Dr. Rigobert Kefferputz

Patient Library / Digestion / SIBO

SIBO

Small intestinal bacterial overgrowth is one of the most common and consistently missed causes of bloating and IBS.

SIBO is found in 60–80% of patients diagnosed with IBS and is one of the most underdiagnosed conditions in gastroenterology. The bloating, distension, and altered bowel habits it produces are driven by bacterial fermentation happening in the wrong place — and when that's addressed properly, symptoms that patients have managed for years can resolve within weeks.

Two Types

Hydrogen-dominant SIBO typically causes diarrhea; methane-dominant IMO (intestinal methanogen overgrowth) typically causes constipation. Each requires a different treatment approach — testing determines which type you have.

Recurrence Is Preventable

SIBO recurs when the underlying cause — low stomach acid, impaired motility, structural factors — isn't addressed. Most treatment failures happen because only eradication, not root cause, is targeted.

Herbal Antimicrobials Work

Herbal antimicrobials — oregano oil, berberine, allicin — match rifaximin in efficacy in head-to-head studies, with the additional benefit of biofilm penetration and no antibiotic resistance risk.

What You Need to Know

Frequently Asked Questions

How I Treat This

These are the services I most commonly draw on when working with sibo.

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