Verywell / Anastasia Tretiak
Bacterial overgrowth in the small intestine(SIBO) is usually treated with antibiotics, but some alternative healthcare practitioners also recommend trying natural remedies such as a low carbohydrate diet, herbal remedies, and probiotics.
This article will discuss bacterial overgrowth and natural ways to treat it. It also provides a brief overview of the causes of bacterial overgrowth as well as the symptoms you may experience.
What Is SIBO?
Small intestinal bacterial overgrowth (SIBO) is a condition that may affect a person for years without causing obvious symptoms.The condition is associated with chronic digestive problems. Some people are told they have irritable bowel syndrome (IBS) instead of bacterial overgrowth.
The small intestine normally contains relatively small numbers of bacteria. However, some alternative medicine healthcare providers believe that certain things may cause too much bacteria to grow inside you, such as:
Other possible causes include immune deficiency, a lack of pancreatic enzymes, stress, insufficient dietary fiber, and certain medications such as steroids, antibiotics, and birth control pills.
Symptoms
Having too much bacteria in the small intestine may make it difficult for your body to absorb nutrients. It may lead to problems digesting and absorbing fat and carbohydrates. This results in carbohydrate fermentation in the intestines and the following:
According to alternative medicine healthcare providers, sweets and starchy foods cause the worst symptoms.
If you are experiencing symptoms, talk with your healthcare provider. Some conditions can look like SIBO, so it is important not to self-diagnose. If you try to self-treat, delay, or avoid going to a healthcare provider, you can harm your health.
How to Treat SIBO Naturally
Due to a lack of research, not much is known about this condition. While some healthcare providers may prescribe antimicrobial drugs, not all of them recognize the condition.
Alternative healthcare practitioners recommend a range of lifestyle changes and remedies for treating SIBO.
During treatment, alternative medicine healthcare providers usually recommend going on a diet that limits the amount of sweet and starchy foods you eat.One such diet is theSpecific Carbohydrate Diet (SCD).
This diet restricts grains, starchy vegetables, and some legumes. It was created to treat digestive disorders such as bacterial overgrowth, Crohn’s disease, andulcerative colitis.
Take Herbal Supplements
Enteric-coated peppermint oil is one of the more common supplements for small intestine bacterial overgrowth. The course of treatment is usually one to six months.
A typical dose of enteric-coated peppermint oil is one to two capsules three times a day. It should be taken in between meals with a glass of water.
Side effects can include:
Other herbal antimicrobials used to treat bacterial overgrowth may include:
Can apple cider vinegar get rid of SIBO?Some people recommend apple cider vinegar as a natural remedy for SIBO. To date, however, there is little scientific evidence that this remedy is effective.
Can apple cider vinegar get rid of SIBO?
Some people recommend apple cider vinegar as a natural remedy for SIBO. To date, however, there is little scientific evidence that this remedy is effective.
Take Probiotics
Adding back good bacteria is considered important in the treatment of SIBO. The good bacteria present in probiotics are intended to replace the ones that cause SIBO. Some recommended probiotics include:
Take Digestive Enzymes
These supplements can support the body’s digestive enzymes until function is restored.They should be taken before meals.
Digestive enzymes may be prescribed or purchased over the counter. They might contain the following ingredients:
Eat Medium-Chain Triglycerides
Medium-chain triglycerides are fats that are absorbed directly without the need for digestive enzymes.These fats are often recommended for people with bacterial overgrowth or any type of malabsorption. Some examples include:
Take Nutritional Supplements
People with bacterial overgrowth are usually deficient in certain vitamins such as B12, magnesium, calcium, iron, zinc, copper, and vitamins A, D, E, and K.
What antibiotics treat SIBO?SIBO can be treated with Xifaxan (rifaximin), a broad-spectrum antibiotic that is often used for bacterial infections in the gastrointestinal tract.Medical treatment of SIBO will also address underlying medical conditions and nutritional deficiencies.
What antibiotics treat SIBO?
