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Ep. 44: You are diagnosed with SIBO, now what? [PART 2]

Don’t believe everything you hear about SIBO treatment.

There is some misleading information out there about treating SIBO and improving digestive health. Here are some common myths:

Myth 1: The same treatment plan works for everyone- one size fits all!

Myth 2: Diet alone will solve the problem- you should just follow a low FODMAP diet.

Myth 3: Antibiotics are the only solution to “fixing” your digestive symptoms.

Want to know the truth?

Truth: Personalized treatment plans are key to long-term relief from SIBO and its symptoms.We have to address YOUR personal root causes. 

In Part 2 of my SIBO series, I will explain some common hurdles in successful SIBO treatment and how to overcome them with personalized strategies. 

In this episode, you will be able to:

  • Examine common root causes that often lead to a SIBO diagnosis.
  • Discover how digestion, detoxification, and motility play a role in recurring SIBO and the preventive steps you can take.
  • Understand the link between “leaky gut” and SIBO.
  • Learn methods to support your gut lining.
  • Recognize the importance of an individualized approach in SIBO treatment for long term relief.


00:02 – Root causes of SIBO

01:32 – Motility and microbiome imbalances

03:32 – Systemic factors that keeps you in the SIBO cycle

07:43 – “Leaky Gut”

16:15 – Why addressing root causes is important

17:48 – An individualized approach to treatment- one size does NOT fit all

18:14 – Case Study: Emma’s SIBO journey

23:51 – Follow these three steps for lasting SIBO relief

After listening, if you find 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 root cause of the SIBO.”
  • You might not be able to get rid of all your stressors, but you can improve your body’s ability to adapt to stress.”
  • SIBO is just a piece of the puzzle, there are other issues that need to be addressed.”
  • You cannot get rid of your SIBO by being handed a low FODMAP diet handout, and then following the low FODMAP diet.”

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Dr. Heather Finley

Dr. Heather Finley  00:02

Just because the SIBO was gone, it doesn’t mean that you’ve addressed the cause 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.

