Why Does SIBO Return?

Small intestinal bacterial overgrowth (SIBO) can show itself in loss of appetite, abdominal pain, nausea, bloating, loose stools, constipation and unintentional weight loss/gain, to name a few symptoms. 

If you have done some functional lab tests which confirm that you have bacterial overgrowth in the small intestine, then you’re one step closer to healing from SIBO. However, the condition can be stubborn to eradicate – this is especially so if you only treat the symptoms, and don’t focus on identifying and treating the root cause of WHY you developed this bacterial overgrowth in the first place. 

So, what are the main reasons why people get SIBO relapses? 


There are two reasons as to why I don’t recommend antibiotics:

ONE: It will kill a lot of the good bacteria as well and simply taking a probiotic afterwards will not bring back the beautiful diverse microbiome you once had. The damage that antibiotics cause is real and you are unlikely to regain the same 300-500 strains of bacteria you had before. This will have a huge impact on your overall health because each strain has a very specific role.

Am I saying that you will never be able to regain back your health after taking antibiotics? No way, and I’ve helped hundreds of clients optimise their gut health again in multiple ways after taking antibiotics but the truth is that the diversity of the microbiome will never be the same.

TWO: Antibiotics causes yeast/candida overgrowth because antibiotics are anti-bacterial and not anti-fungal. This means that as more bacteria die as a result of antibiotics in the gut, it begins to leave a lot of space for the yeast to flourish and cause overgrowth. So the SIBO might be gone but now you end up with worst symptoms due to yeast overgrowth!

I have seen many people that have taken antibiotics for SIBO only to relapse multiple times 2 to 10 weeks later. The reason for this is that the antibiotics do nothing to kill certain types of bacteria, remove the bio films, or kill any type of yeast.


You may have an underlying condition that was missed during your SIBO diagnosis. I.e. you were diagnosed with SIBO but that was actually just a side effect of a different condition. 

There are many conditions such as diabetes, celiac, low stomach acid, Crohn’s and hypothyroidism which slows down your gut motility, and therefore can predispose you to SIBO. 

It is important to test for these eventualities, as you would have more success identifying and healing the underlying condition, rather than just focussing on the symptoms of SIBO.


Many people treat their SIBO and then return to the same unhealthy diet and lifestyle that will have contributed to developing the health issue in the first place. 

For example, sitting down or not moving for long periods of the day reduces blood flow to the digestive tract, thus slowing GI motility. As a result, food sits in the small intestines for longer, allowing more bacteria to multiply, leading to bacterial overgrowth. 

Snacking is also a factor that can lead to the reoccurrence of SIBO. If you are constantly adding food into your stomach, your migrating motor complex (MMC) which clears food from your small intestine is inhibited. Therefore, it is unable to keep your small intestine clean and results in bacterial overgrowth. The combination of these two lifestyle factors is a recipe for disaster when it comes to SIBO relapse. 


Treating SIBO removes the immediate symptoms but maintaining a healthy diet (and lifestyle) is required to keep SIBO at bay. Sugar, alcohol and processed food will all negatively impact your gut function. 

A poor diet can cause all sorts of gut health issues, and this results in poor gut motility and a digestive system that is not functioning properly – both of which make it harder for your body to effectively move food (including the toxins from the poor diet) through your small intestine. What’s the result? You got it, bacterial overgrowth in the small intestine. 


Medications such as antibiotics, antihistamines and NSAIDs can do more harm than good when it comes to your gut health. 

Antibiotics kill bacteria; however, they do not know the difference between good bacteria and bad bacteria, and this can lead to an imbalance of bacteria in the gut (gut dysbiosis). This imbalance caused by antibiotics leads to bacterial overgrowth. 

How does this bacterial overgrowth get to your small intestine? Well, if your gut flora is out of whack in your large intestine and colon, this overgrows and colonises your small intestine. 


Firstly, think twice before going on medications. Is it absolutely necessary? As we have just explored, medicine can do more harm than good when it comes to SIBO, as it only treats the symptoms but never addresses the root cause. 

You must figure out whether SIBO is indeed the cause of your symptoms via functional lab testing, this will give us a better indication of where to start with your healing journey. However, I do understand that these tests aren’t financially feasible for everyone. 

With or without the functional lab testing, the bacterial overgrowth must be starved by removing the foods that feed it from your diet. Unfortunately, food alone is not enough as one must take a very specific combination of varying supplements at the same time for approximately 12 weeks.

Once the bad bacteria have been reduced, it is important to restore your good bacteria. Probiotics should not be taken in the first few weeks, and this is a mistake that I see being done all the time. This would simply be adding more fuel to the fire!  

Your gut motility also needs to be improved, to stop bacteria having time to build-up in the small intestine in the future. This can be done by directly addressing the root cause.

It is also important to boost digestion. This can be done by a nutrition and lifestyle plan, incorporating a balanced and anti-inflammatory diet, movement, and supplementation. 

The good news is that my GI Protocol has been incredibly successful with helping hundreds of people with this condition. It’s a 12-week protocol that addresses these imbalances in three keyways by following a very specific and science-based method. 

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