Why Does SIBO Keep Coming Back?The Overlooked Reasons No One Talks About

If you’ve ever been diagnosed with SIBO (Small Intestinal Bacterial Overgrowth), you already know it can feel like a never-ending cycle: restrictive diets, rounds of antibiotics or herbs, and then… symptoms creep back in. Bloating, brain fog, fatigue, food reactivity, it’s like déjà vu.

Here’s the truth: SIBO often returns because the root causes are being overlooked. What no ones telling you is SIBO is a SYMPTOM of something else in the body being off, its not THE problem. If we don’t fix the underlying “why,” it’s like putting out a kitchen fire without turning off the gas.

Let’s dig into the most common, but often missed, reasons SIBO keeps coming back—and what we can do about it.

1. Poor Gut Motility (The Gut’s “Cleaning Crew” Isn’t Working)

Your small intestine is supposed to regularly “sweep” food and bacteria down into the colon. This is controlled by the Migrating Motor Complex (MMC). If the MMC isn’t firing—due to stress, hypothyroidism, nutrient deficiencies, or nerve dysfunction—bacteria linger where they don’t belong.

👉 How I help: We look at lifestyle, thyroid health, and even nervous system regulation to reset motility so your gut can finally move like it should.

2. Low Stomach Acid & Digestive Enzymes

Many women are put on acid blockers early in life for reflux or heartburn. But low stomach acid and sluggish enzyme output create the perfect storm: undigested food becomes fuel for bacteria in the small intestine.

👉 How I help: We run advanced labs to check digestive function and use nutrition, supplements, and stress management tools to restore proper breakdown of food.

3. Unaddressed Gut Infections or Candida

It’s not always just SIBO. Candida overgrowth, parasites, or H. pylori can lurk in the background, fueling recurrence. If you only treat SIBO without looking at the bigger picture, symptoms rebound fast.

👉 How I help: Comprehensive stool testing helps us uncover the “hidden players” so we’re not just treating surface symptoms.

4. Structural Issues Nobody Checked

Things like adhesions from old surgeries, endometriosis scarring, or anatomical “kinks” in the intestines physically block movement—making SIBO more likely to return, no matter how many protocols you try.

👉 How I help: I screen for these overlooked causes and, when needed, collaborate with specialists in manual therapy or advanced imaging.

5. Stress & Nervous System Dysregulation

High-functioning women often run on adrenaline and coffee. Chronic stress suppresses the digestive system and weakens immunity, leaving you more prone to SIBO relapse.

👉 How I help: Together, we build realistic routines—nervous system support, sleep optimization, and lifestyle changes that actually fit into your busy life.

6. Not Addressing the Type of SIBO (Hydrogen vs. Methane vs. Hydrogen Sulfide)

Not all SIBO is created equal. The type of gas produced by bacteria — hydrogen, methane, or hydrogen sulfide — impacts your symptoms and your treatment. For example, methane-dominant SIBO often shows up as constipation and may require a different protocol than hydrogen-dominant SIBO, which tends to cause diarrhea and bloating. If you don’t know your type, you may be chasing the wrong plan and another course of Rifaximin may not be the solution.

👉 How I help: I use advanced breath testing and stool testing to identify your SIBO subtype, so we can target it precisely instead of throwing spaghetti at the wall (pun intended).

7. Nutrition That’s Personalized

The “LOWFODMAP" Diet” is not the answer to SIBO, it can help symptom’s but sometimes you may need additional dietary support.

👉 How I help: I guide you through nutrition strategies and stages that heal your gut, not just restrict your plate.

Breaking the Cycle for Good

If you’ve been stuck in the cycle of SIBO coming back again and again, know this: it’s not because you’re failing—it’s because the deeper causes haven’t been addressed.

With functional medicine, we don’t just chase symptoms. We uncover the why behind your SIBO and create a personalized plan that restores your digestion, energy, and confidence in food again.

✨ Ready to finally stop the cycle? Book a free consult to learn how we can get to the root cause of your gut symptoms.

Serving Strongsville OH, St. Pete & Tampa FL, Austin TX, and nationwide via telehealth.