Should you get a SIBO test?

There are two kinds of people in the world right now. Those who have never heard of SIBO, and those whose newest TikTok obsession revolves around it. 

In med school, I was in the former camp. Small Intestinal Bacterial Overgrowth (SIBO) was never talked about. When I eventually learned about this gut health issue while studying functional medicine later in my career, it rocked my world. 

SIBO is responsible for everything from bloating to brain fog to skin rashes. And despite the fact that it’s massively on the rise, it’s still wildly under-diagnosed by the medical community (including gastroenterologists). In fact, SIBO only got an official diagnosis code—the codes we doctors use in medical records to document a patient’s illnesses—in 2023. (A big development for medical nerds like me—we cheered!) 

What is SIBO?

SIBO (small intestinal bacterial overgrowth) is a bowel disorder caused by excess bacteria in the small intestine. (There are 3 types of it: methane-dominant, hydrogen-dominant and hydrogen sulfide-dominant!) 

It’s often the culprit behind common gut health symptoms including gas, bloating, diarrhea, abdominal pain, and nausea. It has similar symptoms to IBS (up to a third of people with IBS also have SIBO, according to one study) and some studies even suggest SIBO might be a cause of IBS. 

But SIBO is sneaky. In addition to the gastro issues, it can also cause a range of symptoms that appear to have nothing to do with the gut: 

  • Rosacea (up to 46% of cases may be caused by SIBO, according to one study
  • Brain fog
  • Joint pain  
  • Headaches
  • Fatigue
  • Mood swings

Despite the fact that SIBO can wreak havoc on several systems in the body, PCPs just aren’t trained to look for it.  

The TL;DR: SIBO is not something you want to get. So, even if you don’t have it, it’s important to understand how to prevent it. 

If you’re interested in gut health, have any unexplained symptoms, or want to know what I personally do to optimize my own gut health, read on! 

The research says

Estimates vary based on the source and the type of diagnostic test used, but it’s assumed SIBO affects anywhere from 2% to 22% of healthy adults. At Parsley, our data shows that the condition is an issue for up to 25% of patients with GI issues. 

Why is SIBO on the rise?

There’s likely a multitude of factors at play here. 

  • Non-invasive breath testing has made SIBO easier to diagnose and an increased awareness of gut health has contributed to more patients asking their doctors about testing.
  • Some studies suggest a link between stress, anxiety, and SIBO (though a lot more research is needed to prove causality). 
  • High-sugar diets and the overuse of antibiotics, both of which disrupt the balance of bacteria in your gut, may also contribute to the rise in cases in recent years. 

How we treat SIBO

The good news is that SIBO is very treatable—with the right protocol. 

At Parsley, we’ve developed the best, most tried and true SIBO treatment plan available. We brought our collective clinical expertise to the problem and partnered with the world’s top experts in SIBO (including all-star gastroenterologists like Dr. Allison Siebecker) to craft what I believe is the world’s most effective treatment protocol for SIBO in all its forms. 

Treating SIBO is one of those things that is wildly gratifying and so challenging at the same time. We see patients every day who were given two weeks of antibiotics by a well-meaning gastro, whose SIBO came right back; people who have been struggling with GI issues like IBS for years and never had anyone even test for it; and people who have non-GI symptoms that stymied doctors who didn’t know how to connect the dots across the body to uncover SIBO as the root cause. 

At Parsley, I get to work with some of the toughest cases of SIBO, where even our protocol requires a couple of rounds of treatment to truly nip it in the bud. But the results can be astounding.

I had one patient who had sharp abdominal pains referring to her back for years—we treated her SIBO and the pains resolved in two weeks. 

I had another patient with horrible acid reflux no matter what she ate, dependent on acid blockers, and suffering from persistent brain fog. We diagnosed her SIBO, treated it over a three month period with a combination of antibiotics and herbs, and her reflux and brain fog totally resolved. 

And I had another patient who couldn’t tolerate any form of raw veggies (and barely could handle cooked ones like broccoli and cabbage). When we treated his SIBO, his whole diet transformed—I’ve never seen anyone so happy about a Brussels sprout in my life!

What I’m doing for my own body

I don’t personally have SIBO—and I take care to keep it that way by prioritizing gut health with the following choices: 

  • I take a probiotic every night (This way, those good bugs can hit my gut in a rested state when I’m not actively eating.) 
  • I avoid refined carbs and foods high in sugar (I aim for less than 25g of sugar—including both natural and refined—per day.)
  • I exercise in the form of yoga, pilates, and strength training (At least 3x a week.) 
  • I take frequent mid-day walk breaks (Studies show regular movement has a significant impact on your gut microbiome and gut physiology.)
  • I avoid unnecessary antibiotics and keep alcohol consumption to a minimum (Both are microbiome disruptors!)
  • I meditate for 15 minutes every morning (For me, stress and slow digestion go hand in hand. When I de-stress through regular meditation, my gut motility is optimal.) 

What I recommend for you 

Should you get tested for SIBO? Whenever a patient complains of IBS-like symptoms, or says something along the lines of, “My stomach is flat in the morning but by nighttime, I feel and look like I’m six months pregnant,” I suspect SIBO.

If you’re regularly experiencing any of the following symptoms, I recommend coming to Parsley or talking to your PCP: 

  • Bloating
  • Nausea
  • Chronic constipation or diarrhea
  • Acid reflux
  • Gas
  • Unexplained weight loss 

If you’re experiencing the above, come talk to one of our experts at Parsley. We’ve developed a best-in-class SIBO testing and treatment plan to address your symptoms. Use my personal code RBMDCREW for $100 off your membership. 
AND! If you want to learn more about how critical gut health is to your overall well being, I have big news! I’m launching a live course on the subject. Healing Your Gut Through the Mind and Body begins on October 23. Space is limited so secure your spot now!