SIBO can be treated with Xifaxan (rifaximin), a broad-spectrum antibiotic that is often used for bacterial infections in the gastrointestinal tract.Medical treatment of SIBO will also address underlying medical conditions and nutritional deficiencies.
SIBO can be treated with Xifaxan (rifaximin), a broad-spectrum antibiotic that is often used for bacterial infections in the gastrointestinal tract.
Medical treatment of SIBO will also address underlying medical conditions and nutritional deficiencies.
Summary
Bacterial overgrowth is a condition that may be present for a long time before causing any symptoms. When they appear, symptoms may include gas, constipation, bloating, abdominal pain, and diarrhea.
Sticking to a low-carb diet as well as taking probiotics and herbal supplements may help with this problem. Some people experience relief when they follow a specific carbohydrate diet.
Since many people with bacterial overgrowth have vitamin deficiencies, a healthcare provider may recommend that you supplement your diet with vitamin B12, magnesium, calcium, iron, zinc, and copper, as well as vitamins A, D, E, and K.
18 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Adike A, Dibaise JK.Small intestinal bacterial overgrowth: Nutritional implications, diagnosis, and management.Gastroenterol Clin North Am. 2018;47(1):193-208. doi:10.1016/j.gtc.2017.09.008Ghoshal UC, Shukla R, Ghoshal U.Small intestinal bacterial overgrowth and irritable bowel syndrome: A bridge between functional organic dichotomy.Gut Liver. 2017;11(2):196–208. doi:10.5009/gnl16126Quigley EMM.The spectrum of small intestinal bacterial overgrowth (SIBO).Curr Gastroenterol Rep. 2019;21(1):3. doi:10.1007/s11894-019-0671-zNational Library of Medicine.Small bowel bacterial overgrowth.Augustyn M, Grys I, Kukla M.Small intestinal bacterial overgrowth and nonalcoholic fatty liver disease.Clin Exp Hepatol. 2019;5(1):1–10. doi:10.5114/ceh.2019.83151Johns Hopkins.FODMAP diet: What you need to know.Kakodkar S, Farooqui AJ, Mikolaitis SL, Mutlu EA.The specific carbohydrate diet for inflammatory bowel disease: a case series.J Acad Nutr Diet. 2015;115(8):1226-1232. doi:10.1016/j.jand.2015.04.016Zhang Y-J, Li S, Gan R-Y, Zhou T, Xu D-P, Li H-B.Impacts of gut bacteria on human health and diseases.IJMS. 2015;16(12):7493-7519. doi:10.3390/ijms16047493Souza C, Rocha R, Cotrim HP.Diet and intestinal bacterial overgrowth: Is there evidence?WJCC. 2022;10(15):4713-4716. doi:10.12998/wjcc.v10.i15.4713Chedid V, Dhalla S, Clarke JO, et al.Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth.Glob Adv Health Med. 2014;3(3):16–24. doi:10.7453/gahmj.2014.019Wright C, Dooley M, Leeson H.Eradication of small intestinal bacterial overgrowth in irritable bowel syndrome using herbal therapy: A case report.Int J Funct Nutr. 2021;2(5):13. doi:10.3892/ijfn.2021.23Leventogiannis K, Gkolfakis P, Spithakis G, et al.Effect of a preparation of four probiotics on symptoms of patients with irritable bowel syndrome: Association with intestinal bacterial overgrowth.Probiotics Antimicrob Proteins. 2019;11(2):627–634. doi:10.1007/s12602-018-9401-3Hubkova T.No more pain in the gut: Lifestyle medicine approach to irritable bowel syndrome.Am J Lifestyle Med. 2017;11(3):223–226. doi:10.1177/1559827617691027Reynolds KH.Small intestinal bacterial overgrowth: a case-based review.Journal of Patient-Centered Research and Reviews. 2015;2(4):165-173. doi:10.17294/2330-0698.1209Rial S, Karelis A, Bergeron K-F, Mounier C.Gut microbiota and metabolic health: the potential beneficial effects of a medium chain triglyceride diet in obese individuals.Nutrients. 