It's because microbes aren't what are causing your issue but the environment that allows them to overgrow is. That single insight changes everything about how you approach SIBO, and it's what most people miss after their first round of antimicrobials fails.
New to this? Start with the pillar guide: How do you tell if you have SIBO.
What Does It Actually Feel Like to Have SIBO?
More symptomatic is easier to read than you might think. Do I bloat during a meal up to an hour after? yes = low stomach acid 90% of the time. Do I have greast floating or yellow/sticky stools? If yes = bile issues.
These two questions alone point you toward the underlying environment rather than just the bacteria themselves.
Why Does SIBO Keep Coming Back After Antimicrobials?
This is the pattern Kieran has seen over and over again with clients.
have SIBO for most of my teenage years put together the strongest round of antimicrobials + biofilm agents Feel better for a month It comes back... realise my stomach acid was always low, hence the overgrowth in the first place realise because of this my bile flow was poor also, making overgrowth even more likely address both of these and do another more gentle round felt immensely better since, now eat pretty much whatever without a worry
I see this happen over and over again with clients, most have already tried antimicrobials by the time they begin working with me. It's because microbes aren't what are causing your issue but the environment that allows them to overgrow is.
What Causes the Environment That Allows SIBO to Develop?
Repeated damage to the stomach and gut lining leads to overgrowths which loops back to previous statement, chronic stress or toxins mostly from my view.
Although commonly stated as a root cause of SIBO the amount of people I've seen this actually be the case is quite low; that being said it's always worth checking and may be the case for you.
What Is the Right Order of Treatment for SIBO?
Working on what caused the overgrowth in the first place then using targeted antimicrobials always seems to work best.
My goal is to restore someone's natural acid production, not have them take betaine hcl for the rest of their lives.
How Do Low Stomach Acid and Bile Flow Connect to SIBO?
Bile flow in big part is down to stomach acid, intestinal lining health and liver health too.
It can improve symptoms drastically by improving gut lining integrity, which in turn could also promote antimicrobial peptides production bile flow and motility so yeah for some it does a lot of jobs in one.
Betaine is good short term, but also stomach lining health through things like zinc l carnosine DGL sulforaphane are helpful all depending on person.
What Antimicrobials Did Kieran Actually Use?
BSO, Berberine, Lactoferrin were the main three, tons of little supporting elements too.
Some people with bacterial overgrowths find it makes them feel worse however, so all depends on the person.
