SIBO can be treated with a combination of antibiotics and diet changes.
First, you need to get the bacteria under control. This is usually done with antibiotics, such as ciprofloxacin (Cipro), metronidazole (Flagyl) or rifaximin (Xifaxan). You may also need intravenous (IV) therapy for nutrition and fluids if your condition has led to malnutrition or dehydration.
Antibiotics may decrease the number of bacteria in the small intestine, but they won’t address the underlying issue that caused the problem in the first place. If your doctor determines that your SIBO is due to an underlying condition, you’ll also need to have treatment for that condition. Diet changes may also help.
Diet and SIBO
There’s no evidence to prove that a certain diet causes SIBO, but many people with SIBO have found relief after following a special diet. Work with your doctor before making any changes to your diet.
You may only need to make small adjustments:
Eat a balanced, nutritious diet.
Eat smaller meals more frequently to avoid having too much food sitting in your stomach.
Avoid gluten products if you have celiac disease.
Your doctor may also recommend trying an elemental diet. This diet replaces food and drinks with certain liquid formulas for a specified amount of time. In one small-scale study, 80 percent of participants with SIBO had a normal breath test result after following an elemental diet for 15 days. The researchers concluded that an elemental diet may be highly effective at managing this condition. More research is needed, however. Work with your doctor before starting this diet, and follow their instructions.
Can probiotics be used to treat SIBO?
Taking probiotics could help return the bacteria in your gut to normal. A 2010 study found that probiotic treatment could be more effective at treating SIBO than antibiotics. However, a review from 2016 found that evidence for the effects of probiotics in treating SIBO was inconclusive. Your best option is to follow your doctor’s advice.