Support for people with SIBO, suspected SIBO, or SIBO that keeps coming back.
Bloating that starts soon after eating and builds through the day. Wind, discomfort, and bowels that swing between loose and stuck. Maybe you’ve had a positive breath test, done a course of treatment, felt better for a few months, and then watched the symptoms creep back.
I’m a registered nutritional therapist specialising in gut health, and SIBO is one of the most common things I work with. I see clients across the UK by video call, and in person in Hove by arrangement.
What SIBO is, briefly
SIBO stands for small intestinal bacterial overgrowth: more bacteria living in the small intestine than should be there. Those bacteria ferment food early, which produces gas and the bloating, pain and bowel changes that go with it.
When the gas involved is mainly methane, constipation tends to be the bigger problem. You may see this called IMO (intestinal methanogen overgrowth). When it’s hydrogen, diarrhoea is more common. Many people have a mix.
For the full picture, including what SIBO is not, read my guide to SIBO symptoms, causes and testing.
Why SIBO keeps coming back
SIBO has a reputation for returning, and in my experience that’s usually because the overgrowth was dealt with but the reason it developed wasn’t. The small intestine normally keeps bacteria in check. When SIBO appears, something in that system has changed. Common contributors include:
- Slow motility. The gut’s ‘cleaning wave’ between meals isn’t sweeping through as it should. This often follows food poisoning.
- Low stomach acid, including from long-term use of acid-reducing medication such as PPIs
- Previous abdominal surgery or other structural changes
- Constant grazing, which gives the gut no gap between meals to reset
- Stress and the nervous system, which directly affect how the gut moves
Working out which of these apply to you is the part I spend most time on. It’s what makes the difference between feeling better for a few weeks and staying better.
Testing for SIBO
SIBO is usually tested with a breath test you do at home. You follow a simple preparation diet the day before, drink a sugar solution (usually lactulose or glucose), then collect breath samples over a few hours. The test measures the gases bacteria produce: hydrogen and methane.
Breath tests are useful but not perfect. Results can be affected by preparation, transit time and recent medication, so I always interpret them alongside your symptoms and history rather than treating a number on a page as the answer. Not everyone needs a test, and if a result wouldn’t change the plan, we don’t run one.
How I work with SIBO
Most clients join my 16-week programme, Restore Revive Thrive. The plan runs in phases, so we change one thing at a time and can see what’s working:
- Understand it. A 90-minute consultation covering your history, symptom pattern, diet, medication and what has or hasn’t worked before
- Test where useful. A breath test, and sometimes a comprehensive stool test if the picture is wider
- Calm symptoms. Short-term dietary changes to give you some relief, without leaving you on a restricted diet indefinitely
- Address the overgrowth. Depending on your results and history, this may include a course of herbal antimicrobials. If your GP or consultant prescribes antibiotics instead, I’ll work alongside them.
- Deal with the cause. Motility, meal timing, digestion and the nervous system, so things stay settled
It’s £350 a month for a minimum of four months, with any testing paid to the lab separately. See everything that’s included.
See your GP first if any of these apply
Nutritional therapy works alongside medical care, not instead of it. Please see your GP before booking if you have blood in your stool, weight loss you can’t explain, anaemia, symptoms that wake you at night, difficulty swallowing, persistent vomiting, or a new change in bowel habit over the age of 50. If you haven’t been tested for coeliac disease, ask about that before cutting out gluten.
Hi, I’m Teddy
I’m a registered nutritional therapist (DipNT, mBANT, CNHC) and founded Berkeley Nutrition in 2020. I focus on gut health because I know first-hand how much digestive problems can take over your life.
Questions about SIBO
Do I need a test to know if I have SIBO?
Not always. Symptoms and history can point strongly towards it, and sometimes testing doesn’t change what we’d do. Where it would, a breath test is the usual starting point. We decide together after your initial consultation, and you’ll know the cost before anything is ordered.
Can I get a SIBO breath test on the NHS?
Some NHS gastroenterology departments offer breath testing, but access varies a lot by area and waiting times can be long. Most of my clients test privately, which I can arrange.
Will I need antibiotics?
Not necessarily. Some people are prescribed antibiotics by their doctor, and if that’s the case I’ll work alongside it. Others take a different route. We’ll talk through the options and what makes sense for you.
I’ve already been treated for SIBO and it came back. Can you help?
This is one of the most common reasons people come to me. Usually the overgrowth was addressed but the underlying cause, such as slow motility or low stomach acid, wasn’t. That’s where we focus.
Do I have to follow a strict SIBO diet?
Short-term dietary changes can help with symptoms, but staying on a restricted diet for months usually causes more problems than it solves. The aim is to get you eating as widely as possible.
Is SIBO the same as IBS?
No, but they overlap. SIBO is more common in people with IBS-type symptoms, and some people diagnosed with IBS turn out to have SIBO driving part of the picture. Read more about how I work with IBS.
Do you work online?
Yes. Most clients work with me by video call, from anywhere in the UK. In-person appointments in Hove are available by arrangement.
Ready to talk it through?
Book a free 30-minute call. We’ll go through your symptoms and history, and you’ll come away with a clearer idea of whether SIBO is likely to be part of the picture, whether or not we end up working together.