2016;8(5):281. doi:10.3390/nu8050281Howard G, Wo J.Fat soluble vitamin, b12 and iron deficiency in patients with coliform small intestinal bacterial overgrowth(Sibo).IMPRS. 2018;1(1). doi:10.18060/22706Feng X, Li XQ.The prevalence of small intestinal bacterial overgrowth in diabetes mellitus: a systematic review and meta-analysis.Aging. 2022;14(2):975-988. doi:10.18632/aging.203854Quigley EMM, Murray JA, Pimentel M.AGA clinical practice update on small intestinal bacterial overgrowth: Expert review.Gastroenterology. 2020;159(4):1526-1532. doi:10.1053/j.gastro.2020.06.090
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Adike A, Dibaise JK.Small intestinal bacterial overgrowth: Nutritional implications, diagnosis, and management.Gastroenterol Clin North Am. 2018;47(1):193-208. doi:10.1016/j.gtc.2017.09.008Ghoshal UC, Shukla R, Ghoshal U.Small intestinal bacterial overgrowth and irritable bowel syndrome: A bridge between functional organic dichotomy.Gut Liver. 2017;11(2):196–208. doi:10.5009/gnl16126Quigley EMM.The spectrum of small intestinal bacterial overgrowth (SIBO).Curr Gastroenterol Rep. 2019;21(1):3. doi:10.1007/s11894-019-0671-zNational Library of Medicine.Small bowel bacterial overgrowth.Augustyn M, Grys I, Kukla M.Small intestinal bacterial overgrowth and nonalcoholic fatty liver disease.Clin Exp Hepatol. 2019;5(1):1–10. doi:10.5114/ceh.2019.83151Johns Hopkins.FODMAP diet: What you need to know.Kakodkar S, Farooqui AJ, Mikolaitis SL, Mutlu EA.The specific carbohydrate diet for inflammatory bowel disease: a case series.J Acad Nutr Diet. 2015;115(8):1226-1232. doi:10.1016/j.jand.2015.04.016Zhang Y-J, Li S, Gan R-Y, Zhou T, Xu D-P, Li H-B.Impacts of gut bacteria on human health and diseases.IJMS. 2015;16(12):7493-7519. doi:10.3390/ijms16047493Souza C, Rocha R, Cotrim HP.Diet and intestinal bacterial overgrowth: Is there evidence?WJCC. 2022;10(15):4713-4716. doi:10.12998/wjcc.v10.i15.4713Chedid V, Dhalla S, Clarke JO, et al.Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth.Glob Adv Health Med. 2014;3(3):16–24. doi:10.7453/gahmj.2014.019Wright C, Dooley M, Leeson H.Eradication of small intestinal bacterial overgrowth in irritable bowel syndrome using herbal therapy: A case report.Int J Funct Nutr. 2021;2(5):13. doi:10.3892/ijfn.2021.23Leventogiannis K, Gkolfakis P, Spithakis G, et al.Effect of a preparation of four probiotics on symptoms of patients with irritable bowel syndrome: Association with intestinal bacterial overgrowth.Probiotics Antimicrob Proteins. 2019;11(2):627–634. doi:10.1007/s12602-018-9401-3Hubkova T.No more pain in the gut: Lifestyle medicine approach to irritable bowel syndrome.Am J Lifestyle Med. 2017;11(3):223–226. doi:10.1177/1559827617691027Reynolds KH.Small intestinal bacterial overgrowth: a case-based review.Journal of Patient-Centered Research and Reviews. 2015;2(4):165-173. doi:10.17294/2330-0698.1209Rial S, Karelis A, Bergeron K-F, Mounier C.Gut microbiota and metabolic health: the potential beneficial effects of a medium chain triglyceride diet in obese individuals.Nutrients. 2016;8(5):281. doi:10.3390/nu8050281Howard G, Wo J.Fat soluble vitamin, b12 and iron deficiency in patients with coliform small intestinal bacterial overgrowth(Sibo).IMPRS. 2018;1(1). doi:10.18060/22706Feng X, Li XQ.The prevalence of small intestinal bacterial overgrowth in diabetes mellitus: a systematic review and meta-analysis.Aging. 2022;14(2):975-988. doi:10.18632/aging.203854Quigley EMM, Murray JA, Pimentel M.AGA clinical practice update on small intestinal bacterial overgrowth: Expert review.Gastroenterology. 2020;159(4):1526-1532. doi:10.1053/j.gastro.2020.06.090
