Picture this: your bloat is gone, your SIBO hasn’t come back and you’re finally living your life again (without the fear of symptoms!) 

Does the constant bloating, abdominal pain, and unpredictable bowel movements sound familiar? Have you been told to simply take antibiotics to treat your SIBO, only to find temporary relief and a recurring cycle of symptoms? This is a common complaint women have before starting the gutTogether® Program. 

If you’ve been diagnosed with Small Intestinal Bacterial Overgrowth (SIBO), you can’t afford to miss this episode of the Love Your Gut Podcast. Once you finally understand what is causing your SIBO you can get rid of the frustrating SIBO cycle and prevent your symptoms from coming back. 

In this episode, you will be able to:

  • Explore the nuances of Small Intestinal Bacterial Overgrowth (SIBO) and how it fits into your health puzzle.
  • Identify the root causes of SIBO that often remain unaddressed in plain sight.
  • Uncover digestive factors that can either push you into the SIBO pit or pull you out.
  • Find out how your gut’s motility and its microbial population can be a breeding ground for SIBO.
  • Appreciate the necessity of a comprehensive SIBO treatment strategy and the profound effect it can have on your health journey.


00:02 – An Introduction to Small Intestinal Bacterial Overgrowth (SIBO)
03:19 – Recurrent SIBO and Incomplete Treatment
07:13 – Understanding the Root Causes of SIBO
09:27 – Reasons for SIBO Treatments Fail
16:05 – How Digestion and Absorption Impacts SIBO
16:24 – Motility and Our Protective Gut Bacteria
17:10 – Poor Gut Motility
19:47 – Large Intestine and Gut Bacteria (LIBO)
21:22 – Disruptions in Gut Barrier Function (Leaky Gut)

If this episode has been helpful, share this episode on Instagram and tag me, and tell me your biggest takeaway! 

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  • “Just because the SIBO is gone doesn’t mean that you’ve addressed the cause of the SIBO.”
  • “The reason that you continue having SIBO symptoms is actually because of incomplete treatment.”
  • Recurrent SIBO is a super complex puzzle that really demands our attention.”

Connect with Dr. Heather

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Dr. Heather Finley

Dr. Heather Finley  00:02

Just because the SIBO is gone doesn’t mean that you’ve addressed the root causes of the SIBO. Hey, welcome to the love your gut podcast. I’m your host, Dr. Heather Finley, I know what you’re thinking, how am I supposed to love my gut when all it does is hold me back. I thought the same thing before I found my own relief from my own gut health issues. I dedicated my life to getting to the bottom of my own gut issues, so I could help women just like you transform theirs. Now I’m here to guide you through your own gut health journey. We do this through identifying your root causes and making sustainable and transformational changes. As a result, you can unleash your true potential. My goal is to empower you with the information and tools you need to love your guts. So it loves you back right here on this podcast.

