Your bloating isn’t “gut nerves”. It’s bacteria in the wrong place.
Flat stomach in the morning, five months pregnant by the afternoon. You get tested, you hear “irritable bowel, try not to stress” and you go home with nothing. Yet a very large slice of what doctors lump together as “irritable bowel syndrome” is actually small intestinal bacterial overgrowth, which has a specific mechanism and specific levers.
Your stomach swells within an hour of a meal, regardless of how much you eat. Wind turns up a moment after eating, not in the evening.
One day you’re plagued by constipation, the next by diarrhoea, plus reflux, a throat tickle, brain fog and tiredness despite a good diet. The probiotics and fibre meant to help paradoxically make things worse.
It isn’t in your head. It’s in your small intestine, but nobody looked there.
“It’s irritable bowel, it’s nerves, try not to stress.”
A label that sounds like a sentence with no cause. Yet “irritable bowel” is often SIBO under another name, and the difference is fundamental, because bacterial overgrowth has a mechanism you can genuinely influence. The second myth, more dangerous still: “you have reflux, so lower your acid.” In many people it’s exactly the reverse, because it’s too little acid that weakens the barrier and lets the bacteria in.
There’s another way. It starts with understanding why the bacteria moved in at all, and with an order of phases almost nobody has set out for you.
This isn’t a guide about miracles or “healing the gut in two weeks”. It’s a practical guide: how to understand the mechanism and give your body the conditions in which the overgrowth eases and doesn’t come back. No magic, no scaremongering, no promises nobody can keep. SIBO can be stubborn and needs work on the cause, not another pill for the symptom.
Inside, I break down what the mainstream doesn’t tell you:
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The small intestine is meant to be nearly sterile. Four mechanisms keep it clean: stomach acid, the housekeeper wave (the migrating motor complex), the ileocaecal valve and secretory immunity. When one of them fails, bacteria colonise the small intestine and ferment your food. Steven Sandberg-Lewis described the four natural barriers of the small intestine.
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The housekeeper only runs on empty. What matters most is often not the presence of bacteria, but that your housekeeper wave has stopped cleaning, and it only gets going when you eat nothing. The advice to “eat little and often” can be a straight road to SIBO.
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The type of gas changes the symptoms. Hydrogen pulls towards diarrhoea, methane slows the gut and gives constipation and a balloon belly, hydrogen sulphide gives the smell of rotten eggs.
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SIBO and reflux go hand in hand. It’s the excess gas from fermentation, not the acid itself, that pushes stomach contents upwards, so acid-lowering medicines can quieten the symptom and deepen the cause. Norm Robillard described the mechanism of gas driving reflux.
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A past poisoning leaves its mark. Past food poisoning can permanently damage gut motility and open the door to relapses. Mark Pimentel described this post-infectious damage to motility.
What's inside
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An “is this you?” test — seven signals to tick off, with a simple rule for when to think about a breath test rather than settle for the “nerves” label.
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A three-phase plan in order — eradication, repair, prokinetics. The most common mistake is starting with probiotics and fibre while the overgrowth is active, that is, pouring petrol on the fire.
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A herb table with ranges — allicin, berberine, oregano oil, biofilm support, plus learning to read labels: form and purity, not the brand name.
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A tests and markers table — what to order (breath test, stool microbiome panel, betaine trial, anti-tTG, calprotectin, ferritin, B12) and how to read the results alongside your symptoms, not instead of them.
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Scenarios for “what to do when” — the methane variant, the hydrogen variant, SIBO with reflux, with an underactive thyroid, with histamine intolerance, in pregnancy.
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Red flags — when to put the guide down and see a doctor.
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A printable tests checklist — you take to the lab, an end to being fobbed off with “all normal”.
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A printable phase plan — one phase after another, no skipping.
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A shopping list to start — what goes in the basket for phase one, what to cut out.
This is for you if
- ✓your stomach swells an hour after eating despite “normal” results
- ✓you’re told it’s “nerves” or “irritable bowel”, but you feel it’s something more
- ✓you alternate between constipation and diarrhoea
- ✓you have reflux, an underactive thyroid or react badly to probiotics and want to understand what to actually do, and in what order
This isn't for you if
- ✕you’re looking for one quick pill without changing your habits
- ✕you want a ready-made diet without understanding why the order of phases matters at all
Working on the gut is part of working on your health, not an experiment to run on your own. The guide gives you clear red flags (blood in the stool, black stools, unintended weight loss, anaemia and other signals of when to call for help) and hard warnings: berberine is contraindicated in pregnancy and adds to medication, you don’t start stomach-acid support on your own with active reflux or on stomach medicines, and the antibacterial herbs are a course, not a daily supplement. SIBO is a diagnosis made after ruling out more dangerous causes. Naturopathy does not compete with emergency medicine, and it never should.
Your body isn’t broken. It’s responding to the conditions you keep it in.
Bacteria don’t grow in the small intestine out of malice, but because the mechanisms meant to sweep them out have weakened. Fix the cause and the overgrowth eases. It’s not a life sentence or another drug forever, just a state with its own causes and its own solutions.
SIBO — have it right now
The PDF lands in your inbox the moment you pay. Read it on your phone, tablet or computer. Your copy is marked with your details (a named licence), for your own use.
SIBO and reflux are two sides of the same gut story. With the Gut & digestion bundle you add Acid reflux for less and work on the cause from both sides at once, while All-Access gives you every guide. See the bundles.
“The first thing I read that made me understand why the order matters and why probiotics were only making me worse. Plain, no scaremongering, with a ready list for the lab.”
A guide hands you the map. If you would rather go through your case with me, with a plan built around your results and your medication, come to a consultation.
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