SIBO - when the intestinal flora ends up in the wrong place

SIBO stands for "small intestinal bacterial overgrowth" and describes an imbalance in the distribution of intestinal bacteria.

This imbalance means you have abnormally large amounts of bacteria where they shouldn't be, in the small intestine. This is a fairly common condition and can cause several problems both in the stomach and in the rest of the body. 

Since the small intestine does not have the same protective mucus layer as the large intestine, the bacteria there can damage the small intestinal wall and lead to a local inflammation, but also in the rest of the body, for example in the skin, as is seen in the case of rosacea and inflammation in muscles and joints.

SIBO can occur for many different reasons, but stress is a common cause, often combined with gastric acid reducing treatment. We will describe SIBO in more detail below and htat there is help to get, in order to balance your intestinal flora again.

The small intestine, which is the longest segment of the intestine, is responsible for absorbing the nutrients from the food we eat. Cells in the intestinal wall also regulate many endocrine (hormonal) signaling pathways, such as those involved in the experience of hunger.

What happens in the body in SIBO?

Your gut flora consists of around 100 trillion gut bacteria and the majority of these should be located in the large intestine. One of the tasks of the large intestine is to break down those dietary fibers that our own cells cannot digest. In this process, fibers are converted into health-promoting substances such as short chain fatty acids and B and K vitamins. 

The task of the small intestine is to absorb the nutrients you ingest such as amino acids, fatty acids, carbohydrates, vitamins and minerals.

The large intestine is adapted to handle the huge amounts of bacteria that are needed in order to digest the dietary fibers that you ingest. When the dietary fibers are digested, residual products called bacterial toxins are formed. The colon has two thick mucus layers to keep these bacteria and toxins away from the intestinal wall.

In the small intestine, there should normally be very few gut bacteria, because this part of the gut does not have the strong protective mucus layer that the large intestine has. 

If you have large amounts of bacteria in the small intestine, the digestion of dietary fiber will take place there instead, and since the small intestine only has a thin layer of mucus, bacterial toxins can get through the intestinal wall, where theses can cause damage to the cells of the small intestine, irritate the immune system found in the wall of the small intestine and leak into the bloodstream. This can result in inflammation both in the gut and in the rest of the body and contribute to the development of chronic diseases and inflammatory conditions in the skin, muscles and joints.

In addition to these negative effects, the unwelcome bacteria in the small intestine can "steal" amino acids, vitamins and minerals that should otherwise benefit our body.

Scientific studies have shown an incidence of SIBO in healthy individuals of between 1-40%. No scientific studies have evaluated whether these healthy individuals developed chronic diseases later on.

What problems can SIBO cause?

When the dietary fibers are broken down in the small intestine, gas is also formed, which can cause a sore, bloated and tense stomach. The pressure in the small intestine can result in an imbalance in the gastrointestinal system with acid reflux and alternating constipation and diarrhea as a result. In addition to swelling and pain, SIBO can also cause heartburn and nausea. The rest of the body can also be affected in SIBO in the form of a systemic low-grade inflammation.

SIBO can lead to a condition called leaky gut. In leaky gut, toxins from bacteria travel through the small intestine and into the bloodstream. This can cause an immune reaction in the body and is thought to contribute to a range of health problems such as obesity, type 2 diabetes, IBS, rosacea (inflammation of the skin on the face), fatty liver, chronic fatigue syndrome, rheumatic diseases and possibly also neurological diseases such as Alzheimer's and Parkinson's disease. In a recently published scientific study in Finland, it was observed that a gut bacterium can help form a protein that is found along the entire small intestine of these patients and that can accumulate in the brain and possibly causes Parkinson's disease. SIBO can make you hypersensitive to certain foods and also cause psychological problems such as low mood.

Local symptom

  • Stomach pain or cramping in the intestine
  • Bloated stomach
  • Gas and belching
  • Diarrhea
  • Constipation
  • Nausea
  • Heartburn / acid reflux

General symptoms

  • Fatigue
  • Joint pain
  • Muscle pain like in fibromyalgia
  • Food intolerance (milk and egg protein, fish, wheat, etc)
  • Skin inflammation, e.g. rosacea
  • Depression/low mood

What causes SIBO?

Stress is a common factor that can contribute to SIBO and the valve between the colon and the small intestine plays an important role here. The valve is kept closed with the help of the vagus nerve. Since the vagus nerve is inhibited during stress, this valve can start to leak and bacteria migrate from the large intestine up into the small intestine. Once this has happened, the bacteria can quickly multiply in the small intestine where there is a rich supply of nutrients. Since the small intestine does not have a strong protective mucus layer, the bacteria can easily migrate into the intestinal wall and create an inflammation. This can make the gut even more permeable to bacteria and bacterial toxins, in other words it becomes a vicious circle.

Factors that can contribute to SIBO

  • Medicines that reduce stomach acid, such as for gastritis
  • Stress is a common cause of slower bowel movements.
  • Pockets in the small intestine
  • Food poisoning from bacteria such as Campylobacter, Salmonella and Shigella
  • Alcohol

Help in SIBO

Treatment of SIBO usually involves combining antimicrobial preparations, dietary changes, stress management while trying to improve bowel motility. There is also a type of intestinal antibiotic that can be effective in SIBO(rifaximin), prescribed by a medical doctor. In a study, it has been seen that even botanical supplements with antibacterial properties can have equivalent effects to rifaximin.

You can try changing your diet yourself and reducing the amount of fermentable carbohydrates called FODMAP. Low FODMAPs can relieve problems with a bloated stomach because of the reduction of the intake of dietary fiber, which otherwise cause the bacteria in the small intestine to produce gas and toxins. Probiotics, such as Lactobacillus and Bifidobacterium, can help reduce inflammation in the intestinal wall. Some studies suggest that digestive enzymes such as protease, amylase and lipase can help. Try to reduce stress in your daily life as much as you can. Try meditation, yoga and deep breathing and mindfulness and spend more time in nature if possible. Kognitiv beteendeterapi (KBT) can also be decisive in overcoming the underlying problem. Moderate exercise such as walking can also be very helpful.

At Gutfeeling Labs, we have developed a plant-based bacteria-balancing dietary supplement that contains jatoba and magnolia tree bark, rose root and psyllium seeds. Bark from the magnolia tree can contribute to normal bowel function, regular bowel emptying and has bacteria-balancing properties. Psyllium seeds can contribute to normal bowel function, bowel passage and digestion. Studies have shown that jatoba can reduce fungi and bacteria and rose root, which is an adaptogen, can reduce the negative effect stress has on the body.

GutClear® - our SIBO supplement

For those who want to know more about SIBO

Here are more in-depth facts about SIBO for those of you who want to read more, or for those of you who work therapeutically and meet people with problems that can be linked to SIBO in your profession.

Learn more about SIBO

Products related to SIBO


For those with a sore and bloated stomach, we recommend that you take GutClear™ before doing a gut microbiome test. A common cause of these problems is that you have bacteria in the wrong place, in the small intestine, also called SIBO and stands for "small intestinal bacterial overgrowth". An increased intake of fiber-rich food can even worsen these problems. GutClear™ can help you reduce bacteria in the small intestine and give your beneficial gut bacteria in the colon a fresh start.

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