Dr. Heather Finley  00:54

Welcome back to another episode of the love your gut podcast, I’m so glad that you’re here. And today we are going to be diving into one of the most popular questions that I get asked over on Instagram and by prospective and current clients, which is I have SIBO. Now what so I want to use this time on the podcast to really explore a framework that we have developed at get together to actually help you find relief from your chronic SIBO. So we’re gonna dive into all the steps of identifying the actual causes, how to go about approaching them, and then what to do to ensure that you have long term relief. So I just want you to take a second to imagine this, you’re on the challenging journey of a SIBO diagnosis. And you’ve done all the treatments, maybe you found temporary relief, maybe your GI doctor said here take Rifaximin or Flagyl. And just when you thought you were clear, these symptoms resurface, leaving you feel feeling really frustrated, defeated, and honestly just discouraged wondering what in the world is going on. So you feel super great when you’re taking the antibiotics. Or maybe you’re like a lot of our clients and you’ve done both antibiotics and herbal treatments. But the symptoms come right back either immediately or weeks later, after finishing them. I want you to know that you’re not alone. Recurrent SIBO is a super complex puzzle that really demands our attention. And to be honest, we’re failing SIBO treatment in the conventional medical world. And I think some of this is the fact that for years, doctors didn’t even really recognize SIBO as an actual thing. I think that’s changing now, depending on you know who your GI doctor is, but for a lot of years, gi doctors wouldn’t even entertain the idea of SIBO, they would say that’s not a thing. I’m not addressing it, etc. So today, let’s dig into what SIBO is, how to address it, and how to uncover these hidden reasons that are leading you to these symptom relapses that you’re actually trying to prevent. So what if I told you that the reason that you continue having SIBO symptoms is actually because of incomplete treatment? It’s not necessarily that I’m anti antibiotics or herbals? Not at all, actually, we have clients that do both of those things and are very successful. And the reason that they’re successful is because those are a part of a larger treatment plan, versus just taking antibiotics or just taking the herbals. It’s pretty rare that someone goes to the GI doctor takes the antibiotics or the herbals and the symptoms are just gone forever. And the other part of the problem is that a lot of times doctors aren’t retesting, so you don’t actually know if the SIBO is gone. And to be honest, maybe that matters. Maybe that doesn’t. Because if your symptoms are better, I guess one could say, oh, well, your symptoms are better than it should be gone. But the problem is, then you never really know in your head. Is it gone? So if you’re if you’re a data as a data person, it might be really helpful to just see on paper, yes, it’s gone. No, it’s not. But here’s the thing. Just because the SIBO is gone, it doesn’t mean that you’ve addressed the cause of the SIBO. And that’s what this episode is really going to help you understand. So SIBO is a symptom of a greater problem. And really, by the way, this entire episode, whether you are a practitioner or a listener, this is going to give away everything that We do in the gut Together program. This is the framework that I’ve developed that I both use in the gut Together program and that I use to teach other practitioners in the gut Practitioner program. So first of all, let’s talk about what SIBO actually is, um, you may be listening, thinking, I don’t even know what SIBO is, I’m going to turn this off. Before you turn it off, let me give you a short little lesson on what SIBO is. So the way that I like to describe it, and I think makes a lot of sense to people is, imagine your stomach or your your gut, well, we’re talking about your gut, your intestines, all the pieces of your gut. Maybe your gut is like a bar. So the bar opens up at night. There’s lots of good food, there’s lots of drinks. And inside the bar, we’re standing right at the door, there is a bouncer and the bouncers job is to make sure that only the right number of guests gets in so it doesn’t get overcrowded. And that dangerous, people don’t get in or wild people, maybe they’re there to filter out, Hey, you can’t come into this bar, because you aren’t following the dress code. Or maybe you’ve already had too much to drink, or whatever it is. So all the guests that are inside of the bar are behaving, they’re having a good time, but they’re behaving. So these good bacteria in our gut are like the people that are at the bar, and they help with digestion. And they keep things running smoothly. We have pounds of bacteria in our gut, which is actually pretty cool to think about. So let’s say that this bouncer gets a little sleepy, maybe he takes a break, maybe he’s worked too many nights in a row, maybe he just doesn’t care anymore. And now too many people start to get into this bar, they start to slip past the door. And now the bar starts to get wild. Trouble starts to happen. When there are too many people inside of a bar doing things that they shouldn’t be doing. We have problems. So this is what happens when bacteria gets into your small intestines. So you have your large intestine, and you have your small intestine. And when bacteria or unwanted people at the bar, get into the small intestine, they start munching on the food that we eat. And they make too much gas and can cause all sorts of problems. Which is why a lot of people with SIBO have unexplained gas, diarrhea, constipation, food intolerances, crazy, crazy symptoms. So now this party has just gotten completely out of control. Everyone’s uncomfortable, everyone is not having a good time. And the reason that this happens is because the bouncer or the natural defenses of our gut, didn’t do a good job of keeping the extra bacteria out. Maybe they got tired, they took a break. So the bacteria or people got in when they shouldn’t have. So hopefully, you’re still following me. And that’s a, an easy way for you to understand this. But here’s the key takeaway. You also need to try to figure out why the bouncer didn’t do a good job of keeping people out. So you can stop it from happening again. Because you want to make sure that your gut stays healthy and happy. You aren’t going to keep hiring the same sleepy bouncer every Friday night and hoping for a better outcome. You’re going to look at the cameras, you’re going to have a talk with him, you’re going to whatever to figure out how do we prevent this from getting completely chaotic again, right? Same thing with SIBO SIBO is, this is what’s happening when