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Speak with a licensed primary care doctor online about treatment for small intestinal bacterial overgrowth (SIBO). Our doctors can prescribe SIBO medication and refer you to the nearest specialist for in-person treatment, if recommended.*

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Address and relieve excessive small intestine bacteria

Diseases like crohn's or diabetes can influence SIBO

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*Prescriptions are provided at the doctor's discretion. Learn more about our controlled substances policy and how to save up to 80% with our prescription discount card. PlushCare doctors cannot treat all cases of SIBO. Our primary care physicians can conduct an initial evaluation of your symptoms but may need to refer you to a specialist or for in-person treatment. If you are experiencing life-threatening symptoms, seek emergency medical attention immediately.

Learn about small intestinal bacterial overgrowth (SIBO)

Small intestinal bacterial overgrowth (SIBO), also called blind loop syndrome, is when you have excessive bacteria in your small intestine.

SIBO occurs when there is an abnormal increase in the overall bacteria in the small intestine—particularly types of bacteria not commonly found in that part of the digestive tract. SIBO commonly occurs when circumstances, such as surgery or disease, slow the passage of food and waste products in the digestive tract.

Small intestinal bacterial overgrowth (SIBO) causes

Intestinal bacterial overgrowth can be caused by:

  • Complications of abdominal surgery

    SIBO can happen after abdominal surgery, such as gastric bypass for obesity and gastrectomy to treat peptic ulcers.

  • Structural issues around the small intestine

    In some cases, scar tissue (intestinal adhesions) can wrap around the small bowel, or bulging pouches of tissue may protrude through the wall of the small intestine (intestinal diverticulosis).

  • Certain medical conditions

    Various medical conditions have been associated with small intestine bacterial overgrowth, including:

    These conditions can slow the movement of food and waste products through the small intestine, creating a breeding ground for harmful bacteria.

Small intestinal bacterial overgrowth (SIBO) symptoms

  • Most SIBO patients experience gastrointestinal symptoms, including:

How to treat small intestinal bacterial overgrowth (SIBO)

The treatment of SIBO typically involves a combination of medication and diet changes. The options for treating SIBO include:


For symptom improvement, it is important to take care of your digestive health and regain the balance of bacteria in your small intestine. This is usually done with antibiotic treatment.

Antibiotic therapy can help manage excess bacteria in the small intestine, but it will not address the underlying cause of bacterial overgrowth. If your healthcare provider determines that SIBO is due to an underlying cause, you will also need to begin treatment for that condition.

Dietary changes

Although there is no evidence that a certain diet causes SIBO, many SIBO patients find relief after following a SIBO diet or a low FODMAP diet. Talk to your doctor before making any changes to your diet.

Most people only need to make small changes to their diet, such as:

  • Eating a balanced diet

  • Eating smaller meals more frequently

  • Avoiding gluten products if you have celiac disease

Your doctor may also recommend an elemental diet. An elemental diet replaces food and drinks with a liquid formula for a specified period.

Small intestinal bacterial overgrowth (SIBO) medication

  • Antibiotic therapy can help you maintain the balance of beneficial bacteria ("good" bacteria) and harmful bacteria ("bad" bacteria) in the gut microbiome. Your doctor may prescribe the following medication to control your gut bacteria:

    Take your antibiotics as prescribed to treat SIBO and avoid bacterial resistance.

    Your doctor may also recommend supplements, such as iron and vitamin B12, if you experience nutritional deficiencies related to SIBO.

How to prevent SIBO relapse

Making healthy lifestyle changes and dietary choices can help you stay healthy after SIBO and prevent recurrence. Some long-term changes to support gut motility include:

  • Incorporating movement into your daily routine

  • Avoiding food at least three hours before bedtime

  • Avoiding food between meals, or intermittent fasting

  • Eating a balanced, nutritious diet

  • Finding healthy ways to manage your stress levels

  • Following basic food safety guidelines to prevent food poisoning

When to see a doctor for SIBO

Talk to your healthcare provider (especially if you have had surgery) if you are experiencing:

  • Persistent diarrhea

  • Rapid and unintentional weight loss

  • Abdominal pain that persists for more than a few days

SIBO symptoms can mimic other gastrointestinal symptoms, such as IBS. If you are experiencing symptoms that do not go away, see your healthcare provider for a full evaluation.


  • What is the best treatment for SIBO?

    The most effective treatment for SIBO involves a combination of antibiotics and dietary changes. While antibiotics can help regulate the bacteria present in the gut microbiome, dietary changes can provide relief from uncomfortable symptoms.

  • What is the root cause of SIBO?

    Intestinal bacterial overgrowth occurs when there are too many bacteria in the small intestine. It often results from a circumstance, such as surgery or disease, that slows the passage of food and waste products in the digestive tract.

