Your IBS Is Probably SIBO
Irritable Bowel Syndrome is not a real diagnosis. It is a description. It means your bowels are irritable and we do not know why. IBS is the label used when a member reports long-term bloating, belly pain, gas, and changes in bowel habits, and standard tests including colonoscopy, celiac screening, and blood work find nothing wrong. The label gives doctors a code for billing but no reason for what is happening, no specific thing to treat, and no cure.
Research shows that 6 out of 10 members with IBS actually have SIBO, Small Intestinal Bacterial Overgrowth. This is not just a theory. It is a huge problem. Millions of members are getting fiber pills and muscle relaxers and being told they will be fine. But they have a real condition that doctors can test for and treat. The condition has a clear reason it happens.
The symptoms of SIBO look exactly like IBS: bloating that gets worse as the day goes on, a swollen belly, gas, belly pain, diarrhea or constipation or both switching back and forth, and feeling bad after you eat. This is not by accident. Most of the time, they are the same thing. One has been given a real reason. The other has just been given a shrug.
At Kure Health, we do not diagnose IBS. We look for what is causing the symptoms that other doctors have called IBS. We test for a common gut problem using a breath test. This test is a standard part of how we check your digestion in the VITAL Index for any Members with long-lasting stomach problems that were labeled IBS without real investigation.
What SIBO Actually Is
The small intestine is supposed to stay mostly clean. It is where your body takes in food nutrients. Bacteria normally do not grow there because stomach acid, bile, and special proteins kill them. Also, your small intestine has waves of muscle squeezes that push bacteria and waste down into the colon when you are not eating.
SIBO happens when the body's guards fail and bacteria from the colon move into the small intestine and grow there. Once they settle in, these bacteria break down carbohydrates in the small intestine. This makes gases like hydrogen and methane. The gases cause bloating, swelling, and pain. The bacteria also make waste products that slow down how the gut moves, hurt the intestinal lining, and stop the body from taking in nutrients.
The damage goes beyond stomach problems. When bacteria grow too much in the small intestine, they cause swelling in the gut wall. This swelling lets bacterial poisons leak into the blood. Once in the blood, these poisons trigger swelling throughout the whole body. The gut also stops absorbing fat-based vitamins, iron, and B12 well. When these run low, Members feel tired, confused, anemic, and have nerve problems. These symptoms seem like they have nothing to do with the gut. Doctors miss the connection because the symptoms show up in different parts of the body and different doctors treat them.
SIBO is not rare. It is not a fringe diagnosis. It is a condition that more and more doctors are recognizing. It has a clear cause. There are specific tests for it. There are proven ways to treat it. The real barrier is not science. It is a healthcare system that names the symptoms and then stops looking deeper.
Why SIBO Keeps Coming Back
SIBO comes back a lot. About 4 out of every 10 people get it again within one year after antibiotics work. This matters because it shows something important: antibiotics kill the extra bacteria, but they do not fix why the bacteria grew in the first place. It is like cleaning up a mess without fixing the leak. The bacteria will come back unless you fix what let them grow.
The sweeping motion in your small intestine is the most common problem. This motion clears out bacteria about every 90 minutes when you are not eating. When this sweeping motion does not work right, bacteria pile up. This sweeping motion can break down from food poisoning, from your body attacking its own vinculin protein after food poisoning, from diabetes that slows your stomach, from a slow thyroid, from taking opioids for a long time, and from long-term stress that weakens your vagus nerve.
Structural causes include a valve that doesn't close right, letting bacteria move backward from the colon into the small intestine. Surgery can leave scar tissue that traps bacteria in pockets. Some people are born with intestinal shapes that don't move food smoothly. Low stomach acid from long-term medicine use, H. pylori infection, or getting older weakens the acid that normally kills bacteria before they reach the small intestine.
Immune problems can cause the sickness to come back. Your gut has a special helper that keeps bad bacteria from growing too much. When this helper gets low, bacteria can grow out of control. Antibiotics kill the bacteria, but if you don't fix what caused the problem in the first place, the bacteria just grow back again. It's like pulling weeds without fixing the soil. The weeds come back.
The Breath Test and What It Reveals
The lactulose breath test is the standard way to check for SIBO without surgery. The member drinks a lactulose solution after not eating overnight. Lactulose is a fake sugar that your body cannot break down or use. It travels through the small intestine without changing until it hits bacteria. The bacteria eat the lactulose and make gases. Breath samples taken every so often over 2 to 3 hours measure these gases.
The timing and type of gas tells us the diagnosis. An early rise in hydrogen or methane, usually within the first 90 minutes, shows that bacteria in the small intestine are fermenting food and confirms SIBO. Gas that rises only after 90 to 120 minutes shows normal fermentation in the colon instead. The difference depends on how fast lactulose moves through the small intestine.
The gas type tells you which kind of SIBO you have, and that tells you how to treat it. Hydrogen gas SIBO usually causes diarrhea and gets better with rifaximin, which is an antibiotic your body does not absorb. Methane gas SIBO comes from tiny organisms that are not bacteria, and it usually causes constipation. It needs rifaximin plus neomycin or allicin to stop the methane-making organisms. Hydrogen sulfide gas SIBO causes both kinds of symptoms and very smelly gas. It needs special antimicrobial treatment.
At Kure Health, we use two tests together to see the whole picture of your gut. A breath test shows if you have SIBO and what kind it is. A stool test finds other problems like bad bacteria, germs, signs of swelling, and leaks in your gut lining. These problems help SIBO start and come back. When you use both tests, you get all the information you need to fix what is really wrong.
Root Cause Treatment vs. Antibiotic Cycling
The usual way to treat SIBO is with antibiotics. Doctors use rifaximin for one type and rifaximin plus neomycin for another type. They repeat the treatment when symptoms come back. These antibiotics work well. They kill the extra bacteria and make people feel better for weeks or months. But they do not stop SIBO from coming back because they do not fix why the bacteria grew too much in the first place. So Members end up in a cycle: get treated, feel better, get sick again, get treated again.
Root cause treatment means finding out exactly what is letting bacteria grow too much and fixing it. A special blood test can find damage to the part of your gut that moves food along. When that test shows damage, doctors give you medicine that helps your gut move food the way it should. You keep taking this medicine to stop the bacteria from coming back.
Your stomach acid level shows whether medicine, a germ, or getting older is weakening your stomach's protection. Your thyroid check shows whether a slow thyroid is making your gut move too slowly. Your valve check shows whether bacteria are moving backward where they should not. If you had surgery, we look for scar tissue that might be causing trouble. When we find what is really wrong, we treat that one thing instead of giving you antibiotics over and over.
The Kure Health SIBO protocol has four phases. Phase one kills the overgrowth using medicine or herbs, depending on how bad it is. Phase two fixes what caused the problem in the first place so it does not come back. Phase three rebuilds the gut by healing the lining, restoring good bacteria, and replacing nutrients that were lost. Phase four changes what you eat to reduce foods that feed the overgrowth, then slowly adds foods back as your gut gets better. A breath test at 8 to 12 weeks shows if the overgrowth is gone. Ongoing checks make sure the root cause treatment keeps the problem from returning.
Frequently Asked Questions
What is the difference between IBS and SIBO?
IBS is a name for symptoms when doctors cannot find what is causing them. SIBO is bacterial overgrowth in the small intestine. SIBO has a real, testable cause. About 60 to 78 percent of IBS Members actually have SIBO instead.
How do you test for SIBO? A breath test uses a special sugar called lactulose. Bacteria in your gut ferment it and make gases. The test measures three gases: hydrogen, methane, and hydrogen sulfide. If these gases show up fast, within 90 minutes, you have SIBO. Which gas appears tells your doctor which treatment will work best.
Why does SIBO keep coming back?
Antibiotics kill the extra bacteria. But they do not fix what caused the problem in the first place. The problem might be a weak stomach muscle that moves food down, low acid in your stomach, a thyroid that does not work right, a valve that does not close the way it should, or an immune system that is not strong. If you find and treat the real cause, SIBO will not come back.
Can SIBO cause fatigue and brain fog?
Yes. SIBO harms the lining of your intestines. This stops your body from taking in B12, iron, and certain vitamins. It also makes your intestines more leaky. When your intestines leak, your whole body gets inflamed. These things cause fatigue and brain fog. You may also feel sick in ways that have nothing to do with your stomach.
About the author
Kenton Gray is the Founder and Chief Executive Officer of Kure Health. He built Kure Health around one idea: Members should be able to see what their own body is doing, in plain terms. He writes here in that role, not as a clinician.