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Adike A, Dibaise JK.Small intestinal bacterial overgrowth: Nutritional implications, diagnosis, and management.Gastroenterol Clin North Am. 2018;47(1):193-208. doi:10.1016/j.gtc.2017.09.008Ghoshal UC, Shukla R, Ghoshal U.Small intestinal bacterial overgrowth and irritable bowel syndrome: A bridge between functional organic dichotomy.Gut Liver. 2017;11(2):196–208. doi:10.5009/gnl16126Quigley EMM.The spectrum of small intestinal bacterial overgrowth (SIBO).Curr Gastroenterol Rep. 2019;21(1):3. doi:10.1007/s11894-019-0671-zNational Library of Medicine.Small bowel bacterial overgrowth.Augustyn M, Grys I, Kukla M.Small intestinal bacterial overgrowth and nonalcoholic fatty liver disease.Clin Exp Hepatol. 2019;5(1):1–10. doi:10.5114/ceh.2019.83151Johns Hopkins.FODMAP diet: What you need to know.Kakodkar S, Farooqui AJ, Mikolaitis SL, Mutlu EA.The specific carbohydrate diet for inflammatory bowel disease: a case series.J Acad Nutr Diet. 2015;115(8):1226-1232. doi:10.1016/j.jand.2015.04.016Zhang Y-J, Li S, Gan R-Y, Zhou T, Xu D-P, Li H-B.Impacts of gut bacteria on human health and diseases.IJMS. 2015;16(12):7493-7519. doi:10.3390/ijms16047493Souza C, Rocha R, Cotrim HP.Diet and intestinal bacterial overgrowth: Is there evidence?WJCC. 2022;10(15):4713-4716. doi:10.12998/wjcc.v10.i15.4713Chedid V, Dhalla S, Clarke JO, et al.Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth.Glob Adv Health Med. 2014;3(3):16–24. doi:10.7453/gahmj.2014.019Wright C, Dooley M, Leeson H.Eradication of small intestinal bacterial overgrowth in irritable bowel syndrome using herbal therapy: A case report.Int J Funct Nutr. 2021;2(5):13. doi:10.3892/ijfn.2021.23Leventogiannis K, Gkolfakis P, Spithakis G, et al.Effect of a preparation of four probiotics on symptoms of patients with irritable bowel syndrome: Association with intestinal bacterial overgrowth.Probiotics Antimicrob Proteins. 2019;11(2):627–634. doi:10.1007/s12602-018-9401-3Hubkova T.No more pain in the gut: Lifestyle medicine approach to irritable bowel syndrome.Am J Lifestyle Med. 2017;11(3):223–226. doi:10.1177/1559827617691027Reynolds KH.Small intestinal bacterial overgrowth: a case-based review.Journal of Patient-Centered Research and Reviews. 2015;2(4):165-173. doi:10.17294/2330-0698.1209Rial S, Karelis A, Bergeron K-F, Mounier C.Gut microbiota and metabolic health: the potential beneficial effects of a medium chain triglyceride diet in obese individuals.Nutrients. 2016;8(5):281. doi:10.3390/nu8050281Howard G, Wo J.Fat soluble vitamin, b12 and iron deficiency in patients with coliform small intestinal bacterial overgrowth(Sibo).IMPRS. 2018;1(1). doi:10.18060/22706Feng X, Li XQ.The prevalence of small intestinal bacterial overgrowth in diabetes mellitus: a systematic review and meta-analysis.Aging. 2022;14(2):975-988. doi:10.18632/aging.203854Quigley EMM, Murray JA, Pimentel M.AGA clinical practice update on small intestinal bacterial overgrowth: Expert review.Gastroenterology. 2020;159(4):1526-1532. doi:10.1053/j.gastro.2020.06.090
Adike A, Dibaise JK.Small intestinal bacterial overgrowth: Nutritional implications, diagnosis, and management.Gastroenterol Clin North Am. 2018;47(1):193-208. doi:10.1016/j.gtc.2017.09.008
Ghoshal UC, Shukla R, Ghoshal U.Small intestinal bacterial overgrowth and irritable bowel syndrome: A bridge between functional organic dichotomy.Gut Liver. 2017;11(2):196–208. doi:10.5009/gnl16126
Quigley EMM.The spectrum of small intestinal bacterial overgrowth (SIBO).Curr Gastroenterol Rep. 2019;21(1):3. doi:10.1007/s11894-019-0671-z
National Library of Medicine.Small bowel bacterial overgrowth.
