SIBO: Preventing Relapse, and Strategies for Long-Term Success
Completing SIBO treatment is a significant milestone on the path to gastrointestinal and overall health. Well done! However, preventing SIBO relapse (and maintaining progress in between rounds of treatment in some cases) requires proactive measures and a comprehensive approach. In this guide, I'll explore actionable tips to help you stay on track during and after SIBO treatment and reduce the risk of recurrence or backsliding. If you don’t know what SIBO is, please read about SIBO 101 here first.
Use Prokinetics
Prokinetics are medications or supplements that promote gastrointestinal motility in the small intestine, helping to prevent bacterial overgrowth. Low-dose naltrexone (LDN), prucalopride, Iberogast and ginger are great examples of prokinetics that can support healthy gut function. Consult with a functional health practitioner to determine the most suitable prokinetic for your needs.
Assess and Support Motility
As you’ve just seen, optimal gastrointestinal motility is essential for preventing SIBO recurrence. This includes motility in the large intestine as well, also known as the colon. Consider undergoing a motility test, such as the sesame seed transit test, to evaluate the transit time of food through your digestive tract. Slow transit time may indicate impaired motility, which can predispose you to SIBO. Work with a healthcare provider to address any underlying motility issues and implement targeted interventions.
Follow a Strict Low-FODMAP Diet
After completing SIBO treatment, adhere to a strict low-FODMAP diet for 4-6 weeks to reduce the risk of bacterial overgrowth recurrence. FODMAPs are fermentable carbohydrates that can feed gut bacteria and contribute to SIBO symptoms. By temporarily eliminating high-FODMAP foods, you give your gut a chance to heal and restore balance. Gradually reintroduce FODMAP-containing foods under the guidance of a qualified nutritionist to identify triggers and maintain symptom control.
Please do not STAY on a low-fodmap diet for too long. This can be detrimental in the long run, as you essentially dig yourself into a deeper hole. Same goes for the carnivore diet for SIBO, which shouldn’t be used as a standalone strategy.
Reintroduce Fermented Foods Gradually
Fermented foods contain beneficial probiotics that support gut health, but they can also be high in fermentable carbohydrates, potentially exacerbating SIBO symptoms. After completing SIBO treatment and following a low-FODMAP diet, reintroduce fermented foods gradually to assess tolerance. Start with small portions of low-FODMAP fermented foods, such as homemade sauerkraut or homemade yogurt (dairy or coconut), and monitor your symptoms closely. Slowly increase serving sizes as tolerated, focusing on diversity rather than quantity. You can have a look at the SIBO Yogurt recipe which is a great option to start with.
Consider Specific Probiotics
Certain probiotic strains, such as Saccharomyces boulardii (S. boulardii), have been shown to be beneficial in preventing gastrointestinal disorders relapse. S. boulardii is a non-pathogenic yeast that can help restore gut microbiota balance and support immune function. You can discuss the use of probiotics with your health practitioners to determine the most appropriate strains and dosage for your individual needs.
Preventing SIBO relapse requires a multifaceted approach that addresses underlying motility issues, supports gut health, and promotes microbial balance. By incorporating prokinetics, temporary following a strict low-FODMAP diet, reintroducing fermented foods gradually, and considering probiotics, you can minimize the risk of recurrence and maintain long-term gastrointestinal wellness. Partner with a qualified health provider who specializes in digestive health to create a personalized plan that meets your unique needs and maximizes your chances of success!