What You Need to Know About SIBO: The Hidden Gut Imbalance Driving Your Symptoms
Guest blogger Courtney Cowie, NTP, FDN-P
If you’ve been battling bloating, unpredictable bowel movements, exhaustion, or food reactions—and every doctor visit leaves you with more questions than answers—Small Intestinal Bacterial Overgrowth (SIBO) might be a major player in your health struggles.
SIBO isn’t just another gut health buzzword. It’s a condition where bacteria that should be thriving in your colon migrate to your small intestine, where they don’t belong. Once there, they ferment foods too soon, causing painful bloating, diarrhea or constipation, poor nutrient absorption, and a cycle of frustration that feels impossible to break.
If this sounds like you, keep reading—because understanding why SIBO happens, why it keeps coming back, and how to finally address it is key to getting your gut (and your life) back.
Signs You Might Have SIBO
SIBO can present differently from person to person, which is one reason it’s often misdiagnosed or overlooked. Some of the most common symptoms include:
✔️ Bloating (especially after meals) – Many of my clients describe it as feeling “six months pregnant” by the end of the day. Their pants feel tight, they constantly shift in their chair for relief, and they hate how their body feels after eating.
✔️ Diarrhea, constipation, or both – Many people with SIBO find themselves racing to the bathroom after eating or, on the flip side, going days without relief. The back-and-forth cycle is exhausting and unpredictable.
✔️ Acid reflux or heartburn – If you’ve been told to take antacids but they don’t seem to help long-term, it might be because SIBO is at the root of the issue.
✔️ Food sensitivities and reactions – Do you feel like your list of “safe” foods is shrinking? SIBO can make you feel like your body is rejecting everything—even healthy foods.
✔️ Fatigue and brain fog – If your gut isn’t absorbing nutrients properly because of SIBO, you’ll feel the effects in your energy, mental clarity, and ability to handle stress.
Sound familiar? If you’ve been dismissed by doctors or told “it’s just IBS,” you’re not alone. Studies show that up to 80% of IBS cases are actually undiagnosed SIBO—which means that if you’ve been diagnosed with IBS, you may be treating the wrong issue.
What Causes SIBO? It’s Not Just About Food
Many people assume SIBO happens because of a “bad diet,” but in reality, there’s a deeper reason your gut bacteria have overgrown in the wrong place. Some of the biggest underlying causes include:
🚨 Low stomach acid – If your stomach acid is too low (often due to stress, medication use, or chronic illness), food isn’t properly broken down, allowing bacteria to flourish in the wrong areas.
🚨 Slow gut motility – If your digestive system isn’t moving food along efficiently, bacteria sit in your small intestine too long, leading to fermentation, bloating, and bacterial overgrowth.
🚨 Past food poisoning or gut infections – Have you ever had a stomach bug, food poisoning, or traveler’s diarrhea? These can damage the nerves in your gut, slowing digestion and making it easier for bacteria to overgrow.
🚨 Leaky gut and inflammation – If your gut lining is inflamed from food sensitivities, stress, or past gut damage, it creates the perfect storm for chronic bacterial overgrowth.
🚨 Underlying conditions – SIBO is common in people with IBD (Crohn’s, colitis), hypothyroidism, autoimmune diseases, and even hormone imbalances. If you’ve been diagnosed with any of these, addressing SIBO is critical to healing your gut and overall health.
Why SIBO Keeps Coming Back (and What to Do Instead)
If you’ve tried antibiotics, herbal supplements, or strict diets but your symptoms keep returning, there’s a reason for that: SIBO isn’t just about killing bacteria—it’s about fixing why it happened in the first place.
This is where a functional health approach makes all the difference. Unlike quick-fix solutions that only target bacteria, my approach is designed to stop the cycle of recurring SIBO by fixing the root causes.
✔️ Step 1: Get to the Root Cause – Instead of guessing, work with a functional practitioner who uses specialized gut testing to figure out exactly what’s causing your symptoms. This includes identifying bacterial imbalances, low stomach acid, enzyme deficiencies, and more.
✔️ Step 2: Identify your Food Triggers – It’s vital to pinpoint your personal food triggers so you can eat with confidence instead of fear. Following a SIBO specific diet can help reduce symptoms while you are working on eradicating the bacterial overgrowth and addressing deeper issues.
✔️ Step 3: Fix any Metabolic Issues – Chronic gut issues drain your energy, and a slow metabolism (and low thyroid function) makes it hard to overcome SIBO.
✔️ Step 4: Learn to Manage Stress – Gut issues aren’t just physical—they’re deeply connected to your nervous system. To truly overcome SIBO, stress management strategies, mindset coaching, and structured daily resets help your body stay in healing mode.
Final Thoughts: Getting Real Relief from SIBO
SIBO is not just a digestive issue—it’s a full-body health issue. If you’ve been struggling with bloating, bathroom urgency, food reactions, or exhaustion, it’s time to stop spinning your wheels with temporary fixes and start healing at the root level.
Meet Guest Blogger, Courtney Cowie, FDN-P
Courtney Cowie is a certified functional nutritionist specializing in helping high-achieving women overcome chronic digestive issues. With accreditations from the Nutrition Therapy Association and AFDN, she has advanced training in SIBO, SIFO, mold detox, and Chinese herbal medicine. She also serves as a clinical advisor for Functional Diagnostic Nutrition.
Her journey into functional medicine was personal—after struggling with unresolved GI issues, she turned to alternative medicine, inspired by her time living in Tokyo. A former competitive swimmer and triathlete, Courtney blends science, nutrition, and holistic healing to help women restore gut health and overall wellness.