Holistic Approach to SIBO

Small intestinal bacterial overgrowth (SIBO), which involves excessive bacterial growth in the small intestine, often causes symptoms like bloating, gas, diarrhea, and abdominal pain. There is no single, accepted diagnostic test for SIBO and its symptoms may overlap with other conditions. Many people with irritable bowel syndrome (IBS) may actually have undiagnosed SIBO, but it is frequently overlooked or misdiagnosed. The first-line treatment for SIBO is a course of antibiotics, after which the root cause of the disease can be addressed through dietary changes.

A 2025 study, published in Nutrients, explored how an integrative treatment plan could improve the quality of life for people with SIBO. The study involved 179 adults diagnosed with hydrogen- or methane-predominant SIBO, confirmed by breath tests. Due to ethical considerations, there was no placebo or control group. All of the participants received an integrative treatment plan consisting of antibiotics (tailored to gas type) with herbal antimicrobials like oregano oil and berberine. Patients also followed a personalized low-FODMAP diet and took probiotics and supplements such as L-glutamine. Quality of life and symptom severity were assessed at the start, one month, and three months using validated questionnaires.

After 90 days, although only about 41% had normalized breath tests, nearly 73% experienced meaningful symptom relief and improved quality of life. Patients reported better mental health, emotional well-being, energy, and social functioning. Symptom severity, including bloating and abdominal pain, decreased significantly, regardless of breath test results. Stool consistency also normalized, and those with improved stool patterns saw a 40% reduction in anxiety and depression scores. Psychological factors and patients’ initial sense of well-being were important predictors of success.

The study highlights that employing a holistic, personalized approach combining medication, diet, supplements, and mental health can offer substantial benefits for SIBO sufferers.