Dr. Heather Finley  00:22

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 the next part two episode of this podcast. I am so excited to pick back up where we left off last week talking about I have SIBO. And now what I know I heard from so many of you after last week’s episode is saying how much you learned and how much just so many lightbulb moments that you had as you were listening to the episode. So I totally think it was the right call cutting this up so that you could really, really apply the information that we’re trying to get across here. So without further ado, we’ll just jump right into part two of this episode. Okay, and then the last thing under the category of motility and microbiome imbalances that I want to talk about today is lack of beneficial bacteria. So when you have insufficient populations of beneficial bacteria, this can compromise your natural defense mechanisms. The gut is a diverse community of trillions of bacteria. And these bacteria do so much for us, including help us digest our food, help with our immune system, etc. When you have an imbalance, known as dysbiosis dysbiosis can either be too many bad or too few good dysbiosis can arise due to factors like antibiotic use, poor fiber intake, stress, etc, as I mentioned before, but we also see this very commonly in our SIBO population because your doctor gave you Rifaximin and a low FODMAP diet handout and said, This is how you’re going to address your SIBO. Well, here’s the problem. You cannot get rid of your SIBO by doing a low FODMAP diet handout, or a low FODMAP diet from the handout. This might help with symptom relief initially, but it is not going to help prevent your symptoms from coming back. Because when you do something like low FODMAP for too long, it reduces the population of good bacteria in your gut. Unless you are really really diligent about making sure you are getting prebiotic fiber in your diet from low FODMAP sources which most people are not. You can also have low amounts of beneficial bacteria in your gut from stress, negative thought patterns. Even chronic dieting, just chronic under eating can be another thing here as well. Okay, last reason why people don’t relapse on SIBO treatment is systemic factors. So I mentioned stress already but stress, food fear, poor blood sugar control. This is when we see a lot hypothyroidism other issues like autoimmune disorders, diabetes, immune system dysfunction, structural abnormalities, medications, surgeries, etc. So, just to briefly cover some of these, when your body is in a state of stress, it shuts everything off related to your digestion. There are really interesting studies that link stress to low levels of IGA. Which if you are curious about IgA, I went in depth on this topic on the last podcast episode with Brian and so you can go back and listen to that episode. If you are curious about this topic and serum bovine immunoglobulin globulin and how that helps. So stress, you have to get your body out of a chronic state of stress. And here’s what I want you to know as well. You might not be able to get rid of all your stressors, right? Like you can’t just quit your job, move, whatever. Those things obviously take time. But what you can and you get to do is improve your body’s ability to adapt to stress. And you can do that through supporting your nervous system. I have other episodes on that. So you can go check those episodes out as well like the one with Lindsay Lindsay Mitchell, I think it was maybe episode three or four, it was one of the first episodes, it’s still one of our most popular episodes. But stress reduction is huge. And hear me when I say when I say stress reduction, I don’t mean get rid of your stressors, necessarily. I mean, that’d be great. But I mean, allow your body to adapt and recover from the stress faster. Food fear is another one. When you have restrictive eating patterns, you fear certain foods, you have a really excessively limited diet, this can lead to inadequate intake of nutrients, or digestive imbalances that can contribute to SIBO. And the cycle can be really vicious. So if you’re under eating, and you’re really mineral deficient, everything goes back to minerals, you need sodium, you need zinc, you need magnesium, all these minerals, potassium, for gut motility, for managing stress for stomach acid production, and you have to get those minerals from food or supplementation. And with really restricted eating patterns, that makes it a lot harder. So working on your food, fear and restrictive eating patterns. And also knowing that food fear is a form of stress. So changing your mindset around food is helpful. They’re poor meal hygiene. So whether you are not chewing your food, and you already have low stomach acid, or all the things that I mentioned prior, this is not helping because you need to be able to rest and digest and relax while you’re eating kind of going along with the whole theme of stress, being able to sit down and eat a meal and relax and take a couple deep breaths and allow your body to do its thing. Poor blood sugar control. When you have frequent blood sugar imbalances, this is also a stress on your body. So you can have high blood sugar, low blood sugar, this disrupts gut function and can contribute to SIBO development. And then hypothyroidism, as I mentioned earlier, your thyroid effects gut motility, and your gut actually affects your thyroid. So this is a very vicious cycle. If your guts off your thyroid can be off and vice versa, and you really have to address it from both ends. So improving your bacterial balance is going to help with the conversion of T four to T three, which is your active thyroid hormone. But improving your thyroid is also going to help improve your gut motility, which is going to make clearing the SIBO more possible and also help with the balance of bacteria. So you want to address it on both ends. So hopefully, this is eye opening for you to see all the different things that could be contributing to your SIBO. So just to recap a little bit, there are three reasons why so many people fail SIBO treatment number one, incomplete treatment, number two underlying causes, which is broken down into three different categories. So digestive factors, motility and microbiome factors and systemic factors. And then the last reason is a disrupted gut barrier function. So I mentioned this in the systemic factors but or the sorry, the motility factors, but the intestinal lining acts as a barrier, and it controls the entry of bacteria and other substances into your bloodstream. When your gut barrier is disrupted, or you have leaky gut, aka intestinal permeability. This can allow bacteria to translocate from the intestines to other parts of the body, which can contribute to SIBO recurrence. And a lot of this is actually driven by something called LPs, lipo polysaccharide. When we address our gut barrier dysfunction through appropriate dietary lifestyle modifications, supplements, antibiotics when needed, it can be essential in preventing relapse. And again, if you want to learn more about this, go listen to the previous episode on gut barrier function. So you may need to reseed your gut and restore your gut barrier. One of the biggest mistakes that you can make is just take the antibiotics and then move on. You’ve now maybe killed off some of the bacteria that contributed to your SIBO but you did nothing to restore balance to the gut afterwards. So we want to restore balance via diet. So including prebiotic rich foods to help feed your beneficial bacteria. We want to potentially reseed the gut with beneficial bacterial strains. And we also want to restore balance. To the gut, via the things that you do in your life, getting enough sleep, hydration, nervous system support, etc. And this all takes a super individualized approach because everyone’s root causes are going to be a little bit different. And so the support that your gut needs after SIBO treatment is going to be different compared to, you know, maybe your friend that had SIBO or somebody else. Alright, so how does this actually work? You’re probably thinking this is a lot of information. Maybe it’s new information, which if it is, I’m so glad that you’re learning something new. And hopefully, you’ve had a lot of lightbulb moments understanding, potentially what’s contributing to the symptoms you’re having. So how does this work and get together we break it down into three steps. So step one is diagnosis or identification? So we’re basically identifying all the contributing factors that are at play that include from birth until now, how did how did everything happen? Where did everything start? What is your health timeline look like? When did you get food poisoning?We re you c-section? Were you breastfed? Did you have a head injury? Were you taking frequent antibiotics? Did you go through a traumatic divorce? Whatever it is, we want to look at every possible contributing factor from birth. Until now, how did all of these things contribute to the development of SIBO? And then we want to bring in some comprehensive testing SIBO testing tells us whether or not you have SIBO, which is beneficial. But again, it doesn’t tell us anything at all about what caused the SIBO. So we use certain diagnostic tests to look at what actually caused it like stool testing, like htma, or hair mineral testing, like adrenal panels, etc. All these things give us a lot more information about specific to you, which bucket Are you falling in, which for a lot of our clients, it’s all of them, or are some of the three buckets that I mentioned earlier. And we also want to look at your day to day patterns. So when you are having symptoms tells us a lot about why for example, if you’re bloating after your meals, this points more at digestive factors, versus if you’re waking up bloating. This is pointing more at microbiome and motility factors. And maybe both of those are the case. And that’s totally normal. It’s pretty rare. Never have ever seen one person have one root cause 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 spark plugs 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. Step two is treatment. Okay, so now that we’ve spent so much in depth time looking at everything related to your health, which by the way, this takes hours, hours outside of sessions that we have with clients of us digging into testing, lab work, and then also looking at forms and things that we have our clients fill out. And then reviewing all of this with the client. There’s no way in the world this is I think why conventional medicine fails. So many people is truly due to the time factor. There. Most doctors they say have 15 minutes per patient per year, which that’s not enough time to really understand someone’s story and have someone truly sit down and listen to you and understand all the pieces to the puzzle. So after we’ve identified all that information, we’re looking at treatment. Okay, how are we going to make a personalized plan to address this? That doesn’t just include taking antibiotics or herbal anti microbials or supplements only? We’re going to look at what dietary modifications do we need to make? And we’re typically more focused on what can we add to improve the gut versus what are we taking away? You’ve already done that. The common question that I often have with clients in our program they’ll say, Well, I my symptoms are so bad, I’m so scared, add foods back in, it’s gonna make things worse. And the question that I often ask is, Well, do you feel any better now that you’re eating five foods compared to when you weren’t? And they have this lightbulb moment of like, oh, yeah, you’re right, I don’t feel any better. As I mentioned earlier, you can use low FODMAP, or other elimination diets for temporary relief. But the goal is to get rid of the causes. So you can actually add foods back in and that’s what we help our clients do. So optimizing the diet, optimizing blood sugar balance, allowing clients to eat what they want again, and enjoy food again, and not feel so scared of it. That’s a big hurdle that we often have to overcome, optimizing lifestyle, so optimizing sleep, looking at hydration, looking at thought patterns, mindset, meal, environment, nervous system, etc. And then, using targeted supplements to support some of these root causes, maybe we’ve identified that someone has not enough stomach acid or poor bile flow, we for sure want to support those things to prevent the SIBO relapse, because those are all upstream things. If nothing upstream is working, nothing downstream will work either. And then, lastly, we want to resolve the root causes. So this is kind of the gut restoration and support phase of SIBO. And it’s critical, because it addresses you’re addressing the underlying factors that contributed to your SIBO in the first place to prevent recurrence. And if this phase is missed, or not given enough attention, it can leave the gut super vulnerable to bacterial overgrowth, and increase the likelihood of the relapse and SIBO. So this involves supporting gut motility are continuing to optimize it, enhancing digestive function, rebalancing and receiving the gut microbiome. You know, it may involve continuing to use prokinetic agents to keep the bowels moving, supporting stomach acid, bile flow, pancreatic enzymes, and optimizing lifestyle. The common question I get is, well, I have to be on supplements forever. And the question or the answer is, I don’t know. For example, let’s say that you have, you know, poor bile flow, and you don’t have a gallbladder, your answer is going to be a lot different than someone who does. If you don’t have a gallbladder, there’s likely things that might be beneficial for you to take long term to prevent SIBO from coming back, which