everything’s already gotten out of control. We want to take precautionary measures to look at what what caused everything to actually get out of control. Now that you actually have developed to SIBO, or are at risk for developing SIBO, or small intestinal bacterial overgrowth. So if that analogy resonates with you, let me know, send me a DM over on Instagram and let me know if that makes sense. So I want to talk about why so many people fail SIBO treatment, so why are things out of control. Number one is incomplete treatment. And I already mentioned this a little bit earlier, but SIBO and treatment should involve addressing both the overgrowth of the bacteria in the small intestine, whether you’re using antibiotics, herbal anti microbials, or combination of both, which is also common, but you also need to address the potential underlying causes. So sometimes the initial treatment may not completely or eradicate all the bacteria, which could lead to a relapse, maybe you didn’t take the antibiotics long enough, or the herbal antimicrobials long enough. So really, we want to make sure are you taking the therapeutic dose for the therapeutic amount of time? I can’t tell you how many clients have come to us saying, Well, I took sigh Faxon for two weeks. And typically that is not long enough to get rid of SIBO. And sometimes it does take multiple treatments depending on how higher levels were, etc. But it will also take less time if you are addressing the reasons. So when you just take antibiotics or even herbals for SIBO you were only addressing the overgrowth, not the underlying causes of why this is happening in the first place. Which leads to the second reason that so many people fail SIBO treatment. So I got together we break these underlying causes into three categories. I’m interrupting this episode really quick to tell you about our sponsor element, you know that I am a huge fan of minerals for gut health if you struggle with constipation, bloating, acid reflux or even poor energy. Often the best place to start is by replenishing your minerals. And as we approach the summer months, this becomes even more crucial. Minerals are the sparkplugs of our body and help us to maintain adequate hydration and that’s why I’m so excited for you to give element a try. The ultimate mineral boost for your gut packed with the perfect balance of sodium, potassium and magnesium element helps us to restore these essential electrolytes ensuring that your gut stays happy and hydrated. It’s like giving your gut the fuel it needs to thrive. So here’s the exciting part. If you want to receive a free sample pack with purchase, be sure to check out the link, Dr. Heather finley.co backslash element lm n t, or you can visit the link in the show notes. Now back to the episode. So number one, the first category is digestive factors. So some of these not all of these include low stomach acid, poor bile flow and poor pancreatic outfit. These are three digestive factors that are very, very important in preventing and getting rid of SIBO. So I’ll break each of these down just a little bit. Inadequate stomach acid is a big deal, because when your initial breakdown of food is impaired, this leads to undigested food reaching the small intestine and potentially contributing to SIBO. Stomach acid plays a huge role in the digestive process by breaking down food into smaller particles, creating an acidic environment that helps kill harmful bacteria. You want your stomach to be acidic. And in a world where everybody is on acid reducing medication. This is also potentially why so many people have gut issues. If you have lower stomach acid levels, or you are taking an acid suppressing medication, this does put you at risk for poor digestion and more harmful bacteria getting through because your stomach just simply isn’t acidic enough. So what happens then, is these undigested food particles serve as a fuel source for bacteria promoting their overgrowth and the development of SIBO. I want to talk about bile flow for a second. If you are in gut practitioner, you know that Bile is the real MVP, we spend a lot of time talking about the gallbladder and about bile for good reason. Because insufficient bile production or impaired bile flow can really disrupt the emulsification and digestion of fats, which creates an environment that is super conducive to SIBO development. So Bile is produced in the liver and stored in the gallbladder. And then it’s released into the small intestine to aid in digestion absorption. The other really cool and interesting thing about Bile is that it’s antimicrobial. So if you don’t have enough bile, you’re not getting that coating of bile in your small intestine that is antimicrobial preventing some of these things from overgrowing. So whether there’s poor bile flow, due to a gallbladder issue or problem, or maybe you don’t have a gallbladder, it doesn’t mean you’re doomed. If you don’t have a gallbladder, you still have bile, it’s just coming from a different source. But as a result, these undigested fats can reach the small intestine, and it can contribute to some of the SIBO symptoms that you’re having. And then lastly, poor pancreatic output. So inadequate pancreatic enzyme secretion can impair the digestion and absorption of nutrients which can also contribute to SIBO. Your pancreas produces digestive enzymes including amylase slow pace proteases. And these are necessary for breaking down carbohydrates, fats and proteins. And when the pancreas does not secrete enough of these enzymes, proper digestion of food is altered. And this can again lead to undigested food reaching the small intestine and SIBO development. So you sense the theme here. Improper food breakdown. And the thing that I want to point out here is all of this happens before food ends up in the small intestine. And this is why you can’t just address the SIBO. Because if there’s issues upstream of for the small intestine, if we’re speaking on an anatomical level, if you look at you know, if you go Google like digestion and anatomy, you’ll see all these organs are before the small intestine. And so low stomach acid, poor bile flow, and adequate pancreatic enzyme secretion, all contribute to SIBO. Because these have to work properly, before food gets there. So when these digestive processes are impaired, undigested food particles will reach the small intestine. And this is part of the contributing factor. So that’s factor number one of the underlying causes is digestive factors. Number two is motility and microbiome factors. So this can be poor gut motility and the migrating motor complex. This can be from large intestinal bacterial overgrowth. And it can also be from lack of beneficial bacteria, which if I’m being honest, I don’t think is talked about enough, everyone is so focused on bad bacteria and getting