Augustyn M, Grys I, Kukla M.Small intestinal bacterial overgrowth and nonalcoholic fatty liver disease.Clin Exp Hepatol. 2019;5(1):1–10. doi:10.5114/ceh.2019.83151
Johns Hopkins.FODMAP diet: What you need to know.
Kakodkar S, Farooqui AJ, Mikolaitis SL, Mutlu EA.The specific carbohydrate diet for inflammatory bowel disease: a case series.J Acad Nutr Diet. 2015;115(8):1226-1232. doi:10.1016/j.jand.2015.04.016
Zhang Y-J, Li S, Gan R-Y, Zhou T, Xu D-P, Li H-B.Impacts of gut bacteria on human health and diseases.IJMS. 2015;16(12):7493-7519. doi:10.3390/ijms16047493
Souza C, Rocha R, Cotrim HP.Diet and intestinal bacterial overgrowth: Is there evidence?WJCC. 2022;10(15):4713-4716. doi:10.12998/wjcc.v10.i15.4713
Chedid V, Dhalla S, Clarke JO, et al.Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth.Glob Adv Health Med. 2014;3(3):16–24. doi:10.7453/gahmj.2014.019
Wright C, Dooley M, Leeson H.Eradication of small intestinal bacterial overgrowth in irritable bowel syndrome using herbal therapy: A case report.Int J Funct Nutr. 2021;2(5):13. doi:10.3892/ijfn.2021.23
Leventogiannis K, Gkolfakis P, Spithakis G, et al.Effect of a preparation of four probiotics on symptoms of patients with irritable bowel syndrome: Association with intestinal bacterial overgrowth.Probiotics Antimicrob Proteins. 2019;11(2):627–634. doi:10.1007/s12602-018-9401-3
Hubkova T.No more pain in the gut: Lifestyle medicine approach to irritable bowel syndrome.Am J Lifestyle Med. 2017;11(3):223–226. doi:10.1177/1559827617691027
Reynolds KH.Small intestinal bacterial overgrowth: a case-based review.Journal of Patient-Centered Research and Reviews. 2015;2(4):165-173. doi:10.17294/2330-0698.1209
Rial S, Karelis A, Bergeron K-F, Mounier C.Gut microbiota and metabolic health: the potential beneficial effects of a medium chain triglyceride diet in obese individuals.Nutrients. 2016;8(5):281. doi:10.3390/nu8050281
Howard G, Wo J.Fat soluble vitamin, b12 and iron deficiency in patients with coliform small intestinal bacterial overgrowth(Sibo).IMPRS. 2018;1(1). doi:10.18060/22706
Feng X, Li XQ.The prevalence of small intestinal bacterial overgrowth in diabetes mellitus: a systematic review and meta-analysis.Aging. 2022;14(2):975-988. doi:10.18632/aging.203854
Quigley EMM, Murray JA, Pimentel M.AGA clinical practice update on small intestinal bacterial overgrowth: Expert review.Gastroenterology. 2020;159(4):1526-1532. doi:10.1053/j.gastro.2020.06.090
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