in my opinion, is super worth it, to make sure that you don’t go down this road again. Whereas other people may not have to do that. So I want to just wrap this all on a bow and tell you about a client that we had, that might be in the same situation as you to just give you a little bit of hope. So we had a client, her name was Emma. And she was this amazing woman who she was about 35 years old, mid 30s. And she was working at Google. And she had had this crazy battle with SIBO. So it had taken a huge toll not only on her personal life, but also her professional life. She was just almost debilitated by the gut symptoms. She came to us actually during COVID, which for her, she said was a huge relief because she could work from home. And it did relieve maybe some of the stress that she had about her symptoms. But she obviously knew that wasn’t going to be a forever thing and decided, You know what, I’m gonna reach out to get support because she had done multiple rounds of antibiotics. She had adhered to low FODMAP for way too long. And yet her symptoms persisted. So Emma reached out to me, and we had a discovery call and talked a lot about her digestive symptoms and kind of what she had been through and honestly a lot of her fears, feeling like she’d never get off of this roller coaster. And when I briefly explained to her exactly what I’ve just kind of gone through in this episode, she had a huge lightbulb moment and realized, I have so many missing puzzle pieces that I have not addressed. And so when she started with our team, and we started our initial investigation process, what we determined was, obviously stress was a big component not only because of just the time in the pandemic, but also because of her job she had just moved like there’s just a lot of stuff going on. So stress was a big component, but she also had things in all of the other buckets so she had some digestive abnormalities, which are some of the most often missed pieces of C Yubo recovery, she also had low amounts of beneficial bacteria because of the low FODMAP diet and because of the antibiotic use and everything else. And so as we put together a plan for her, it was amazing to watch her journey because she started with us. Really tentative, really scared of food, really scared to go out to eat. It was really affecting her relationship. And really, even within the first month as we started supporting her gut motility, we started supporting her digestion, we started giving her tools for nervous system support, she found herself already just feeling better. And that was before we even addressed things that came back on her personal testing. Once we got into her personal testing, and saw some of the other things that I mentioned, we didn’t even actually do an herbal antibiotic, her antimicrobial protocol on her. At that time, we believed that she didn’t have SIBO a positive SIBO anymore. She we didn’t know for sure, but a lot of it we believed was related to her large intestine. But she has still had a significant bloating and a significant constipation. And once we addressed her motility, once we addressed her digestive abnormalities, and once we also addressed her beneficial bacteria, the bloating actually started to go away. So I want you to what I want you to take away here is that her plan looked so different than she thought she thought she was going to work with us get another plan for, you know, targeting her SIBO. And, you know, then going on her merry way. And that is not at all what we did, we had to make so many adjustments to the rest of her digestive system that eventually we didn’t even need to because her hormones started to improve, her hair started to improve, her energy started to improve her boat started to go away, she was having regular daily bowel movements. And after six months, she felt amazing. And so many so many lightbulb moments on the way I was so proud of her, and how she really just really took the reigns of embracing a different approach, I think she was really ready for something different than she had done previously. While also slightly scared, of course, and it was truly an honor to be a part of her journey. She reaches out often on Instagram saying how great she still feels and just, you know, living her life and all the things and it’s just, it’s I’m so passionate about talking about this topic. Because I think sometimes the thought is I’m still bloated, or I’m still having symptoms, I still have SIBO. And while that could be true, it could also not be true. You could have bloating and other symptoms, because of all the other issues that just haven’t been addressed. SIBO is just a piece of the puzzle, which it was for Emma. So I hope that encourages you. And regardless, even if she we believe she still had SIBO or that was you know, there were signs pointing to that, then we could have we could have addressed it and it would have been no problem. But the path was actually simpler for her than she thought, which is great. So just to kind of conclude this and recap it if you really want to identify the sources and you want to find full relief from your SIBO and digestive issues. It’s a three step process. First identify, identify all the things that are contributing. Number two is obviously treat it address it. So with a personalized treatment plan, come up with nutrition, lifestyle, supplements, etc, that you’re going to use. And then number three is resolution. So restore gut function, restore that mucosal barrier, support your gut immune system so that you can have long term relief.

I hope this episode was helpful. I had a lot of fun outlining this episode and it’s really fun for me to share with you a little bit about the method behind our madness and how it works and why our clients are so successful and give you just some tools so that you personally can address your digestive issues. So thanks for joining me on today’s episode.

If you are looking for support, we have two ways that you can work with our team. Number one is in the membership you will learn about all of this you will learn about how to identify your root causes, how to address them, and also how to restore balance to your gut. So that is One way and the second way is in our VIP program. So if you want some of the testing and the more high touch support, you can for sure apply for the VIP program. Both of those links are in the show notes and we will be so excited to work with you. So thanks for joining, and I’ll see you next time on the next episode. Keep loving your gut so it will love you back.

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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Hi, I’m Dr. Heather

Registered dietitian and helps people struggling with bloating, constipation, and IBS find relief from their symptoms and feel excited about food again.

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