rid of their, quote unquote, bad bacteria in their gut. And no one’s actually talking about the fact that maybe you just have too few good bacteria, which we actually see a ton and our clients. So to break these down just a little bit more poor gut motility. This is a reduced or dysregulated movement of the digestive tract. And this disrupts the clearance of bacteria, which can allow overgrowth to occur in the small intestine. You want your gut to be contracting and moving things through so that you’re having regular bowel movements, and it’s getting rid of waste. When things sit in your gut for longer than they should they ferment and they can cause gases and overgrowth, etc. It can lead to a buildup of bacteria in your small intestine. We don’t want a stagnant environment. It’s like a lake that you know, hasn’t moved in weeks. It’s like growing things on top and there’s bugs and whatever else. Sorry for the visual, but that’s kind of what’s going on. So, in a healthy gut, you have coordinated contractions and relaxations of the muscles. And this ensures that food moves through the stomach, small intestine and beyond. So some of the causes of poor gut motility can be muscle dysfunction or damage. So this can be from obstructions, gastroparesis. mismanaged diabetes, food poisoning is another one. If you’re one of those people that you’re like, oh, my gosh, I was fine. And then I, you know, got food poisoning this one time. And then I’ve never been the same since I remember talking to a friend years ago, and she’s like, I can trace it all back to the one time at the Fourth of July barbecue ate some bad watermelon. And I’ve never been the same sense and it’s so true. Food poisoning damages the nerves of your migrating motor complex and can 100% contribute to SIBO. This can also poor gut motility can be caused by hormonal imbalances. So like hypothyroidism, diabetes, etc. And then medications unfortunately, there’s just some side effects of certain medications like opioids, any medication that is going to relax smooth muscles, is going to slow down gut motility and can contribute to SIBO. Another one that we often see is structural abnormalities. So this can be a stricture adhesion. So I think like even endometriosis, this can disrupt the normal motility and promote bacterial overgrowth. Again, this doesn’t mean you’re doomed if you’re like, oh my gosh, I’ve had multiple C sections or endometriosis, I have scar tissue. There are things that you can do for that. So that is why a comprehensive approach is so needed. And then the last or the one of the other things that can contribute to motility and microbiome factors is what’s actually going on in your large intestine. your large intestine is where most of your gut bacteria are. And so if you have an imbalance of bacteria in your large intestine, this can lead to a disruption in your overall gut microbes. biome and potentially be a risk factor for SIBO as well. So your large intestine is also known as your colon. And some, there’s, there’s a lot of reasons why, but you can have an overgrowth of bacteria in your large intestine from reduced bowel movements, slow gut motility, structural abnormalities, taking antibiotics a lot, there’s a, there’s a lot of things, poor dietary choices. So if you’re not eating any fiber, and you’re, you know, not eating anything that’s feeding or beneficial bacteria, then that for sure can contribute here. Another one that we see a lot and people don’t see the connection, oftentimes is chronic stress. So prolonged periods of stress can alter the composition of your gut microbiome, which potentially promotes the growth of opportunistic bacteria, which is 100%, what we do not want, we want your good bacteria to be so robust that they can fight off anything they come in contact with. There’s other underlying health conditions, you know, if you have IBD, celiac disease, other autoimmune diseases, immune dysfunction, this can definitely contribute as well. And then disruptions in your gut barrier. So you have a gut barrier that basically protects your gut from the outside world. A lot of people on Instagram know this as leaky gut. The actual term for this is intestinal permeability. And what happens when you have intestinal permeability is this can allow bacteria to translocate from the large intestine to the small intestine, which can increase the risk of SIBO. So we want to take a look at what’s going on in your large intestine, are you? Do you actually have beneficial bacteria? Do you have too many overgrowth bacteria, and then what’s contributing to that maybe it was years of antibiotic use as a kid or chronic stress from your job. What I want to point out here is, and hopefully you’re kind of getting the point, nothing happens in isolation. And the way that our conventional medical system is set up is you have this problem, you do this thing, instead of looking at the whole body, how is everything working together? How did this symptom contribute to these other things? Or how did this cause contribute to X, Y, and Z? And really peeling back the layers to get to the actual core of how is this actually all related? You know, for example, let’s say you do have SIBO, but you also have fatigue, and skin issues, etc. You may think, okay, I need to see my GI for the SIBO, I need to see my dermatologist for the skin issues. They need to see my endocrinologist for the fatigue because I might have thyroid issues. And while that is true, those things could be helpful. What if they all stemmed from the same problem, or some of the same problems, there’s always a lot of factors involved. But all those things are actually all related. And it can be a huge relief when you finally realize, Oh, these all go together versus these are all separate issues that I’m dealing with. Hey, popping in here really quick to give you a bit of an update about what is going on with this episode. After I recorded the episode, I realized how much information I packed into one episode. And my intention with the podcast is to create digestible, sorry for the pun, information that you can apply immediately. And so what we’ve decided to do is chop this in half. So that way if you feel like okay, I’ve already got some action steps. And I’ve already got some things to look into you now have some time before the next piece of the episode comes out. So next week, we will be releasing part two, so that you can really learn the rest of this information. But we really want you to be able to take in and digest everything that we’re talking about so that you truly can apply it and truly find relief from your digestive symptoms. So I hope that this is helpful. The intention, like I said, is always to make it very applicable for you. And so we will see you next week on the part two episode of the love of that podcast.