  • What are the main symptoms of SIBO?

    SIBO primarily involves gastrointestinal symptoms, including:

    • Loss of appetite

    • Abdominal pain

    • Bloating

    • Nausea

    • Diarrhea

    • Unintentional weight loss

    Because the symptoms of SIBO often mimic the symptoms of other functional gastrointestinal disorders, it is important to talk to your doctor to receive a SIBO diagnosis.

  • What does SIBO feel like?

    If you have SIBO, you might feel bloated or "full" all the time, even if you have not eaten.

    SIBO can cause a wide range of symptoms, including painful gas, belching, and nausea. It can also lead to abnormal bowel habits (such as constipation or diarrhea) and unintentional weight loss.

  • How do you fix SIBO?

    The best way to fix SIBO is to talk to your doctor. Your doctor can review your medical history and symptoms to determine the underlying cause of SIBO.

    If you receive a SIBO diagnosis, your doctor may recommend antibiotic therapy and dietary changes to improve your symptoms. Your doctor will also treat the underlying cause of SIBO.

  • What foods should be avoided with SIBO?

    Dietary changes, such as the SIBO diet and low FODMAP diet, can help expedite your recovery and soothe uncomfortable symptoms.

    The SIBO diet is a gradual elimination diet that helps reduce inflammation in the digestive system and bacterial overgrowth in the small intestine. For some SIBO patients, eliminating only sugars can ease symptoms.

    Your healthcare provider may recommend a diet low in FODMAPs. "FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, which are short-chain carbohydrates (sugars) that the small intestine absorbs poorly," according to Johns Hopkins Medicine.

    Some foods to avoid include:

    • Sugary fruits and vegetables

    • Honey and agave nectar

    • Ice cream

    • Soda and soft drinks

    • Barely

    • Rye

    • Sweetened cereals

    • Grains

    • Sausage

    If you need help creating a food plan, reach out to your healthcare provider for nutritional support.

  • How do I know if I have SIBO or IBS?

    Because SIBO and IBS often present similar symptoms, it is important to talk to your doctor to diagnose SIBO.

    Breath tests, such as lactulose breath testing, are the most common tests to diagnose SIBO. Excess bacteria in the small intestine can release hydrogen and methane, which can be identified through a breath test.

    If your breath test is inconclusive, your doctor may need to take a sample of fluid from your small bowel to determine what bacteria are growing there. Your doctor may also perform imaging tests, such as X-rays, to identify structural abnormalities of the intestine.

3 simple steps to request SIBO treatment today

Step 1: Book an appointment

Step 1

Book a SIBO treatment appointment.

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Step 2: Visit with a doctor on your smartphone

Step 2

Talk to your doctor about your SIBO symptoms.

Visit with a doctor on your smartphone or computer.

Step 3: pick up at local pharmacy

Step 3

Pick up a prescription for SIBO treatment, if prescribed.

We can send prescriptions to any local pharmacy.

Related conditions to SIBO

  • Irritable bowel syndrome (IBS)

    Small intestinal bacterial overgrowth and irritable bowel syndrome share several symptoms. Some IBS patients also have SIBO.

    With SIBO, excess bacteria can be verified in clinical practice. IBS, on the other hand, is a functional disorder that is diagnosed when your symptoms cannot be clinically explained.

    When you seek a diagnosis, your doctor will perform breath testing and other diagnostic exams for SIBO and other similar conditions. If you test positive, you can be treated for those conditions. However, if no clinical cause can be found, you will be diagnosed with irritable bowel syndrome.

  • Inflammatory bowel disease (IBD)

    IBD is a group of diseases characterized by inflammation in the gastrointestinal tract, with the two most common being Crohn's disease and ulcerative colitis.

    In some patients with IBS, the gastrointestinal mechanisms to prevent the presence of too much bacteria (low gastric acid pH, the integrity of the small bowel, and the motor complex of the small intestines) can become compromised, leading to SIBO.

SIBO treatment pricing details

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Often the same as an office visit. Most patients with in-network insurance pay $30 or less!

  • We accept these insurance plans and many more:

    • Humana
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Paying without insurance



First month free

First visit


Repeats only $99

30 days of free membership

  • Same-day appointments 7 days a week

  • Unlimited messages with your Care Team

  • Prescription discount card to save up to 80%

  • Exclusive discounts on lab tests

  • Free memberships for your family

  • Cancel anytime

Visit price without insurance

Initial visits are $129 and follow-ups are only $99 for active members.

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If we're unable to treat you, we'll provide a full refund.


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PlushCare content is reviewed by MDs, PhDs, NPs, nutritionists, and other healthcare professionals. Learn more about our editorial standards and meet the medical team. The PlushCare site or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment.