Gut health
How does a dietitian help with SIBO?
Your doctor diagnoses and treats SIBO. A registered dietitian handles the nutrition side: eating in a way that fits your symptoms, adding foods back with a plan, and making sure you are still getting what your body needs.
Clinically reviewed by Dr. Ambily Kushal, RD, MS, PhD · Published · Last reviewed
What is SIBO?
SIBO stands for small intestinal bacterial overgrowth. The American College of Gastroenterology describes it as an imbalance of bacteria in the small intestine that causes digestive symptoms.
Common symptoms include belly pain, bloating, gas, diarrhea or constipation, and fatigue. They overlap with IBS and other conditions, which is why testing and a proper diagnosis matter. Guessing and cutting out foods on your own can leave you undernourished without answers.
What does your doctor do, and what does the dietitian do?
Your doctor orders testing, diagnoses SIBO, decides on treatment and looks for underlying causes. The dietitian does not diagnose or prescribe, and works on food, nutrients and symptom tracking.
Your doctor
- Orders a test, most often a hydrogen breath test
- Diagnoses SIBO and rules out other conditions
- Prescribes treatment, usually a short course of antibiotics
- Looks for underlying causes and plans repeat care if SIBO returns
Your dietitian
- Reviews your food and symptom pattern
- Plans meals that are gentle on your gut right now
- Reintroduces foods in steps
- Checks your intake of key nutrients and your labs
What does a dietitian do day to day?
A dietitian helps you eat comfortably around treatment without cutting out more than you need to. The aim is a broad, nourishing diet you can keep up, with a plan for what comes next.
- Spot which foods and meal patterns tend to flare your symptoms.
- Keep restrictions short and specific, since long lists of avoided foods can leave gaps.
- Plan how to bring foods back after treatment, one group at a time.
- Look at your labs with you for signs of nutrient shortfalls, and share findings with your doctor.
- Review any supplement with you and your doctor or pharmacist.
When should you see your doctor first?
See your doctor before starting a restrictive diet for symptoms you have not had checked. Get care promptly for blood in your stool, unplanned weight loss or severe pain.
- You have never been tested and are guessing at a cause.
- You see blood in your stool or have black, tarry stools.
- You are losing weight without trying.
- Symptoms return after treatment. SIBO can come back, so repeat care may be needed.
How do you start?
Bring any breath-test results and your symptom notes to a first visit ($140, self-pay).
For follow-up through each step, see the Personalized Care Plan.
What patients say about this kind of care
One patient with long-standing, unexplained symptoms valued a dietitian's step-by-step approach to supplements.
“She did not bombard me with supplements … but rather followed an iterative approach.”
A dietitian who explains something new at each visit helps you understand your plan.
“She's very knowledgeable and teaches me something new every appointment.”
One patient working on prediabetes and gut symptoms was skeptical of online nutrition help and was sold after four sessions.
“I was skeptical of online nutrition help, but I'm sold now.”
Excerpts from patient reviews of Dr. Ambily Kushal, quoted word for word. Each describes one person’s care; individual experiences vary and are not a promise of results.
Frequently asked questions
Should I cut out many foods while I wait for testing?
Talk with your doctor first. Cutting out many foods before you have answers can leave you undernourished, and a dietitian can help keep any restriction short and specific.
How is SIBO diagnosed?
The most common test is a hydrogen breath test, according to the American College of Gastroenterology. Your doctor will tell you how to prepare.
Can SIBO come back?
It can. The American College of Gastroenterology says repeat treatment may be needed, and providers may also look at underlying causes.
Is SIBO the same as IBS?
No, but the symptoms overlap, and NIDDK lists SIBO as one possible contributor to IBS. Your doctor can sort out which applies.
Sources
- Small Intestinal Bacterial Overgrowth (SIBO) (American College of Gastroenterology)
- Symptoms & Causes of Irritable Bowel Syndrome (NIDDK, National Institutes of Health)
- Diagnosis of Irritable Bowel Syndrome (NIDDK, National Institutes of Health)
Related reading
Our condition guides are general education, not medical advice. Talk with your doctor about your own diagnosis, tests and medicines.