As always, please note that this episode or anything discussed on this podcast is not a substitution for medical advice. And you should always consult your health practitioner before trying anything new.

Thanks so much for tuning into this episode of the Love Your Gut podcast. I always appreciate spending some time in your air pods.

And this message is for the practitioners. So if you are a practitioner that is passionate about gut health, and maybe you don’t quite feel confident in your skills with clients, I have an amazing opportunity for you to join the August cohort of gut practitioner. Gut practitioner is my signature, comprehensive four month educational program for health professionals and registered dietitians to truly empower you with the knowledge and confidence to tackle even the most complex GI cases, we truly start head to toe and uncover all the things that could possibly go wrong, just like you learned about in these past episodes to help you really understand how to assess for what’s going on with your clients how to come up with a comprehensive treatment plan, and how to make sure that you are the absolute last provider that they see because they found lasting relief. So if you are ready to expand your expertise, and learn advanced diagnostic and treatment strategies from a functional perspective, and also join a community of like minded professionals, don’t let the complex cases intimidate you any longer. You can join a good practitioner and transform your practice and really provide the best care for your patients which is what we all want. So you can visit https://www.drheatherfinley.co/gutpractitioner/ to learn more. The link is also in the show notes or you can DM me on Instagram got practitioner and I’m happy to give you more information.


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