment needs the help of an experienced healthcare provider.

SIBO treatment is generally divided into phases.

The first phase is eradication, where your goal is to kill off the excessive bacteria in your small intestine. You have two options here — peppermint oil and elemental diet (you can read more about the elemental diet here).

Peppermint oil is an herbal supplement that can reduce bacterial overgrowth. While you have other options too (like oregano oil capsules, garlic, and olive leaf extract), peppermint oil is more common, so it’s best to stick to it. Some side effects of peppermint oil you should be aware of include burping and heartburn.

 Note: Probiotics have also been shown to treat bacterial overgrowth and you might want to try them during the elimination phase.

While you wait for peppermint oil to eradicate your SIBO, you can use a low-FODMAP diet to control your symptoms.

FODMAPs are sugar molecules that the body can’t break down well. This means bacteria can thrive off these sugars and release gas, causing the symptoms of SIBO. By restricting FODMAPs in your diet, you reduce the chance that bacteria in your small intestine will cause uncomfortable symptoms.

You can also try FODMAP digestive enzymes to reduce the amount of FODMAPs in your diet.

Once you’ve eradicated bacterial overgrowth, it’s now time to treat the underlying cause of SIBO. SIBO usually occurs secondary to some problem with the gut. Examples of conditions that increase your risk of SIBO are:

  • Scleroderma
  • Opioid-induced constipation
  • Diseases that cause strictures in the small bowel (like Crohn’s disease)
  • Small bowel diverticulosis
  • Diabetes

If you don’t treat these conditions, bacterial overgrowth will recur no matter how effective a natural treatment is!



Medically reviewed by Onikepe Adegbola, MD PhD

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