Bloating. Cramping. Gas. Burping. Irregular bowel movements. If you’re dealing with persistent digestive discomfort, chances are you’ve come across terms like IBS and SIBO in your quest for relief.
But what exactly are they — and how do you know which one you’re experiencing?
At Natural Medicine of Denver, we believe that healing begins with understanding. These two conditions often share similar symptoms, but the underlying causes (and treatment approaches) can be quite different. Let’s break down the key differences between SIBO and IBS, why they’re often confused, and how naturopathic medicine can help you get to the root of the issue—naturally.
What Is IBS?
Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder, meaning it affects how your digestive system works, but doesn’t cause visible structural damage.
Common symptoms of IBS include:
- Abdominal pain or cramping
- Bloating and gas
- Diarrhea, constipation, or alternating between the two
- A sense of incomplete bowel movements
- Mucus in the stool
There are three main types of IBS:
- IBS-D: Diarrhea dominant
- IBS-C: Constipation dominant
- IBS-M: Mixed (alternating diarrhea and constipation)
While the exact cause of IBS is still debated, contributing factors may include:
- Gut-brain axis dysfunction
- Imbalanced gut microbiome
- Food intolerances or sensitivities
- Chronic stress
- Previous infections (such as food poisoning)
Many patients are told that they have IBS without any further workup. Technically, IBS is considered a diagnosis of exclusion, meaning it’s diagnosed when other conditions (like Crohn’s disease or celiac disease) are ruled out. Unfortunately, many of our patients never receive this workup. This is where a comprehensive assessment comes into play. And while conventional medicine often focuses on symptom management (although many of my patients have been told to deal with the symptoms & that there’s nothing they can do), naturopathic medicine asks why those symptoms exist in the first place. Naturopathic doctors also dive deeper into some of these other potential causes using functional medicine testing.
What Is SIBO?
Small Intestinal Bacterial Overgrowth (SIBO) occurs when too many bacteria are present in the small intestine, where bacterial levels are normally quite low.
These misplaced bacteria ferment carbohydrates in the food you eat, leading to excess gas production and many of the same symptoms as IBS, including:
- Bloating (often worse after meals)
- Gas and belching
- Abdominal pain
- Diarrhea, constipation, or both
- Nutrient deficiencies (like B12 or iron)
- Fatigue and brain fog
So, what causes SIBO in the first place?
- Poor gut motility (slow transit time)
- Food poisoning or gastrointestinal infections
- Scar tissue or structural changes from surgeries
- Chronic use of antacids or antibiotics
- Underlying conditions like hypothyroidism or diabetes
SIBO can be diagnosed through a breath test, which measures levels of hydrogen, sulfur, and methane gas produced by bacterial fermentation in the small intestine.
SIBO vs. IBS: What’s the Connection?
Here’s where it gets interesting:
Studies suggest that up to 70% of people with IBS actually have SIBO.
That’s right — many cases of IBS may be misdiagnosed or underdiagnosed SIBO. The difference is that while IBS is a general label for a set of symptoms, SIBO is a measurable, treatable condition with a known cause: bacterial overgrowth in the wrong place.
This overlap is one reason so many people struggle for years without finding lasting relief. They treat symptoms without addressing the bacterial imbalance underneath.
At Natural Medicine of Denver, we dig deeper to identify what’s driving your digestive symptoms — whether that’s SIBO, IBS, or both.
How Naturopathic Medicine Approaches SIBO and IBS
Whether you’re navigating IBS, SIBO, or both, the goal is the same: restore digestive balance by identifying and treating the root cause. Here’s how we do it.
Step 1: Testing & Diagnosis
We start with a comprehensive intake and diagnostic testing. For suspected SIBO, we may recommend:
- Lactulose breath test to measure gas levels and bacterial fermentation
- Comprehensive stool analysis to assess gut flora, pathogens, and inflammation
- Hormone or thyroid panels, since imbalances can slow gut motility and influence the GI microbiome
- Food sensitivity testing to identify hidden triggers
This thorough approach ensures that your treatment is tailored to your specific needs — not just based on symptoms alone.
Step 2: Remove the Imbalance
If SIBO is confirmed, treatment begins with clearing the overgrowth. Depending on your individual case, we may use:
- Botanical antimicrobials like oregano oil, berberine, and neem
- Targeted dietary changes, such as a low FODMAP or SIBO-specific diet
- Digestive support, like herbal carminatives, bitters, or enzyme supplements
- Stress reduction, since the nervous system plays a major role in gut motility
This “remove” phase is gentle but effective, and far less disruptive to the microbiome than repeated rounds of antibiotics.
Step 3: Repair & Restore
Once the overgrowth is cleared, we shift focus to healing the gut lining and restoring a healthy microbiome.
This may include:
- Probiotics (at the right time) to support long-term microbial balance
- Prebiotic-rich foods, introduced gradually to nourish good bacteria
- L-glutamine, zinc carnosine, and aloe vera to support intestinal healing
- Nervous system regulation, such as craniosacral therapy or visceral manipulation, to restore the brain-gut connection
We also address underlying causes like thyroid dysfunction, chronic stress, or nutrient deficiencies, so you’re less likely to relapse.
Step 4: Empower Through Prevention
Education is a key part of our naturopathic philosophy. We help you understand:
- Which foods support gut health, and which may trigger flares
- How to support digestion naturally with mealtime rituals, proper chewing, and mindful eating
- The importance of hydration, movement, and sleep in supporting regularity and motility
- How vagal nerve stimulation and stress resilience, including breathwork, can promote the “rest and digest” mode
By taking a whole-person approach, we don’t just help you feel better — we equip you with tools to stay well for the long haul.
You Don’t Have to Live with Digestive Discomfort
If you’ve been told you “just have IBS” and left your appointment feeling directionless — or you suspect something deeper is going on — you deserve answers. And options.
At Natural Medicine of Denver, we work with you to uncover what’s really going on beneath the surface and develop a natural, personalized treatment plan to restore your gut health from the inside out.
Schedule a free consultation today, and let’s take the first step toward healing your digestion!
