Many in the SIBO community believe that SIBO is a relapse condition. You can clear it out temporarily, but you can never get rid of it entirely. With this belief, trying to heal from SIBO seems like a hopeless cause and cyclical antibiotic/antimicrobial treatment seems inevitable.

This mentality is so flawed!

It leads people to give up and just accept that they will have SIBO forever instead of digging deeper and looking for the potential root causes that could be preventing them from truly kicking SIBO.

This myth stems from the belief that SIBO is primarily a bacterial problem, but the bacteria are just the symptom of a larger problem. If your sole solution to treat your SIBO is to clear the bacteria with herbal/pharmaceutical antibiotics without addressing the root, then you will relapse.

But, if you are treating your SIBO with a multifaceted approach that addresses underlying problems while clearing the overgrowth, then you should be able to beat your SIBO.

SIBO stems from 4 big problems: MMC deficiency, digestive impairment, hormonal imbalances and adhesions from past GI surgeries. These breakdowns need to be addressed to heal.

Finding and addressing root causes is not always easy. It requires a greater emotional, physical and time commitment than taking cyclical antibiotics to keep your symptoms at bay. But, your investments in root cause approaches will yield a much higher long-term reward than if you become reliant on antibiotics, which typically have a diminishing rate of return for SIBO patients.

Excessive treatment with herbal or pharmaceutical antibiotics can also exacerbate SIBO recovery by killing off too much bacteria in the large intestines. The small intestine relies heavily on a healthy population of large intestine bacteria to function properly.

By bombing both the large and small intestine continuously with antibiotics, you could be making it much harder to fully recover the function of your small bowel. You end up solving one problem and creating another.

Working with a SIBO knowledgeable practitioner may be a necessary step to help dig through the complexities of your individual SIBO case. Every SIBO patient has different root causes, genetics, health statuses and nutrition needs. These individual differences need to be weighed when trying to figure out what treatment paths are best for you.

If your doctor or practitioner is not root focused and/or tells you something along the lines of “SIBO is just a relapse condition”, you should find a new practitioner. Conventional practitioners are often guilty of this mainly because they have been trained to treat symptoms and not root causes. They don’t have the time or knowledge to help address the root causes of SIBO.

With the tools available to the conventional medicine folks (antibiotics), SIBO really is a relapse disease. But from a functional medicine and root cause perspective, SIBO can be cleared for good with the right protocol for each individual case.

While there are rare cases of SIBO that may never fully clear, these cases are the exception and NOT the rule. SIBO is not inherently a relapse condition. But, if you find that you are constantly relapsing, you should view that as a sign that you need to diversify your treatment strategy to address root causes.

Bottom Line:

If you treat the overgrowth and root cause, you can beat SIBO for good!

    • Intermittent fasting really helped me too! I didn’t do super well on a low carb diet, but I am glad that worked for you! Different diets work for different people. Thanks for sharing!

  • Hi Amy, I’m suspecting I have SIBO and have felt very stressed out because of my issues. Your blog has been super helpful and has made me feel like I have hope, thank you so much for your great posts. I wanted to ask you what your SIBO symptoms were? I suffer from GERD and extreme bloating as well as several food sensitivities. I tried probiotics but they seem to give me even more bloating and extreme cramps. Help!

    • Hi Sini! Thanks so much for reading! I had lots of bloating, GI pain, fatigue, brain fog! It was miserable. I hate to hear that you are struggling to get rid of your symptoms. Have you been tested or treated for SIBO?

      • Hi, I’m seeing a functional nutritionist soon and I’ll ask her about testing. I hope the tests would provide some sort of answer and I could start treatment asap if I truly have sibo. I’m looking forward to your future posts!

  • Hi I have recently been diagnosed with sibo by a wellness practitioner. I am currently going the herbal and diet route but seem to be struggling with the no carb diet (taking antibiotics is a risky thing for me because I have Steven Johnson syndrome). Extreme amounts of appetite loss, nausea, and weakness but if I eat a carb that goes away. I have been this way for about 3 and have only recently found out what it was after being told my symptoms were from “stress” repeatedly. I have an extreme b12 deficiency causing anemia. I’m almost certain that this came from a specific span of 2 years were I had at least 5 rounds of ciproflaxen (the only antibiotic family I can take) for wisdom tooth infections and respiratory infections. I recently started getting b12 injections. I read your post about a fecal transplant and I wanted to know what your results were? Sorry for the life story.

    • Hi Whitney!

      It sounds like you are battling hard! I would reconsider if the low carb diet is right for you, because it can actually have negative effects on hormones, intestinal balance downstream. And it seems like you are not tolerating it well.

      As far as the FMT, I got 60% better with my FMT and had address my hormones to resolve the remainder of my symptoms. I have written some articles you can check out on this site 🙂


  • Hi, I’m suffering from SIBO. My symptoms are brain fog, weight loss, indigestion, stomach pains fatigue and here and there acid reflux, & anxiety. It’s horrible.. so I’m trying the herbal route first.. how do i put some weight on? 😫 i hate to look in the mirror. I do believe that I’m under eating because I’m so scared of the reaction i may get.

    • Hi Synita. So sorry to hear you are struggling. Weight gain can be complicated with SIBO so I would highly recommend working with someone who can help. Treating the gut issues definitely will help. Also, making sure you are getting enough calories and developing strategies on how to increase calories if that is a struggle. I hope you find relief soon!