SIBO Die-off Symptoms Explained (Plus How to Minimize Them)

You’re working hard to improve your SIBO symptoms by changing your diet and starting your SIBO treatment then… BAM – you’re suddenly feeling worse. What the heck? Are you experiencing SIBO die-off symptoms? Here’s what you need to know.

What is SIBO?

Let’s start at the beginning: what is SIBO?

SIBO stands for Small Intestinal Bacterial Overgrowth. In general, we want to have a diverse and happy colony of bacteria, fungi, yeast and microorganisms in our body, just like a happy zoo has many different animals to visit. But, the critters need to be in the right place.

We feel (and our digestive system functions) best when these microorganisms are mostly in the colon, supporting the work of digesting our food, feeding the cells lining our intestines and making nutrients, such as vitamin K. This gaggle of microorganisms is also known as the microbiome.

If things are out of balance; we can start to develop digestive issues.  If we have an overgrowth of certain kinds of microorganisms or they go rogue and set up shop in the small intestine, they can cause more harm and a wide range of symptoms – UGH.

You can read our comprehensive overview of SIBO here.

SIBO treatment options

If you’ve gotten a diagnosis of SIBO or suspect that SIBO is the cause of your symptoms, you may be ready for treatment.

You might first be thinking about or have started one of the SIBO diets, which reduce fermentable carbohydrates.  A SIBO diet can pull up the proverbial welcome mat – no tasty snacks for you – for organisms that are hanging out where they are not welcome. Reducing their preferred foods means that they’re thriving less. They also get grumpy. Hangry? Let’s say hangry.

While most clients feel much better reducing the amount of fermentable carbohydrates in their diet, which the SIBO bugs like to eat, some can experience SIBO die-off symptoms.  But this may be less severe than the symptoms experienced when using an antimicrobial SIBO treatment.

Antibiotics and herbal treatments are used to target the overgrowth living in your small intestine. They do their work to kill the organism, but as they’re dying, you might experience SIBO die-off symptoms.

Psst: you can read more about the SIBO Diet right here.

What is SIBO Die-Off?

As the rogue organisms are killed, they don’t go quietly into the night. They’re releasing toxins to fight back.  This is also known as a Herxheimer reaction (or Herx for short). 

Not surprisingly, having any toxins released into your body doesn’t feel great; these toxins are the cause of your SIBO die-off symptoms.

Our clients can’t wait to treat their SIBO and expect to feel so much better once they start treatment.  Unfortunately, it’s not always a smooth ride.  Buckle up and prepare for turbulence. 

What are the symptoms of SIBO die-off?

Having the toxins released in your body is the cause of your SIBO die-off symptoms. You’re just not going to feel great while the microorganisms are fighting to stay alive in your gut.

SIBO die-off is short-lived, and symptoms vary by person, but you may experience:

  • Anxiety
  • Bloating (very common)
  • Fatigue
  • Nausea
  • Diarrhea
  • Difficulty focusing
  • Flu-like symptoms
  • Muscle and joint pain

How long does SIBO die-off last?

This can vary by person, but we find that the more you’re able to improve digestive function prior to having a SIBO treatment, you can reduce the likelihood or severity of die-off symptoms.  The next section explains more about preventing SIBO die-off symptoms before they begin.

In our experience, our clients may experience SIBO die-off for 2 – 4 days.  Think of it as the storm before the calm. 

Ready for SIBO Relief?

How can you prevent SIBO die-off symptoms?

After reading the list of possible SIBO die-off symptoms, you’re probably hoping to experience none of them. We agree: prevention is best!

This is how working with a knowledgeable functional nutritionist can set you up for success to minimize the complications as you treat SIBO (as well as help to prevent SIBO recurrence, which is common).

Pooping is a must

One of the main purposes of having bowel movements is to eliminate toxins. If you’re constipated or have slowed transit time, there is an opportunity for toxins to linger, ACK!

When we’re working with clients to mitigate SIBO, we like to focus on reducing constipation first, before discussing any antimicrobial treatment. By having regular bowel movements, we reduce the amount of time that the toxins are able to linger and cause symptoms.

Hydration is key

Being well hydrated helps to provide your body with the fluids it needs to flush out the toxins, supporting your body’s natural ability to detoxify the toxins that cause the SIBO die-off symptoms.

Being well hydrated also helps to prevent constipation. You’ll also feel less anxious and able to better focus if you’re well hydrated.

Herbal teas may offer additional benefits, beyond hydration, such as reducing bloating or belly pain. We love chamomile tea before bed!

Extra sleep

Did you know that poor sleep can cause digestive problems? You can click on the link for the full scoop.

Sleep is our body’s time to rest and repair. Our digestive system always benefits from being well-rested, but it is even more important while treating a SIBO overgrowth.

Getting enough sleep also supports the best functioning of your immune system.

Key takeaways

All that being said, if your symptoms are severe, reach out to your physician.  You may be having a reaction to the antimicrobial treatment.

SIBO die-off can be uncomfortable, but with the right preparation and partnership with your clinical nutritionist, the SIBO die-off symptoms can be minimized.

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