Small Intestinal Bacterial Overgrowth (SIBO) -

What is small intestinal bacterial overgrowth (SIBO)?

Small Intestinal Bacterial Overgrowth (SIBO) is a condition defined as excessive bacteria in the small intestine. It often occurs when bacteria that usually live in the large intestine appear in the small intestine and begin to multiply.

Common Related Conditions

Abdominal or pelvic adhesions

Small Bowel Obstruction

Diverticulitis Of The Small Intestine

Irritable Bowel Syndrome (IBS)

Crohn’s Disease

Causes of small intestinal bacterial overgrowth (SIBO)

Abdominal problems are some of the most common ailments. The most common causes include:

Slow intestinal motility (food moves too slowly through the gut)
Post-surgical adhesions or scarring that alter intestinal movement
Structural problems in the intestines (e.g., strictures, diverticula)
Chronic conditions such as Crohn’s disease, diabetes, or scleroderma
Long-term use of proton pump inhibitors (PPIs), which reduce stomach acid and allow bacteria to thrive

Why It Matters:

The excess bacteria ferment carbohydrates in food, producing gas and toxins that can irritate the gut lining and interfere with nutrient absorption. If untreated, SIBO can lead to vitamin deficiencies, especially of B12 and fat-soluble vitamins.

Symptoms of small intestinal bacterial overgrowth (SIBO)

Recurrent SIBO is SIBO that does not go away after multiple courses of an antibiotic/antimicrobial

Abdominal bloating and distention
Excessive gas or belching
Abdominal pain or cramping
Diarrhea or constipation (sometimes alternating)
Nausea
Fatigue and brain fog
Unintended weight loss or malnutrition in severe cases

Treatment for recurrent small intestinal bacterial overgrowth (SIBO)

Most SIBO is cured with a course of antibiotics or antimicrobials while following a specific diet, usually the low FODMAP diet. If recurrent SIBO is experienced, it is believed the bacteria burrow into an adhesion to evade the antibiotics/antimicrobial regimen. Internal scars called adhesions can form in the bowel due to various causes, including surgery, infection, inflammation, injury, and food poisoning. We believe the inflammation caused by the proliferation of SIBO bacteria themselves may cause bowel adhesions due to the inherent inflammatory processes in the gut.

In chronic cases of SIBO, you and your physician may find that the medications help for a few days, then symptoms recur. The reason is that treated bacteria cannot exit the bowel due to being blocked by adhesions. In these cases, Clear Passage® therapists work with your physician to create a protocol to start treatment medications three days before our 5-day therapy protocol. You will continue with your medications during Clear Passage® therapy for several days thereafter. This approach has helped reverse and cure even severe chronic cases of SIBO.

Condition Specific Disclaimer:

Clear Passage® Therapy is a non-surgical, manual physical therapy designed to address adhesions and restricted soft tissue mobility in the body. While published research and patient experiences suggest that this therapy may help reduce adhesions and improve function in certain conditions — including small bowel obstruction, SIBO, Crohn’s-related adhesions, infertility, and post-surgical pain — individual results will vary.

The information provided by Clear Passage® is for educational purposes only and is not intended as medical advice. Clear Passage® Therapy should not replace consultation with a qualified physician or licensed healthcare provider.

If you are experiencing severe or urgent symptoms such as persistent abdominal pain, vomiting, fever, or suspected bowel obstruction, seek immediate medical attention.

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Small Intestinal Bacterial Overgrowth (SIBO)